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Systemic Arterial Supply to the Lungs in Adults: Spiral CT Findings¹

¹ From the Departments of Radiology, Seoul National University Hospital and Seoul National University College of Medicine and Clinical Research Institute, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea. Presented as a scientific exhibit at the 1999 RSNA scientific assembly. Received April 3, 2000; revision requested May 17 and received July 12; accepted July 13. Supported in part by a grant from Brain Korea 21. Address correspondence to J.G.I. (e-mail: imjg@radcom.snu.ac.kr).

Systemic arterial supply to the lungs can be congenital or due to acquired disease. Congenital diseases encompass bronchopulmonary sequestration and congenital pulmonary venolobar syndrome, in which the involved lung parenchyma is supplied by the aberrant systemic arteries. An anomalous systemic artery can also supply an area of otherwise normal lung parenchyma. In acquired diseases, hypertrophied normal systemic arteries supply the lungs. Hypertrophied systemic arteries include the bronchial arteries, intercostal arteries, internal mammary arteries, inferior phrenic arteries, branches of the thyrocervical trunk, branches of the hepatic arteries, and branches of the abdominal aorta. Hypertrophy of normal systemic arteries is encountered in patients with bronchiectasis, pulmonary tuberculosis, other pulmonary infections, pulmonary thromboembolism, or chronic obstructive pulmonary disease. These systemic arteries are considered to supply the lungs by means of anastomoses between bronchial and pulmonary arteries within the lung parenchyma or transpleural systemic-pulmonary artery anastomoses. In most cases, the correct diagnosis and treatment plan can be determined by identification of the systemic arteries on computed tomographic scans.

Index Terms: Arteries, bronchial, 563.1556, 60.1422, 943.15 • Bronchopulmonary sequestration, 60.1422, 60.1451, 943.15 • Computed tomography (CT), helical, 60.12115 • Lung, abnormalities, 60.14 • Pneumonitis, 60.2 • Pulmonary arteries, abnormalities, 564.1556, 60.1422 • Pulmonary arteries, stenosis or obstruction, 564.625 • Venolobar syndrome, 60.142

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