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ATELECTASIS

ATELECTASIS. Types of atelectasis. Obstructive Intrinsic: tumors, mucus plugs, foreign bodies Extrinsic: lymph node enlargement, mediastinal masses Passive Space-occupying lesion within pleural space i.e. PTX, HTX, pleural effusion, pleural tumor Adhesive

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ATELECTASIS

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  1. ATELECTASIS

  2. Types of atelectasis • Obstructive • Intrinsic: tumors, mucus plugs, foreign bodies • Extrinsic: lymph node enlargement, mediastinal masses • Passive • Space-occupying lesion within pleural space i.e. PTX, HTX, pleural effusion, pleural tumor • Adhesive • Inactive or insufficient surfactant i.e. ARDS • Cicatrization • Fibrosis or scarring i.e. chronic TB, fungal infections, post-radiation

  3. Diagnosis • Chest x-ray [and history and physical examination]

  4. Normal Lung Lobes Images obtained from http://rad.usuhs.edu/medpix/radpix.html

  5. Signs of atelectasis • Increase in lung density • Displacement of interlobar fissures • Mediastinal shift • Displacement of hilum • Elevation of diaphragm • Compensatory overinflation • Approximation of ribs

  6. Complete atelectasis • Increase in lung density • Displacement of interlobar fissures • Shift of trachea / mediastinum ** • Displacement of hilum • Elevation of diaphragm • Compensatory overinflation • Approximation of ribs Image obtained from: http://priory.com/cmol/stent1.jpg

  7. RUL atelectasis ribs approximated elevated horizontal fissure Golden S sign trachea slightly deviated Images obtained from Basic Radiology (Chen MYM, Pope TL, Ott DJ) via http://www.accessmedicine.com

  8. RML atelectasis narrow triangular opacity superimposed on heart right heart border obscured Images obtained from Basic Radiology (Chen MYM, Pope TL, Ott DJ) via http://www.accessmedicine.com

  9. RLL atelectasis increased density over lower vertebra oblique fissure displaced downward silhouette sign Images obtained from http://eradiology.bidmc.harvard.edu/Classics/list.aspx

  10. LUL atelectasis ‘veil-like’ increased density over entire left lung anterior displacement of major fissure Luftsichel sign Juxtaphrenic peak sign Images obtained from Basic Radiology (Chen MYM, Pope TL, Ott DJ) via http://www.accessmedicine.com

  11. LLL atelectasis flat waist sign silhouette sign major fissure displaced posteriorly triangular opacity behind heart Increased density over lower vertebra Images obtained from http://eradiology.bidmc.harvard.edu/Classics/list.aspx

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