SCINTIGRAPHY, ANGIOGRAPHY AND COMPUTED-TOMOGRAPHY IN UNILATERAL HYPERLUCENT LUNG DUE TO OBLITERATIVE BRONCHIOLITIS

This study examines the value of different imaging methods in assessin g the anatomic structures of unilateral hyperlucent lung due to oblite rative bronchiolitis. We studied 9 patients, 5 males and 4 females, su ffering from UHL (mean age 49 years). Ventilation-perfusion scan (VPS) and computed tomography (CT) of the chest were performed in all, and conventional angiography or digital substraction angiography (DSA) in 7 patients. The VPS showed the characteristic pattern of a matched ven tilation-perfusion defect and considerable air trapping during the was hout phase. Conventional angiography and DSA displayed a smaller pulmo nary artery on the affected side, with a poor peripheral vasculature. CT displayed a loss of lung volume in all cases, with diminished mean attenuation values, a markedly diminished vasculature and integrity of the main airways. In constrast to other imaging modalities, CT imaged bronchiectasis, which was the cause of the patients' clinical symptom s of bronchorrhea and hemoptysis. We conclude that CT of the chest is the most valuable imaging method for evaluating unilateral hyperlucent lung, particularly in symptomatic patients.