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Superior lingular vein of left lung

The superior lingular vein of the left lung is a segmental pulmonary vein that drains the superior lingular segment (S4) of the left upper lobe. It courses medially within the lingula, running alongside the lingular bronchus and pulmonary artery branches, and converges with the inferior lingular vein (V5) to form the lingular vein. The lingular vein then empties into the left superior pulmonary vein (LSPV), which drains into the left atrium.

Anatomically, the lingular veins of the left lung mirror the middle lobe venous drainage on the right side. Variations are common: the superior lingular vein may drain independently into the LSPV, or share a common trunk with the anterior vein. Precise mapping is important in atrial fibrillation ablation, pulmonary resections, and transplant surgery.

Synonyms

  • Left superior lingular segment vein (V4)

  • Lingular vein of left lung (superior branch)

  • Tributary of left superior pulmonary vein

Function

  • Drains oxygenated blood from the superior lingular segment (S4)

  • Joins with inferior lingular vein to form the lingular vein → LSPV → left atrium

  • Key anatomical landmark in pulmonary venous mapping and segmentectomy planning

Tributaries

  • Intrapulmonary venules of the superior lingular segment (S4)

MRI Appearance

T1-weighted images:

  • Appears as a signal void (black lumen) adjacent to the lingular bronchovascular bundle

  • Differentiated from arteries by orientation and contrast timing

T2-weighted images:

  • Seen as a linear signal void; intraluminal thrombus would appear as abnormal intermediate or high signal

STIR:

  • Fat suppression enhances visualization within hilar and mediastinal fat planes

  • Highlights surrounding pathology such as edema or infiltration

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Enhances brightly and homogeneously with venous filling

  • Clearly demonstrates confluence with inferior lingular vein and drainage into LSPV

  • Detects stenosis, anomalous drainage, or thrombus

MRI Non-Contrast Cardiac-Gated 3D Imaging:

  • Provides 3D view of superior lingular venous drainage pattern

  • Useful in AF ablation mapping and lingular resections when contrast is contraindicated

CT Appearance

CT Post-Contrast (CT Pulmonary Venography / CCTA):

  • Contrast opacifies the superior lingular vein and its junction with the inferior lingular vein

  • Multiplanar and 3D reconstructions define segmental drainage and venous variants

  • Essential for pulmonary vein isolation planning, surgical segmentectomy, and post-ablation stenosis assessment

MRI image

Superior lingular vein of left lung CT axial image -img-00000-00000