Air-space opacification (summary)

Last revised by Ryan Thibodeau on 6 Aug 2024
This is a basic article for medical students and other non-radiologists

Air-space opacification is a descriptive term that refers to filling of the lung parenchyma with material that attenuates x-rays more than the unaffected surrounding lung tissue. It is the radiological correlate of the pathological diagnosis of pulmonary consolidation.

Reference article

This is a summary article; read more in our article on air-space opacification.

  • anatomy

  • pathophysiology

    • material fills the lung parenchyma

    • distribution

      • patchy

        • air-space filling is incomplete and non-contiguous

        • residual gas within the alveoli

      • lobar

        • complete filling of a lobe of the lung

        • clear delineation between consolidation and adjacent gas-filled structures

          • the remainder of the lung or in bronchi traveling through the lobe

        • no margin between consolidation and other soft-tissue density structures

          • mediastinum or diaphragm

      • multifocal

        • symmetrical or asymmetrical

        • perihilar or peripheral

        • often non-specific without clinical history and examination findings

  • role of imaging

    • confirm air-space opacification and differentiate from atelectasis or pleural effusion where possible

    • help to determine the cause, e.g. other signs of heart failure

    • identify complications, e.g. abscess formation

    • demonstrate accompanying pathology, e.g. effusion or empyema

    • determine severity and extent, e.g. number of lobes involved, uni- or bilaterality

  • common pathology

  • normal air-filled lung is black

  • air-space opacification is radiopaque (white)

  • aerated bronchi

  • air-space opacification looks very similar to the chest x-ray

    • distribution can be assessed more accurately

    • assessment of complications is more accurate

Cases and figures

  • Case 1: Left lower lobe consolidation
  • Case 2: Left lower lobe consolidation
  • Case 3: Right upper lobe consolidation
  • Case 4: Right sided consolidation (multi-lobar)
  • Case 6: right upper lobe consolidation
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