VASCULAR CHANGES IN PULMONARY EMPHYSEMA

Abstract

The pulmonary vasculature has been studied in patients with emphysema by selective pulmonary and peripheral pulmonary wedge angiography. Six cases are described in detail illustrating the range of changes which may be encountered. These are: differential blood flow; dilatation of the main pulmonary artery and its major branches and increased attenuation of the larger peripheral arteries; reduction in the number of smaller peripheral arteries, arterioles and veins; obliteration of the capillary bed; and arteriovenous shunts. The extent of involvement may vary greatly from one segment of lung to another with one area being normal and the other markedly abnormal.The plain roentgenogram of the chest in patients with emphysema may be normal. Hyperinflation and air-trapping are nonspecific findings and may be entirely absent. Reduction in the peripheral pulmonary vessels, the most reliable roentgenologic evidence of emphysema may not be detectable on the chest roentgenogram even though advanced vascular changes...