eMedicine Specialties > Radiology > Chest

Atelectasis, Lobar: Multimedia

Author: Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St. Boniface General Hospital
Coauthor(s): Bruce Maycher, MD, Director of Pulmonary Radiology, St Boniface General Hospital; Associate Professor, Department of Radiology, University of Manitoba
Contributor Information and Disclosures

Updated: Mar 6, 2008

Multimedia

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Media file 1: Gross anatomic specimen showing airless lungs, or atelectasis. Atelectasis refers to either incomplete expansion of the lungs or the collapse of previously inflated lungs, which produces areas of relatively airless pulmonary parenchyma.

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Gross anatomic specimen showing airless lungs, or atelectasis. Atelectasis refers to either incomplete expansion of the lungs or the collapse of previously inflated lungs, which produces areas of relatively airless pulmonary parenchyma.

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Media file 2: Image depicting a right upper lobe collapsing posteriorly and inferiorly.

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Image depicting a right upper lobe collapsing posteriorly and inferiorly.

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Media file 3: Image depicting a right middle lobe collapsing medially.

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Image depicting a right middle lobe collapsing medially.

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Media file 4: Image depicting a right lower lobe collapsing anteriorly and superiorly.

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Image depicting a right lower lobe collapsing anteriorly and superiorly.

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Media file 5: Image depicting a left upper lobe collapsing superiorly and anteriorly.

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Image depicting a left upper lobe collapsing superiorly and anteriorly.

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Media file 6: Image depicting the lingula collapsing medially.

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Image depicting the lingula collapsing medially.

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Media file 7: Image depicting a left lower lobe collapsing posteriorly and inferiorly.

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Image depicting a left lower lobe collapsing posteriorly and inferiorly.

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Media file 8: Chest radiograph demonstrating complete atelectasis of the left lung.

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Chest radiograph demonstrating complete atelectasis of the left lung.

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Media file 9: Left upper lobe collapse. This radiograph shows an opacity that is contiguous with the aortic knob, a smaller left hemithorax, and a mediastinal shift. The luftsichel sign involves hyperextension of the superior segment of the left lower lobe, which then occupies the left apex.

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Left upper lobe collapse. This radiograph shows an opacity that is contiguous with the aortic knob, a smaller left hemithorax, and a mediastinal shift. The luftsichel sign involves hyperextension of the superior segment of the left lower lobe, which then occupies the left apex.

(Enlarge Image)

Media file 10: Chest radiograph demonstrating a left upper lobe collapse, resulting in a veil-like opacity that extends upward and outward from the hilum. Additional signs of loss of volume in the left hemithorax and crowding of the ribs are also evident on this radiograph.

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Chest radiograph demonstrating a left upper lobe collapse, resulting in a veil-like opacity that extends upward and outward from the hilum. Additional signs of loss of volume in the left hemithorax and crowding of the ribs are also evident on this radiograph.

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Media file 11: Lateral chest radiograph demonstrating a left upper lobe collapsing anteriorly.

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Lateral chest radiograph demonstrating a left upper lobe collapsing anteriorly.

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Media file 12: Computed tomography scan shows a left lower lobe collapse with a small pleural effusion.

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Computed tomography scan shows a left lower lobe collapse with a small pleural effusion.

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Media file 13: Chest radiograph depicting complete right lung atelectasis.

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Chest radiograph depicting complete right lung atelectasis.

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Media file 14: Left lower lobe collapse. This chest radiograph shows volume loss on the left side, an elevated and silhouetted left diaphragm, and an opacity behind the heart (ie, sail sign).

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Left lower lobe collapse. This chest radiograph shows volume loss on the left side, an elevated and silhouetted left diaphragm, and an opacity behind the heart (ie, sail sign).

(Enlarge Image)

Media file 15: Right upper lobe collapse. This chest radiograph shows volume loss in the upper lobe, upward shifting of the horizontal fissure, and elevation of the right side of the diaphragm.

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Right upper lobe collapse. This chest radiograph shows volume loss in the upper lobe, upward shifting of the horizontal fissure, and elevation of the right side of the diaphragm.

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Media file 16: Lateral chest radiograph depicting left a lower lobe collapse. The opacity is in a posteroinferior location.

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Lateral chest radiograph depicting left a lower lobe collapse. The opacity is in a posteroinferior location.

