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Superior vein of right lung

The right superior pulmonary vein (also called the superior vein of the right lung) is one of the four main pulmonary veins that return oxygenated blood from the lungs to the left atrium. It drains the upper and middle lobes of the right lung, carrying blood from lobar and segmental tributaries into the left atrium.

It runs horizontally across the right hilum, anterior and inferior to the right pulmonary artery, and passes posterior to the superior vena cava before entering the left atrium. In most individuals, it is a single vein, though variations exist (e.g., separate entry of the middle lobe vein).

Clinically, the right superior pulmonary vein is critically important in atrial fibrillation (AF), since ectopic electrical foci often originate near the pulmonary vein ostia. It is also a major focus during pulmonary vein isolation procedures and cardiac imaging.

Synonyms

  • Right superior pulmonary vein

  • Superior vein of right lung

  • Vena pulmonalis dextra superior

Function

  • Returns oxygenated blood from right upper and middle lobes to the left atrium

  • Contributes to systemic arterial circulation via the left heart

  • Serves as an electrophysiological landmark in atrial fibrillation ablation

  • Acts as a key structure in thoracic imaging and surgical planning

Tributaries

  • Right upper lobe vein (apical, anterior, posterior segmental branches)

  • Middle lobe vein (medial and lateral segmental branches, often joining before entry into left atrium)

MRI Appearance

T1-weighted images:

  • Lumen shows a signal void (black) due to venous flow

  • Surrounded by hyperintense mediastinal and perihilar fat for contrast

T2-weighted images:

  • Pulmonary vein lumen appears as a signal void

  • Perivascular edema or inflammatory changes may appear hyperintense

T2 TRUFISP (cardiac-gated):

  • Demonstrates the right superior pulmonary vein as a bright, well-defined structure draining into the left atrium

  • Allows cine-like evaluation of venous flow during cardiac cycle

  • Excellent for assessing anatomical variations and ostial size

STIR (Short Tau Inversion Recovery):

  • Suppresses fat, improving delineation of the vein at the hilum and near the left atrial ostium

  • Hyperintense signal suggests surrounding edema or inflammatory pathology

T1 Post-Contrast (Gadolinium-enhanced MRI):

  • Vein lumen enhances homogeneously

  • Critical for mapping pulmonary venous anatomy in atrial fibrillation ablation planning

MRI Non-Contrast 3D Cardiac-Gated Imaging:

  • Whole-heart 3D ECG-gated MRI visualizes the course, tributaries, and left atrial entry of the right superior pulmonary vein without contrast

  • Useful for patients with renal dysfunction or contraindications to gadolinium

  • Provides 3D reconstructions for pre-ablation planning

MRA (Magnetic Resonance Angiography):

  • Contrast-enhanced MRA provides high-resolution imaging of pulmonary venous ostia and branches

  • Essential in evaluation of pulmonary vein stenosis, anomalies, or post-ablation follow-up

CT Appearance

CT Coronary Angiography (CCTA):

  • Clearly demonstrates the origin, tributaries, and drainage of the right superior pulmonary vein into the left atrium

  • Differentiates right upper lobe vein from middle lobe tributary (anatomical variation common)

  • Multiplanar and 3D reconstructions provide accurate mapping for pulmonary vein isolation procedures and surgical planning

  • Detects pulmonary vein stenosis, thrombus, or anomalous drainage patterns

CT images

Superior vein of right lung anatomy CT axial image -img-00000-00000

CT images

Superior vein of right lung anatomy CT axial image -img-00000-00000_00001

MRI image

Superior vein of right lung mri image