Pulmonary Angiogram

By Lou Akin

(Angiogram-Pulmonary, Pulmonary Angiography, Pulmonary Arteriogram, Pulmonary Arteriography, Angiogram of the Lungs)

Procedure Overview

What is a pulmonary angiogram?

An angiogram, also called an arteriogram, is an x-ray image of the blood vessels. It is performed to evaluate various vascular conditions, such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages.

A pulmonary angiogram is an angiogram of the blood vessels of the lungs. A pulmonary angiogram may be used to assess the blood flow to the lungs. One of the primary indications for the procedure is the diagnosis of a pulmonary embolus (clot). It may also be used to deliver medication into the lungs to treat cancer or hemorrhage.

In order to obtain a radiographic (x-ray) image of a blood vessel, an intravenous (IV) access is necessary so that a contrast dye can be injected into the body's circulatory system, which includes the pulmonary (lungs) circulatory system. This contrast dye causes the blood vessels to be visible on x-ray film. This allows the physician to see the size, shape, and many branches of the pulmonary vessels, in particular, the pulmonary artery that circulates blood to the lungs.

Fluoroscopy is often used during a pulmonary angiogram. Fluoroscopy is the study of moving body structures - similar to an x-ray "movie." A continuous x-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail.

An additional technology that may be used with an angiogram is called digital subtraction angiography (DSA). Instead of using x-rays, DSA is based on computer imaging. DSA still requires a contrast dye to be injected into the pulmonary circulation. However, with DSA, a computer image is made prior to the injection of the dye. A computer digitally subtracts (or removes) everything from the image except that which is injected with the contrast dye, so that the computer image remaining is one of the pulmonary blood vessels only.

Other related procedures that may be used to diagnose problems of the chest and respiratory tract include chest x-rays, computed tomography (CT scan) of the chest, bronchoscopy, bronchography, chest fluoroscopy, chest ultrasound, lung biopsy, lung scan, mediastinoscopy, positron emission tomography (PET scan) of the chest, pleural biopsy, 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.

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