Air-space opacification (summary)
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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.
Summary
- anatomy
-
pathophysiology
- material fills the lung parenchyma
- fluid: pulmonary oedema
- pus: pneumonia
- blood: pulmonary haemorrhage
- cells: cancer
- protein: alveolar proteinosis (rare)
-
appearancedistribution- 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 travelling through the lobe
- no margin between consolidation and other soft-tissue density structures
- mediastinum or diaphragm
- patchy
-
distribution- multifocal
- symmetrical or asymmetrical
- perihilar or peripheral
- often non-specific without clinical history and examination findings
- multifocal
- material fills the lung parenchyma
-
common pathology
Imaging
-
role of imaging
- confirm air-space opacification
- and differentiate from atelectasis
- 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
- confirm air-space opacification
-
radiographic featurescommon pathology
Radiographic features
Chest x-ray
- normal air-filled lung is black
- air-space opacification is radiopaque (white)
- aerated bronchi
CT chest
- air-space opacification looks very similar to the chest x-ray
- distribution can be assessed more accurately
- assessment of complications is more accurate
-<li>appearance<ul>- +<li>distribution<ul>
-</ul>-</li>-<li>distribution<ul><li>multifocal<ul>- +<li>multifocal<ul>
-</li></ul>-<li>-<strong>common pathology</strong><ul>-<li><a href="/articles/pneumonia-summary">pneumonia</a></li>-<li><a href="/articles/pulmonary-oedema-summary">pulmonary oedema</a></li>-<li><a href="/articles/lung-cancer-summary">lung cancer</a></li>-</ul><h4>Imaging</h4><ul>-<li>confirm air-space opacification<ul><li>differentiate from <a href="/articles/atelectasis">atelectasis</a>-</li></ul>-</li>- +<li>confirm air-space opacification and differentiate from <a href="/articles/atelectasis">atelectasis</a> or <a title="Pleural effusion (summary)" href="/articles/pleural-effusion-summary">pleural effusion</a> where possible</li>
-<strong>radiographic features</strong><ul>-<li>-<a href="/articles/chest-x-ray-summary">chest x-ray</a><ul>- +<strong>common pathology</strong><ul>
- +<li><a href="/articles/pneumonia-summary">pneumonia</a></li>
- +<li><a href="/articles/pulmonary-oedema-summary">pulmonary oedema</a></li>
- +<li><a href="/articles/lung-cancer-summary">lung cancer</a></li>
- +</ul>
- +</li>
- +</ul><h4>Radiographic features</h4><h5>Chest x-ray</h5><ul>
-</ul>-</li>-<li>-<a href="/articles/ct-chest-summary">CT chest</a><ul><li>air-space opacification looks very similar to the chest x-ray<ul>- +</ul><h5>CT chest</h5><ul><li>air-space opacification looks very similar to the chest x-ray<ul>
-</li></ul>-</li>-</ul>-</li>-</ul>- +</li></ul>
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