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Congenital anomalies of the thoracic veins are infrequent but important developmental disorders. Anomalies of the systemic thoracic veins usually are asymptomatic but may be associated with other more serious cardiovascular abnormalities and complicate their management. We present a case of a vertical vein consisting in an abnormal venous drainage from the left upper pulmonary lobe to the superior vena cava, resulting in a non cyanotic shunt.

Computed tomography, and particularly high-resolution computed tomography, allows a detailed exploration of the pulmonary parenchyma. We discuss here work on the use of this technique in the diagnosis and quantification of pulmonary emphysema. We stress first the subjective quantification then the objective approach based on specific software. We summarize our work which has demonstrated. 1) that the relative surface with density below -950 Hounsfield units and measured on millimetric tomographic slices obtained at the end of maximal inspiration is a valuable measurement of the extent of the macroscopic emphysema and reflects the microscopic emphysema; 2) that subjective quantification overestimates minimally extensive emphysema and shows important intra- and inter-operator variability; 3) that indexes derived from computed tomographic images acquired at the end of expiration reflect more the obstructive syndrome than emphysematous destruction; 4) that age and the size of the lungs influence computed tomographic measurements while hyperinflation appears to have no effect. Finally, we present an example of recent work applying the computed tomographic technique.