ArticleLung2017
"Pulmonary Vein Sign" for Pulmonary Embolism Diagnosis in Computed Tomography Angiography.
Article in Lung, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- COVID-19 mimics on chest CT: a pictorial review and radiologic guide.The British journal of radiology · 2021Pooled it
- Chest compression synchronized ventilation during prolonged experimental cardiopulmonary resuscitation improves oxygenation but may cause pneumothoraces.Resuscitation plus · 2025Article
- Slow flow mimicking pulmonary embolism.BMJ case reports · 2023Article
- Measuring right ventricular lateral wall thickness on CTPA and inpatient mortality in patients with acute PE-promising but more evidence required.Emergency radiology · 2021Article
- Abnormal Pulmonary Venous Filling: An Adjunct Feature in the Computed Tomography Pulmonary Angiogram Assessment of Chronic Thromboembolic Pulmonary Hypertension.Journal of the American Heart Association · 2020Observational
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposesConsidering that pulmonary arterial obstruction decreases venous flow, we hypothesized that filling defects in pulmonary veins can be identified in areas adjacent to pulmonary embolism (PE). This sign was named the "pulmonary vein sign" (PVS), and we evaluated its prevalence and performance for PE diagnosis in computed tomography pulmonary angiography (CTPA).
methodsThis retrospective study enrolled consecutive patients with clinical suspicion of PE who underwent CTPA scan. The PVS was defined by the following criteria: (a) presence of a homogeneous filling defect of at least 2 cm in a pulmonary vein; (b) attenuation of the left atrium > 160 Hounsfield units. Using the cases that presented PE on CTPA as reference, sensitivity, specificity, and positive and negative predictive values were calculated for PVS.
resultsIn total, 119 patients (73 female; mean age, 62 years) were included in this study. PE was diagnosed in 44 (35.8%) patients. The PVS was present in 16 out of 44 patients with PE. Sensitivity was 36.36% (95% confidence interval (CI) 22.83-52.26%); specificity, 98.67% (95% CI 91.79-99.93%); positive predictive value, 94.12% (95% CI 69.24-99.69%); negative predictive value, 72.55% (95% CI 62.67-80.70%). The Kappa index for the PVS was good (0.801; 95% CI 0.645-0.957). PVS was correlated with lobar and segmental pulmonary embolism (p < 0.01).
conclusionDespite a low sensitivity, presence of the pulmonary vein sign was highly specific for PE, with a good agreement between readers. This sign could contribute for PE diagnosis on CTPA studies.
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