ATELECTASIS

Atelectasis Right Lung

• Homogenous density right hemithorax

• Mediastinal shift to right
• Right hemithorax smaller
• Right heart and diaphragmatic silhouette are not identifiable
 Atelectasis Right Lung
Open Bronchus Sign / Alveolar Atelectasis/ Cornified Lung

• Homogenous density right hemithorax

• Mediastinal shift to right
• Right hemithorax smaller
• Right heart and diaphragmatic silhouette are not identifiable
 Atelectasis Left Lung

• Homogenous density left hemithorax

• Mediastinal shift to left
• Left hemithorax smaller
• Diaphragm and heart silhouette are not identifiable

Review lateral below

 Atelectasis Left Lung

• Homogenous density left hemithorax

• Mediastinal shift to the left
• Left hemithorax smaller
• Diaphragmatic and heart silhouette are not identifiable
 Atelectasis Left Lower Lobe

• Double density over heart

• Inhomogenous cardiac density
• Triangular retrocardiac density
• Left hilum pulled down

Other findings include:

• Pneumomediastinum
 Left Lower Lobe Atelectasis

• Inhomogeneous cardiac density

• Left hilum pulled down
• Non-visualization of left diaphragm
• Triangular retrocardiac atelectatic LLL
 Atelectasis Left Lower Lobe

• Loss of left diaphragmatic silhouette in PA view

 Atelectasis Left Lower Lobe

• Loss of left diaphragmatic silhouette

• Blunting of costophrenic angle
• Left main bronchus pulled down
•

Atelectasis

Left Lower Lobe

• Inhomogeneous cardiac density

• Triangular retrocardiac density
• Left hilum pulled down
 Atelectasis Left Upper Lobe

• Mediastinal shift to left

• Density left upper lung field
• Loss of aortic knob and left hilar silhouettes
 Atelectasis Left Upper Lobe

• Hazy density over left upper lung field

• Loss of left heart silhouette
• Tracheal shift to left
 Atelectasis Right Upper Lobe

• Density in the right upper lung field

• Transverse fissure pulled up
• Right hilum pulled up
• Smaller right lung
• Smaller right hemithorax
 Atelectasis Right Upper Lobe

• Homogenous density right upper lung field

• Mediastinal shift to right
• Loss of silhouette of ascending aorta
 RUL Atelectasis

• Density in the projection of right upper lung field

• Right hilum pulled up
 RML Atelectasis

• Vague density in right lower lung field (almost a normal film).

• Dramatic RML atelectasis in lateral view, not evident in PA view. Movement of transverse fissure.

Other findings include:

• Azygous lobe
 RML Atelectasis

• Vague density in right lower lung field, almost normal

• RML atelectasis in lateral view, not evident in PA view
 Atelectasis Right Lower Lobe

• Density in right lower lung field

• Indistinct right diaphragm
• Right heart silhouette retained
• Transverse fissure moved down
• Right hilum moved down
 Adhesive Atelectasis

Alveoli are kept open by the integrity of surfactant. When there is loss of surfactant, alveoli collapse. ARDS is
an example of diffuse alveolar atelectasis.

Plate-like atelectasis is an example of focal loss of surfactant.

 Relaxation Atelectasis

The lung is held in apposition to the chest wall because of negative pressure in the pleura. When the negative pressure is
lost, as in pneumothorax or pleural effusion, the lung relaxes to its atelectatic position. The atelectasis is a secondary
event. The pleural problem is primary and dictates other radiological findings.
 Round Atelectasis

• Mass like density

• Pleural based
• Base of lungs
• Blunting of costophrenic angle
• Pleural thickening
• Pulmonary vasculature curving into the density

Esophageal surgical clips.

 Round Atelectasis

• Mass like density

• Pleural based
• Base of lungs
• Blunting of costophrenic angle, pleural thickening
• Pulmonary vasculature curving into the density

This is not a good example.

RML Lateral Segment Atelectasis
 Sub-segmental Atelectasis

Also note the posterior mediastinal mass in the left apex.

 Atelectasis

• Segmental
• Anterior sub-segment of RUL
• "Bronchial wedge"