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CT of obstructive lobar collapse.

M B Khoury, J D Godwin, R A Halvorsen

    Investigative Radiology
    |October 1, 1985
    PubMed
    Summary
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    Computed tomographic (CT) scans reveal diverse appearances of obstructive lobar collapse. The S-sign is key for identifying obstructing tumors, though contrast enhancement may not always distinguish tumors from collapsed lung.

    Area of Science:

    • Radiology
    • Pulmonology
    • Oncology

    Background:

    • Obstructive lobar collapse presents varied appearances on computed tomographic (CT) scans.
    • Understanding the morphology and mechanisms of lobar collapse is crucial for diagnosis.

    Purpose of the Study:

    • To describe the varied CT appearance of obstructive lobar collapse.
    • To evaluate the utility of CT in diagnosing atypical cases and understanding collapse mechanisms.

    Main Methods:

    • Retrospective analysis of 25 cases with obstructive lobar collapse.
    • Detailed review of computed tomographic (CT) findings, including the S-sign and contrast enhancement patterns.

    Main Results:

    • The final shape of collapsed lobes depends on tumor characteristics and fluid accumulation.

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  • Focal bulging of the fissure (S-sign) was the most reliable indicator of an obstructing tumor.
  • Intravenous contrast enhancement failed to reliably differentiate tumors from collapsed lung in 75% of cases.

    • Conclusions:

    • CT is valuable for assessing lobar collapse morphology, mechanisms, and atypical presentations.
    • The S-sign is a significant CT finding for identifying obstructing lesions.
    • Limitations exist in using CT to assess mediastinal or pleural invasion in lobar collapse.