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Media file 17: Lateral chest radiograph demonstrating a right upper lobe collapsing anteriorly and superiorly. The opacity is seen in the anterior and superior locations.

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Lateral chest radiograph demonstrating a right upper lobe collapsing anteriorly and superiorly. The opacity is seen in the anterior and superior locations.

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Media file 18: This computed tomography scan shows a right upper lobe collapse secondary to a right hilar mass. On bronchoscopy, an endobronchial lesion that occluded the right upper lobe bronchus was seen.

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This computed tomography scan shows a right upper lobe collapse secondary to a right hilar mass. On bronchoscopy, an endobronchial lesion that occluded the right upper lobe bronchus was seen.

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Media file 19: Chest radiograph demonstrating both a right lower lobe collapse and a right middle lobe collapse. The left lung is hyperexpanded.

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Chest radiograph demonstrating both a right lower lobe collapse and a right middle lobe collapse. The left lung is hyperexpanded.

Posteroanterior (PA) (<i>left</i>) and lateral ch...

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Media file 20: Posteroanterior (PA) (left) and lateral chest (right) radiographs. A right middle lobe collapse obliterates the right heart border on the PA image and projects as a wedge-shaped opacity on the lateral view.

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Posteroanterior (PA) (left) and lateral chest (right) radiographs. A right middle lobe collapse obliterates the right heart border on the PA image and projects as a wedge-shaped opacity on the lateral view.

(Enlarge Image)

Media file 21: Lateral chest radiograph demonstrating a right lower lobe collapse that results in volume loss, obliteration of the right side of the diaphragm, and a posterior opacity.

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Lateral chest radiograph demonstrating a right lower lobe collapse that results in volume loss, obliteration of the right side of the diaphragm, and a posterior opacity.

(Enlarge Image)

Media file 22: Computed tomography scan demonstrating rounded atelectasis in a patient exposed to asbestos. This image shows a peripheral pleural-based opacity with crowding of the bronchovascular structures in the comet-tail sign.

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Computed tomography scan demonstrating rounded atelectasis in a patient exposed to asbestos. This image shows a peripheral pleural-based opacity with crowding of the bronchovascular structures in the comet-tail sign.

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Media file 23: Posteroanterior (PA) (left) and lateral chest (right) radiographs from a patient with collapse of the right middle lobe. The PA view shows the right middle lobe collapse obscuring the right heart border. The lateral view shows a triangular opacity that overlies the heart because the major fissure shifts upward and the minor fissure shifts downward. With worsening collapse, the opacity diminishes in size, and it may be barely perceptible.

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Posteroanterior (PA) (left) and lateral chest (right) radiographs from a patient with collapse of the right middle lobe. The PA view shows the right middle lobe collapse obscuring the right heart border. The lateral view shows a triangular opacity that overlies the heart because the major fissure shifts upward and the minor fissure shifts downward. With worsening collapse, the opacity diminishes in size, and it may be barely perceptible.

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Media file 24: Chest radiograph showing collapse of the left lower lobe toward the posterior and inferior aspect of the thoracic cavity. The atelectatic left lower lobe is present as a sail sign behind the cardiac shadow.

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Chest radiograph showing collapse of the left lower lobe toward the posterior and inferior aspect of the thoracic cavity. The atelectatic left lower lobe is present as a sail sign behind the cardiac shadow.

