Lobar collapse
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Lobar Collapse. Lung Anatomy. (1) aortic arch (2) pulmonary trunk (3) left atrial appendage (4) left ventricle (5) right atrium (6) superior vena cava (7 & 8) diaphragm (9) transverse fissure. Lung Anatomy. (1) oblique fissure (2) transverse fissure (3) retrocardiac space

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Lung anatomy l.jpg
Lung Anatomy

(1) aortic arch

(2) pulmonary trunk

(3) left atrial appendage

(4) left ventricle

(5) right atrium

(6) superior vena cava

(7 & 8) diaphragm

(9) transverse fissure


Lung anatomy3 l.jpg
Lung Anatomy

(1) oblique fissure

(2) transverse fissure

(3) retrocardiac space

(4) retrosternal space




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Silhouette Sign

  • If two soft tissue densities lie in apposition, then they will not be visible separately

  • If they are separated by air, the boundaries of both will be seen


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Uses of Silhouette

  • Localisation without a lateral view

  • Loss of clarity of a structure suggests there is adjacent soft tissue shadowing even when the abnormality itself is not clearly visualised. This is particularly valuable in some cases of lobar collapse.


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Lobar Collapse

  • Partial or complete loss of lung volume

  • Air resorption

  • Atelectasis


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Common causes of lobar collapse

  • Proximal stenosing bronchogenic carcinoma.

    • Middle aged or elderly, almost always smokers.

  • Asthma due to mucous plugging

    • Young adult or older child ,responds to physiotherapy.

  • Inhaled foreign body

    • Infants , such as a peanut.

  • Retention of secretions

    • Any age, frequent cause of post operative collapse.

  • Ventilation

    • Endotracheal tube is inserted too far, entering one main bronchus and occluding the other.


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Signs of Lobar Collapse

  • Lobar

    • Shift of fissures

    • Crowding of vessels (increased opacity)

  • Extra lobar

    • Hemi diaphragm elevation

    • Mediastinal shift towards side of collapse

    • Hilar shift and distortion

    • Compensatory hyperinflation

    • Rib approximation

    • Shift of other structures e.g. granuloma


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Right upper lobe collapse

  • Minor fissure pivots and bows

  • Right hilar elevation

  • May simulate mediastinal widening

  • Deviation of trachea

  • Both fissures concave superiorly





Right lower lobe collapse l.jpg
Right Lower lobe collapse

  • Posterior and medial collapse

  • Obliteration of the right hemi diaphragm

  • Heart border clearly seen

  • Transverse fissure pulled inferiorly



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Right Middle Lobe Collapse

  • Right horizontal and oblique fissure move towards each other

  • often subtle

  • blur the normally sharp right-heart border (silhouette sign)



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Left lower lobe collapse

  • Posterior and medial collapse

  • triangular opacity – sail sign

  • hemidiaphragm may be obscured



Left upper lobe collapse l.jpg
Left Upper Lobe Collapse

  • veil like opacity

  • aortic knuckle, left hilum, and left-heart border initially ill defined but may progress to become sharp

  • almost vertical oblique fissure



Left upper lobe collapse luftsichel l.jpg
Left Upper Lobe Collapse‘Luftsichel’



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Summary Right

  • Right Upper lobe

  • Right middle lobe

  • Right Lower Lobe


Summary left l.jpg
Summary Left

  • Left upper lobe

  • Left lower lobe


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