Y. Saida et al., BRONCHOARTERIAL INVERSION - RADIOGRAPHIC-CT CORRELATION IN COMBINED RIGHT MIDDLE AND LOWER LOBE COLLAPSE, Journal of thoracic imaging, 12(1), 1997, pp. 59-63
Pulmonary arteries of the right middle (RML) and right lower (RLL) lob
es lie toward the lung periphery relative to their corresponding bronc
hi, i.e., along their lateral or posterior aspects. In contrast, those
of the right upper lobe (RUL) tend to be located along the medial or
anterior aspect of the bronchi. We postulate that a reversal of the no
rmal bronchoarterial relationship at the lung base may indicate combin
ed RML and RLL collapse. We evaluated bronchoarterial relation by comp
uted tomography (CT) and posteroanterior (PA) chest radiographs in pat
ients with combined RML and RLL collapse. On PA chest radiographs, an
inverse bronchoarterial relationship could be recognized in the lower
perihilar region in seven of 10 patients. In the 10 patients with comp
lete collapse of both the RML and RLL, CT disclosed that the normal br
onchoarterial relationship of the RUL was preserved, despite caudal ex
tension of the RUL. In no case were arteries visible along the lateral
aspect of bronchi. Thus, on frontal radiographs, when the bronchoarte
rial relationship in the right lower lung is inverse to that of normal
subjects, combined collapse is strongly suggested.