An Unusual Case of Systemic Arterial Supply to the Lung with Bronchial Atresia
Prachi P. Agarwal1,
Fred R. Matzinger1,
Jean M. Seely1,
Pasteur Rasuli1 and
Farid M. Shamji2
1 Department of Diagnostic Imaging, The Ottawa Hospital, Civic Campus, 1053
Carling Ave, Ottawa, ON, Canada K1Y 4E9.
2 Division of Thoracic Surgery, The Ottawa Hospital, Civic Campus, Ottawa, ON,
Canada K1Y 4E9.
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Fig. 1A —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Chest radiograph reveals an abnormal tubular opacity
with hyperlucency of left lower lobe.
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Fig. 1B —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Pulmonary angiogram shows decreased pulmonary arterial
supply to left lower lobe.
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Fig. 1C —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Aortogram reveals aberrant systemic artery arising
from lower thoracic aorta and supplying left lower lobe. Venous drainage is
seen into inferior pulmonary vein.
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Fig. 1D —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Contrast-enhanced CT scan (axial image) shows vascular
enhancement of anomalous systemic artery arising from aorta.
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Fig. 1E —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Maximum intensity projection image shows close
relationship between aberrant systemic artery (black arrow), inferior
pulmonary vein (thin white arrow), and bronchocele (curved
arrow). Left pulmonary artery and its branches (thick white
arrow) are also shown.
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Fig. 1F —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Axial CT scan through lower lobe shows aberrant
systemic artery (thick arrow) along with fluid-density tubular
branching structure-bronchocele (thin arrow).
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Fig. 1G —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Axial CT scan (lung window) shows bronchocele in left
lower lobe with fairly well-demarcated hypoattenuating lung parenchyma.
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Fig. 1H —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. 3D volume rendering of airways and lung parenchyma
(upper threshold, -400 H; lower threshold, -800 H) shows overinflated left
lower lobe with dilated bronchus (arrow).
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Fig. 1I —31-year-old man with systemic arterial supply to lung and
with bronchial atresia. Ventilation-perfusion scan shows small matched defect
in left lower lobe posteriorly.
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Copyright © 2005 by the American Roentgen Ray Society.
