Sheehan vessels refer to vessels that arise from neovascularity that develops due to pulmonary hypertension, particularly, but not exclusively, in the context of Eisenmenger syndrome.
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Pathology
The exact pathogenesis of Sheehan vessels has not been fully elucidated, but it is felt that neovascularization develops secondary to chronic hypoperfusion secondary to obstructive disease of small pulmonary arteries in patients with pulmonary hypertension 1-3.
Although this phenomenon can occur in any cause of pulmonary hypertension and is associated with its severity 2, it is most commonly observed in patients with pulmonary hypertension due to Eisenmenger syndrome 1,2, particularly those with a post-tricuspid etiology 1.
Radiographic features
Sheehan vessels can have the following characteristics on CT chest 1-3:
consist of small, nodular, and serpiginous vessels, without a nidus, draining vein, or feeding artery
present towards the periphery of the lungs, sometimes with a 'beading' appearance against the pleura
are often adjacent to lobular ground-glass opacities
Other imaging features of pulmonary hypertension are often also present, such as dilated pulmonary arteries 2.
History and etymology
Sheehan vessels are named after Ramon Sheehan, an Australian/New Zealand radiologist, who initially described them in 2005 1.
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