Characteristic Bronchogaphic Patterns Associated with Mechanics of Breathing

¹ Staff Physician, Arkansas Tuberculosis Sanatorium, State Sanatorium, Arkansas

1. Peripheral bronchographic images are closely related to the mechanics of breathing which cause relatively characteristic patterns with age, sex, and lung volume in the normal individual.

2. In the normal lung of a young person, the bronchographic images are related to the volume-pressure of the lung. This relationship is less true in the elderly and emphysematous because of uneven ventilation due to a decrease of elastic recoil and morphologic change, especially in the emphysematous patient.

3. Bronchographic patterns in normal lungs are classified as:

A. Even alveolar filling, found usually in the young, especially in the small lung volume group.

B. Even bronchial branching, usually found in the middle aged or large lung volume group.

C. Images of elderly, uneven or nonuniform, usually present in the over 60-years of age group, regardless of lung volume.

4. Bronchiectasis usually accompanies obstructive bronchial branching which always brings on collateral ventilation and sooner or later, emphysema develops. Therefore, we can assume the possibility of collateral ventilation or emphysema when we find an uneven bronchographic image with poor bronchial branching.

5. Because much remains hypothetical in both airflow and oilflow in the airways, further bronchographic study of the physical properties of the lung is necessary before the use of bronchography for localized lung function evaluation.