Fig. 4

Anomalous drainage into the azygos vein. Images a and b are from an adolescent patient with anomalous pulmonary venous drainage into the azygos vein. Images c and d are from a paediatric patient with anomalous pulmonary venous drainage identified on echocardiography. a Sagittal maximum intensity projection (MIP) CT image showing the right superior pulmonary vein (white arrow) draining into a dilated azygos vein (labelled AZ). b Three-dimensional (3D) CT reconstruction of patient in (a), posterior view. The black arrow indicates the right superior pulmonary vein draining into the azygos vein. c 3D CT reconstruction. Most of the right sided pulmonary veins are seen draining into a dilated azygos vein (labelled AZ). d Axial CT image of the patient described in (c). Only a very small right middle pulmonary vein is seen draining normally into the left atrium (white arrow). Note the dilated right atrium and right ventricle consistent with a significant left-to-right shunt