The Value of the Lateral Chest Roentgenogram in the Diagnosis of Pulmonary Venous Hypertension

Dilatation of upper lobe veins is a reliable roentgen sign of pulmonary venous hypertension (1, 3–9). Largely dilated upper lobe veins are easy to detect on routine chest roentgenograms. Minimal dilatation, however, is difficult to identify on the postero-anterior or anteroposterior projection because of overlying arterial branches. Due to anatomical distribution, the anterior vein of the right upper lobe is easily identifiable on the left lateral projection, especially when pulmonary venous hypertension is present. The recognition of dilated upper lobe veins on the lateral view leads to early radiological diagnosis of abnormal pulmonary venous pressure. Lack of knowledge of the roentgen anatomy of upper lobe vessels will limit radiological diagnostic ability. The roentgen anatomy of upper lobe vessels is not well described in the literature. To the author's knowledge, the anatomical relationship between upper lobe veins and arteries and their distribution, especially on lateral chest roentgenograms, has ...