This series of images shows some subtle changes that reflect the local control of blood flow to a small segment of the right middle lobe. Note that in image a, there is a small area of increased lucency (blacker) in the right lung just lateral to the vessels of the right hilum. This region is highlighted in b. Note also that in b, the rapid diminution of the size of the blood vessel to that subsegment when compared to the size change of the vessels in the image in c. The lucent appearance of the lung suggests air trapping and the vasoconstriction reflects decreased perfusion – ie with decreased ventilation there is an associated consequent associated decrease in perfusion.
47170c01.800 bronchocentric inflammation lung bronchovascular bundle chest inflammation peribronchial halo air trapping mosaic perfusion ground glass changes alveolar change air bronchogram acute bronchovascular inflammation ddx allergic collagen vascular disease infection CTscan
Ashley Davidoff MD TheCommonVein.net
Music
Lyrics
“The Air That Can’t Get Out (Air Trapping)”
(Verse 1) I am the air that can’t get out, The silent, suffocating doubt. You breathe in deep, the lung expands, A simple, easy, soft command. But when you try to breathe out, I am the air that stays about.
(Chorus) Oh, I am Air Trapping! The small airway is snapping Shut! The bronchiole is tight, It steals the air and dims the light. The lung that’s dark when it should be white, I am the sign, the trapped-air plight.
(Verse 2) On the inspiratory scan, you see, A lung that looks as it should be. You’d swear the tissue’s normal, fine, There is no “tree-in-bud,” no line. The trap is set, the secret’s deep, A promise that I’m bound to keep.
(Chorus) Oh, I am Air Trapping! The small airway is snapping Shut! The bronchiole is tight, It steals the air and dims the light. The lung that’s dark when it should be white, I am the sign, the trapped-air plight.
(Bridge) But then, the vital, telling test: “Breathe out! Expire! Give it your best!” The healthy lung turns white and dense, My prison shows, in stark defense. I am the dark, lucent patch, A “mosaic” pattern, lock and latch.
(Outro) I am the sign the tube has failed, The small airway, the one assailed. I am the air that should be free, I am Air Trapping. Look for me. The “constrictive” disease… Look for me.
I am the air that can’t get out, The silent, suffocating doubt. You breathe in deep, the lung expands, A simple, easy, soft command. But when you try to breathe out, I am the air that stays about.
Poem
“The Air That Can’t Get Out (Air Trapping)”
I am the prisoner, I am the stop, The tiny airway, the bronchial drop. The bronchiole, a tube so small, Has scarred and tightened, closed its wall. This “constrictive” disease, this narrow track, It lets air in… but not back.
On the inspiratory scan, you see, A lung that looks as it should be. You’d swear the tissue’s normal, fine, There is no “tree-in-bud,” no line. The trap is set, the secret’s deep, A promise that I’m bound to keep.
But then, the vital, telling test: “Breathe out! Expire! Give it your best!” The healthy lung turns white and dense, My prison shows, in stark defense. I am the dark, lucent patch, A “mosaic” pattern, lock and latch.