Morphoanatomical radiological analysis of pulmonary venous drainage patterns and left atrial morphology based on CT angiography.

Abstract

Purpose: This study aimed to characterize the pulmonary venous (PV) drainage patterns and left atrial (LA) morphologies, and to perform a detailed morphoanatomic analysis based on computed tomography angiography (CTA) data.

Methods: Pulmonary CTA images of 204 adults (123 males, 81 females) were retrospectively analyzed. PV drainage patterns and LA morphological types were determined. In LAs with classical configuration, ostial diameters, interostial distances, transverse and vertical LA diameters, and angles between ostia and the y-axis as well as between the ostia themselves were measured. Measurements were compared by sex and side (right-left).

Results: The mean age was 54.16 ± 15.8 years (60.3% male,39.7% female). The most common drainage type was the two-ostium pattern bilaterally (right R2:78.3%; left L2:81.3%). On the right, subtype R2a was most frequent, whereas R3e and R4 were rare. On the left, L2a predominated, while L2c-L2d and L3 were uncommon. Non-classical drainage patterns were seen in 21.7% of right and 18.7% of left. The oval-type LA was the most prevalent morphology (76% overall). The two-ostium pattern was the most frequent drainage pattern on both the right and left sides in both oval and rectangular LA types. Morphometrically, the superior ostial diameter and its angle to the y-axis were greater on the left, whereas the distance and angle between superior and inferior ostia, and the intervenous saddle length, were greater on the right (p < 0.05).

Conclusion: This study may improve the safety and accuracy of interventional procedures involving the LA by providing comprehensive morphoanatomical information on PV drainage patterns and LA morphology.