More on Atelectasis, Lobar

Overview: Atelectasis, Lobar

Imaging: Atelectasis, Lobar

Follow-up: Atelectasis, Lobar

Multimedia: Atelectasis, Lobar

References

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References

Qureshi NR, Gleeson FV. Imaging of pleural disease. Clin Chest Med. Jun 2006;27(2):193-213. [Medline].
Ashizawa K, Hayashi K, Aso N, Minami K. Lobar atelectasis: diagnostic pitfalls on chest radiography. Br J Radiol. Jan 2001;74(877):89-97. [Medline]. [Full Text].
Woodring JH, Reed JC. Radiographic manifestations of lobar atelectasis. J Thorac Imaging. 1996;11(2):109-44. [Medline]. [Full Text].
Stark P, Leung A. Effects of lobar atelectasis on the distribution of pleural effusion and pneumothorax. J Thorac Imaging. 1996;11(2):145-9. [Medline].
Proto AV, Tocino I. Radiographic manifestations of lobar collapse. Semin Roentgenol. Apr 1980;15(2):117-73. [Medline].
McHugh K, Blaquiere RM. CT features of rounded atelectasis. AJR Am J Roentgenol. Aug 1989;153(2):257-60. [Medline]. [Full Text].
Westcott JL, Cole S. Plate atelectasis. Radiology. Apr 1985;155(1):1-9. [Medline]. [Full Text].
Molina PL, Hiken JN, Glazer HS. Imaging evaluation of obstructive atelectasis. J Thorac Imaging. 1996;11(3):176-86. [Medline].
Lee KS, Logan PM, Primack SL, Müller NL. Combined lobar atelectasis of the right lung: imaging findings. AJR Am J Roentgenol. Jul 1994;163(1):43-7. [Medline]. [Full Text].
Woodring JH. Determining the cause of pulmonary atelectasis: a comparison of plain radiography and CT. AJR Am J Roentgenol. Apr 1988;150(4):757-63. [Medline]. [Full Text].
Khoury MB, Godwin JD, Halvorsen RA Jr, Putman CE. CT of obstructive lobar collapse. Invest Radiol. Oct 1985;20(7):708-16. [Medline].
Naidich DP, McCauley DI, Khouri NF, et al. Computed tomography of lobar collapse: 1. Endobronchial obstruction. J Comput Assist Tomogr. Oct 1983;7(5):745-57. [Medline].
Herold CJ, Kuhlman JE, Zerhouni EA. Pulmonary atelectasis: signal patterns with MR imaging. Radiology. Mar 1991;178(3):715-20. [Medline]. [Full Text].
Kattan KR, Eyler WR, Felson B. The juxtaphrenic peak in upper lobe collapse. Semin Roentgenol. Apr 1980;15(2):187-93. [Medline].
Partap VA. The comet tail sign. Radiology. Nov 1999;213(2):553-4. [Medline]. [Full Text].
Gurney JW. Atypical manifestations of pulmonary atelectasis. J Thorac Imaging. 1996;11(3):165-75. [Medline].
Franken EA Jr, Klatte EC. Atypical (peripheral) upper lobe collapse. Ann Radiol (Paris). Jan-Feb 1977;20(1):87-93. [Medline].
Alptekin B, Tran DT, Lisbon A, Kaynar AM. Bedside ultrasonography in the differential diagnosis of pulmonary pathologies in the intensive care unit. J Clin Anesth. Nov 2006;18(7):534-6. [Medline].
Volpicelli G, Mussa A, Garofalo G, et al. Bedside lung ultrasound in the assessment of alveolar-interstitial syndrome. Am J Emerg Med. Oct 2006;24(6):689-96. [Medline].
Wu KH, Lin CF, Huang CJ, Chen CC. Rigid ventilation bronchoscopy under general anesthesia for treatment of pediatric pulmonary atelectasis caused by pneumonia: a review of 33 cases. Int Surg. Sep-Oct 2006;91(5):291-4. [Medline].
Cai H, Gong H, Zhang L, Wang Y, Tian Y. Effect of low tidal volume ventilation on atelectasis in patients during general anesthesia: a computed tomographic scan. J Clin Anesth. Mar 2007;19(2):125-9. [Medline].
Mahmut M, Nishitani H. Evaluation of pulmonary lobe variations using multidetector row computed tomography. J Comput Assist Tomogr. Nov-Dec 2007;31(6):956-60. [Medline].
Proto AV. Lobar collapse: basic concepts. Eur J Radiol. Aug 1996;23(1):9-22. [Medline].
Stark P. Round atelectasis: another pulmonary pseudotumor. Am Rev Respir Dis. Feb 1982;125(2):248-50. [Medline].
Toyoshima M, Maeoka Y, Kawahara H, Maegaki Y, Ohno K. [Pulmonary atelectasis in patients with neurological or muscular disease; gravity-related lung compression by the heart and intra-abdominal organs on persistent supine position] [Japanese]. No To Hattatsu. Nov 2006;38(6):419-24. [Medline].

