369507

5:33 p.m.

8:08 p.m.

Atelactasis

Deminished lung volume affecting all or part of the lung. Which may or may not include loss of normal lucency in the affected part of the lung. We will review:

Mechanism of atelectasisthe types of atelectasis

Sings and Radiological manifestation

mechanism

Can be divided into 6 timesresorptiveAdhesiveCompressivePassiveCicatrizationGravity dependent.

Resorptive atelectasis the most common type

Adhesive atelectasis

Compressive atelectasis

Passive atelectasis

Cicatrization

Gravity dependent atelectasis

Radiographic signs of atelectasis

Crowding of the vesselsDisplacement of the fissures Crowded air bronchogramsAbnormal pulmonary opacificationObscured heart or diaphragm bordersDiaphragm elevationDisplacement of mediastinal structuresHilar displacementCompensatory hyperexpansion of

surrounded lungApproximation of ribs

Lobar atelectasis

Right upper lobe collapseElevation parallel of the minor fissure

opacification of the upper lungCompensatory hyperexpansion of the

middle and right lower lobes leads to forwardward and upward displacement

of the right lower lobe pulmonary artery2 radiologic signs are associated with

the right upper lobe atelectasis. The golden S sign. The juxtaphrenic peak

sign due to traction of the inferior pulmonary ligaments.

Right middle lobe collapseLoss of silhouette of the right heart

border. Best appreciated on lateral view as a

well-defined linear or wedge shaped opacity

Approximation of the minor and major fissures

Sometimes can be mistaken by thinkened fissure .

combination right middle and lower lobe atelectasis

Almost always caused by obstruction of the bronchus intermedius .

Elevation of right hemidiaphragm

depression of the minor fissure and increased opacification in the right

lower lung that extend to the lateral costophrenic angle.

Lower lobes atelectasisMinor fissure being displaced inferiorly.The atelectatic lobe lies posterio-medially in

the lower thoracic cavity which result in triangular opacity on the diaphragm and

mediastinum.On lateral radiograph, lower lobe atelectasis

results in loss of the outline of the posterior half of the hemidiaphragm shadow. Also,

with lower lobe atelectasis, the lower vertebrae appear more opaque than the vertebrae higher up: this is called to the

spine sign.

Left lower lobe

The flat waist sign describe the flattening of the left heart border as

a result of downward shift of the hilar structures and a resultant cardiac

rotation .

Right lower lobe atelectasis

Right lower lobe atelactasis is the mirror-image of the left lower lobe

atelactasis

The collapsed lower lobe appears a retrocardiac opacity .

Left upper lobeFrontal radiograph seen as opacification

extending out from the left hilum due to the lung apex

Lobes of left cardiomediastinal silhouette silhouette, elevation of the left hemidiaphragm, and shift of the mediastinal structure to the left.

Subinsular segment of the lower lobe were hyperexpanded to take place of the posterior

segment of the upper lobe. Crescentic lucency be present the hyperexpanded superior

segment of the left lower lobe invaginating between the aortic arch and the collapsed left

upper lobe this is called Luftchel sign (air – sickle in German).

Non lobar collapse

Round atelactasis:Chronic atelactasis associated with

pleural disease .

Discoid atelactasis (platelike or linear) :

Peripheral pulmonary volume loss secondary to bronchial obstruction.

Seen as linear band like opacities.