(Bronchogram, Laryngography)

Procedure Overview

What is bronchography?

A bronchography is a radiographic (x-ray) examination of the interior passageways of the lower respiratory tract. The structures of the lower respiratory tract, which include the larynx (voice box), trachea (windpipe), and bronchi (larger branching airways to the lungs), become visible on x-ray film after contrast dye is instilled through either a catheter or bronchoscope (narrow, flexible, lighted tube) into these areas. Contrast dye is a substance that causes a particular organ, tissue, or structure to be more visible on x-ray or other diagnostic images.

The contrast dye is released as the catheter or bronchoscope is inserted through the nose or mouth and advanced down the throat into the trachea and bronchi. The contrast dye forms a coating on the lining of the interior walls of these structures, thus outlining their anatomy on x-ray. In addition, abnormalities such as tumors, cavities, cysts, and obstructions may be revealed.

As a result of improved computerized tomography (CT scan) and bronchoscopy technology, as well as increased availability of these procedures, bronchography is performed on an infrequent basis.

Other related procedures that may be used to diagnose problems of the lungs and respiratory tract include bronchoscopy, CT scan of the chest, chest fluoroscopy, chest x-ray, chest ultrasound, lung biopsy, lung scan, mediastinoscopy, oximetry, peak flow measurement, positron emission tomography (PET) scan, pulmonary angiogram, pulmonary function tests, and thoracentesis. Please see these procedures for additional information.

Anatomy of the respiratory system:

The respiratory system is made up of the organs involved in the interchanges of gases, and consists of the:

  • nose

  • pharynx

  • larynx

  • trachea

  • bronchi

  • lungs

The upper respiratory tract includes the:

  • nose

  • nasal cavity

  • ethmoidal air cells

  • frontal sinuses

  • maxillary sinus

  • larynx

  • trachea

The lower respiratory tract includes the lungs, bronchi, and alveoli.

What are the functions of the lungs?

The lungs take in oxygen, which cells need to live and carry out their normal functions. The lungs also get rid of carbon dioxide, a waste product of the body's cells.

The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They take up most of the space in the chest, or the thorax (the part of the body between the base of the neck and diaphragm).

The lungs are enveloped in a membrane called the pleura.

The lungs are separated from each other by the mediastinum, an area that contains the following:

  • the heart and its large vessels

  • trachea (windpipe)

  • esophagus

  • thymus

  • lymph nodes

The right lung has three sections, called lobes. The left lung has two lobes. When you breathe, the air enters the body through the nose or the mouth. It then travels down the throat through the larynx (voice box) and trachea (windpipe) and goes into the lungs through tubes called main-stem bronchi.

One main-stem bronchus leads to the right lung and one to the left lung. In the lungs, the main-stem bronchi divide into smaller bronchi and then into even smaller tubes called bronchioles. Bronchioles end in tiny air sacs called alveoli.

Reasons for the Procedure

A bronchography may be performed to diagnose structural or functional abnormalities of the larynx, trachea, and/or bronchi. Abnormalities may include, but are not limited to, the following:

  • bronchiectasis - an irreversible enlargement of the bronchi as a result of deterioration of the muscle and elastic tissue of the bronchial walls. Generally, this is the result of chronic inflammation from various causes.

  • hemoptysis - coughing up blood

  • tracheoesophageal fistula - abnormal tract between trachea (windpipe) and esophagus (hollow tube used for swallowing)

  • tumors (abnormal growths)

  • chronic pneumonia or bronchitis

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