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Keywords

obstructive atelectasis, nonobstructive atelectasis, platelike atelectasis, discoid atelectasis, subsegmental atelectasis postoperative atelectasis, cicatrization atelectasis, rounded atelectasis, folded-lung syndrome, Blesovsky syndrome, Blesovsky's syndrome, replacement atelectasis, incomplete expansion, diminished lung volume, pulmonary volume deficiency, lung foreign body, lung tumor, mucus plugging, pleural effusion, right middle lobe syndrome, atelectatic lung tissue, bronchial obstruction, pneumothorax lobar collapse, pneumothorax, airless lung

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Contributor Information and Disclosures

Author

Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St. Boniface General Hospital
Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Bruce Maycher, MD, Director of Pulmonary Radiology, St Boniface General Hospital; Associate Professor, Department of Radiology, University of Manitoba
Bruce Maycher, MD is a member of the following medical societies: American Roentgen Ray Society, Canadian Medical Association, Radiological Society of North America, and Society of Thoracic Radiology
Disclosure: Nothing to disclose.

Medical Editor

Kitt Shaffer, MD, PhD, Director of Undergraduate Medical Education, Associate Professor, Department of Radiology, Cambridge Health Alliance
Kitt Shaffer, MD, PhD is a member of the following medical societies: American Roentgen Ray Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

W Richard Webb, MD, Chief of Thoracic Imaging, Professor, Department of Radiology, University of California at San Francisco
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Staff, Department of Radiology, Virginia Mason Medical Center
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

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eMedicine Specialties > Radiology > Chest

Atelectasis, Lobar: Multimedia

Multimedia

Gross anatomic specimen showing airless lungs, or atelectasis. Atelectasis refers to either incomplete expansion of the lungs or the collapse of previously inflated lungs, which produces areas of relatively airless pulmonary parenchyma.

Image depicting a right upper lobe collapsing posteriorly and inferiorly.

Image depicting a right middle lobe collapsing medially.

Image depicting a right lower lobe collapsing anteriorly and superiorly.

Image depicting a left upper lobe collapsing superiorly and anteriorly.

Image depicting the lingula collapsing medially.

Image depicting a left lower lobe collapsing posteriorly and inferiorly.

Chest radiograph demonstrating complete atelectasis of the left lung.

Left upper lobe collapse. This radiograph shows an opacity that is contiguous with the aortic knob, a smaller left hemithorax, and a mediastinal shift. The luftsichel sign involves hyperextension of the superior segment of the left lower lobe, which then occupies the left apex.

Chest radiograph demonstrating a left upper lobe collapse, resulting in a veil-like opacity that extends upward and outward from the hilum. Additional signs of loss of volume in the left hemithorax and crowding of the ribs are also evident on this radiograph.

Lateral chest radiograph demonstrating a left upper lobe collapsing anteriorly.

Computed tomography scan shows a left lower lobe collapse with a small pleural effusion.

Chest radiograph depicting complete right lung atelectasis.

Left lower lobe collapse. This chest radiograph shows volume loss on the left side, an elevated and silhouetted left diaphragm, and an opacity behind the heart (ie, sail sign).

Right upper lobe collapse. This chest radiograph shows volume loss in the upper lobe, upward shifting of the horizontal fissure, and elevation of the right side of the diaphragm.

Lateral chest radiograph depicting left a lower lobe collapse. The opacity is in a posteroinferior location.

Lateral chest radiograph demonstrating a right upper lobe collapsing anteriorly and superiorly. The opacity is seen in the anterior and superior locations.

This computed tomography scan shows a right upper lobe collapse secondary to a right hilar mass. On bronchoscopy, an endobronchial lesion that occluded the right upper lobe bronchus was seen.

Chest radiograph demonstrating both a right lower lobe collapse and a right middle lobe collapse. The left lung is hyperexpanded.

Posteroanterior (PA) (left) and lateral chest (right) radiographs. A right middle lobe collapse obliterates the right heart border on the PA image and projects as a wedge-shaped opacity on the lateral view.

Lateral chest radiograph demonstrating a right lower lobe collapse that results in volume loss, obliteration of the right side of the diaphragm, and a posterior opacity.

Computed tomography scan demonstrating rounded atelectasis in a patient exposed to asbestos. This image shows a peripheral pleural-based opacity with crowding of the bronchovascular structures in the comet-tail sign.

Chest radiograph showing collapse of the left lower lobe toward the posterior and inferior aspect of the thoracic cavity. The atelectatic left lower lobe is present as a sail sign behind the cardiac shadow.

More on Atelectasis, Lobar

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Coauthor(s)

Medical Editor

Pharmacy Editor

Managing Editor

CME Editor

Chief Editor