Bronchography
Bronchography, also referred to as bronchogram or laryngography, is a radiographic procedure that evaluates the interior passageways of the larynx, trachea, and bronchi. Although its use has declined with advancements in imaging technologies like CT scans and MRIs, bronchography serves to identify structural or functional abnormalities in the lower respiratory tract. Common conditions assessed through this procedure include bronchiectasis, hemoptysis, chronic bronchitis, chronic pneumonia, and lung tumors.
Prior to the procedure, patients are required to fast and maintain oral hygiene. The process involves sedation, numbing the throat, and using a bronchoscope to administer a contrast dye that coats the airways, enabling X-ray imaging. Post-procedure, patients are monitored for vital signs and may experience a sore throat. A follow-up chest X-ray is often conducted to ensure the contrast dye has cleared from the airways. While bronchography can provide valuable diagnostic information, it carries risks such as infection and airway obstruction, especially in individuals with pre-existing respiratory conditions.
On this Page
Subject Terms
Bronchography
ALSO KNOWN AS: Bronchogram, laryngography
DEFINITION: Bronchography is a radiographic evaluation that examines the interior passageways of the larynx, trachea, and bronchi. Bronchography is only used occasionally because of technological advances with computed tomography (CT) scans, bronchoscopy, magnetic resonance imaging (MRI), and High-Resolution CT.
Cancers diagnosed:Lung cancers
Why performed: Bronchography examines structural or functional abnormalities of the lower respiratory tract. Abnormalities commonly investigated with bronchography include bronchiectisis, hemoptysis, chronic bronchitis, chronic pneumonia, and tumors.
Patient preparation: The patient is asked not to eat or drink for several hours before the procedure. The patient may also be asked to perform thorough mouth hygiene before the procedure.
Steps of the procedure: The patient is asked to remove all clothing, jewelry, and dentures; to dress in a gown, and to empty the bladder. Vital signs (such as blood pressure and respiratory rate) are taken. The patient is positioned on a table that can tilt in various directions. The patient may also be given a sedative. Next, numbing medication is injected into the back of the patient’s throat to prevent gagging. Finally, the physician passes the bronchoscope down the back of the throat into the trachea and bronchi. Contrast dye is released from the bronchoscope as it advances. The dye forms a coating on the lining of the interiors of the bronchi, trachea, and larynx. The physician then takes several X-rays from different positions, after which the bronchoscope is removed.
After the procedure: The patient is moved to a recovery room and has vital signs monitored for several hours post procedure. The patient will not be allowed to eat or drink until the gag reflex has returned. The patient may be asked to gently cough up any remaining contrast dye. Normal diet may be resumed after the procedure. The throat may feel sore after bronchography. A follow-up chest X-ray is often performed twenty-four to forty-eight hours after the bronchography to verify the removal of the contrast dye from the airways.
Risks: Risks of the procedure include infection or pneumonia and airway obstruction from the contrast dye in patients with emphysema or chronic obstructive pulmonary disease (COPD).
Results: The contrast dye allows the physician to assess the likely presence or absence of respiratory system abnormalities, such as tumors, in the larynx, trachea, or bronchi. If abnormalities are detected, then the physician will either perform a confirmatory diagnostic procedure or devise a treatment plan based on the specific test results.
Bibliography
Ferretti, G. R., et al. "Benign Abnormalities and Carcinoid Tumors of the Central Airways: Diagnostic Impact of CT Bronchography." Amer. Journal of Roentgenology, vol. 174.5, 2000, pp. 1307–1313.
Joseph, T. M., and T. Reghunath. "An Alternative Contrast Medium for Bronchography." Indian Journal of Thoracic and Cardiovascular Surgery, vol. 6.1, 1989–90, pp. 82–83.
Holland, Robert H. "A Simple Technique for Bronchography." JAMA, vol. 165.14, 1957, pp. 1819–1820.
McGuinness, Georgeann, and David P. Naidich. "CT of Airways Disease and Bronchiectasis." Radiologic Clinics of North America, vol. 40, no. 1, 2002, pp. 1-19, doi.org/10.1016/S0033-8389(03)00105-2. Accessed 17 June 2024.
Sarkar, P., et al. "The Role of Computed Tomography Bronchography in the Management of Bronchopleural Fistulas." Journal of Thoracic Imaging, vol. 25.1, 2010, pp. W10–W13.
Shimuzu, K., et al. "Segmentectomy Guided by Three-Dimensional Computed Tomography Angiography and Bronchography." Interactive Cardiovascular and Thoracic Surgery, vol. 15.2, 2012, pp. 194–196.
Thompson, I. M., et al. "Evaluation of Contrast Media for Bronchography." Pediatric Radiology, vol. 27.7, 1997, pp. 598–605.