Upper lobe pulmonary venous diversion
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Upper lobe pulmonary venous diversion (also described as cephalisation of the pulmonary veins) reflects elevation of left atrial pressure and is an early sign of pulmonary edema.
The normal left atrial pressure is 5-10 mmHg. An elevation of left atrial pressure to 10-15 mmHg will result in upper lobe venous diversion. Typically, the cause for that increase in left atrial pressure is left heart failure (most commonly), or mitral valve disease 1.
On frontal chest radiograph, it is seen as dilation of the upper lobe pulmonary veins as they branch superiorly from the hilum. This can be measured objectively, with cephalisation present if the upper lobe veins are of the same or higher diameter than the lower lobe veins, measured equidistant from the hilar point 2.
- 1. Goodman LR, Felson B. Felson's Principles of Chest Roentgenology. W.B. Saunders Company. (2007) ISBN:1416029230. Read it at Google Books - Find it at Amazon
- 2. Barile M. Pulmonary Edema: A Pictorial Review of Imaging Manifestations and Current Understanding of Mechanisms of Disease. (2020) European journal of radiology open. 7: 100274. doi:10.1016/j.ejro.2020.100274 - Pubmed
- 3. Daga BVM, Shah VSM, Daga SV. Radiodiagnosis, Nuclear Medicine, Radiotherapy and Radiation Oncology. Jaypee Brothers Medical Pub. ISBN:9350257122. Read it at Google Books - Find it at Amazon
- 4. Lacey GD, Morley S, Berman L. The Chest X-Ray, A Survival Guide. Saunders. (2008) ISBN:0702030465. Read it at Google Books - Find it at Amazon