EURORAD ESR

Case 2464

Lobar collapse, plain radiographic features

Author(s)
Poels JAD
 
 
  • Published 07.12.2005
  • DOI 10.1594/EURORAD/CASE.2464
  • Section Chest Imaging
  • Case Type Clinical Cases
  • Difficulty Resident
  • Views 5049
  • Language(s)
  • Figure 1
    The right upper lobe collapse

    The collapsed lobe is to the right of the superior mediastinum (indicated by an open arrow). The right hilum has been pulled up to the level of the left hilum. There is a broad tent-shaped juxtaphrenic peak projecting...

     
    Area of Interest: unknown; Imaging Technique: Right upper lobe collapse;
     
     
  • Figure 2
    The right middle lobe collapse

    The right heart border is obscured, demonstrating the Silhouette Sign (indicated by a black arrow). The horizontal fissure is demonstrated by the double white arrow.

     
    Area of Interest: unknown; Imaging Technique: Right middle lobe collapse;
     
     
  • Figure 3
    The right middle and lower lobe collapse
     

    The right hilar shadow is small. There is a reversal of the normal relationship between the right lower lobe artery (indicated by a black arrow) and bronchus (indicated by a white arrow), and the right heart border is...

     
    Area of Interest: unknown; Imaging Technique: Right middle and lower lobe collapse;

    An image of the same patient as shown in Fig. 3a taken 6 weeks after for comparison. The collapsed lobes have now reexpanded. The bronchovascular relationship between the right hilum and the right lower lobe has now...

     
    Area of Interest: unknown; Imaging Technique: Right middle and lower lobe collapse;
     
     
  • Figure 4
    Left upper lobe collapse
     

    The superior segment of the left lower lobe has expanded between the superior mediastinum and the collapsed left upper lobe producing the Luftsichel Sign (indicated by three white arrows). The vessels within the...

     
    Area of Interest: unknown; Imaging Technique: Left upper lobe collapse;

    An intravenous contrast enhanced axial CT, in soft tissue window, taken at the level of the manubrium.The expanded superior segment of the left lower lobe is seen projecting anteriorly to the left of the trachea...

     
    Area of Interest: unknown; Imaging Technique: Left upper lobe collapse;
     
     
  • Figure 5
    The left lower lobe collapse
     

    The left hilum has been drawn down, and a sail-shaped triangular opacification is seen projecting behind the heart, which represents the collapsed lower lobe (indicated by arrowheads).

     
    Area of Interest: unknown; Imaging Technique: Left lower lobe collapse;

    Four weeks later, the left lower lobe collapse has now nearly resolved. The lingula is collapsed, adjacent to the left heart border. The oblique fissure with the collapsed lingula anterior to it is indicated by the...

     
    Area of Interest: unknown; Imaging Technique: Left lower lobe collapse;
     
     
The collapsed lobe is to the right of the superior mediastinum (indicated by an open arrow). The right hilum has been pulled up to the level of the left hilum. There is a broad tent-shaped juxtaphrenic peak projecting up from the medial part of the right hemidiaphragm (indicated by an oblique arrow).
 
The right heart border is obscured, demonstrating the Silhouette Sign (indicated by a black arrow). The horizontal fissure is demonstrated by the double white arrow.
 
The right hilar shadow is small. There is a reversal of the normal relationship between the right lower lobe artery (indicated by a black arrow) and bronchus (indicated by a white arrow), and the right heart border is obscured suggesting the combined middle and lower lobe collapse. The depressed horizontal fissure is demonstrated by an open arrowhead.
 
An image of the same patient as shown in Fig. 3a taken 6 weeks after for comparison. The collapsed lobes have now reexpanded. The bronchovascular relationship between the right hilum and the right lower lobe has now returned to normal, the artery (indicated by a white arrow) being located lateral to the bronchus (indicated by a black arrow).
 
The superior segment of the left lower lobe has expanded between the superior mediastinum and the collapsed left upper lobe producing the Luftsichel Sign (indicated by three white arrows). The vessels within the expanded lower lobe superior segment exhibit a characteristic divergent pattern, radiating up from the hilum (indicated by an open arrow). The left hemidiaphragm is raised, with small, sharp Juxtaphrenic Peaks (indicated by arrowheads).
 
An intravenous contrast enhanced axial CT, in soft tissue window, taken at the level of the manubrium.The expanded superior segment of the left lower lobe is seen projecting anteriorly to the left of the trachea (indicated by an asterisk). The interface perpendicular to the PA X-ray beam (indicated by an open arrow), is responsible for the Luftsichel Sign on the posteroanterior radiograph, as depicted in Fig. 4a. The collapsed lobe is seen anteriorly.
 
The left hilum has been drawn down, and a sail-shaped triangular opacification is seen projecting behind the heart, which represents the collapsed lower lobe (indicated by arrowheads).
 
Four weeks later, the left lower lobe collapse has now nearly resolved. The lingula is collapsed, adjacent to the left heart border. The oblique fissure with the collapsed lingula anterior to it is indicated by the arrows. Lingula atelectasis often occurs when the left lower lobe collapses, and this association when seen on a frontal radiograph is the Nordenstrom sign.
 
 
 
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