CTICasesBronchial-to-Pulmonary Artery Shunting in Aspiration Pneumonia
Imaging findings
CT chest shows right-sided aspiration pneumonia with hyperdense, heterogeneous flow (smoke phenomenon) within the right pulmonary artery. Massively dilated, hyperenhanced bronchial arteries course along the hilum.
Key takeaways
Severe, acute localized pulmonary infections (such as aspiration pneumonia) induce severe regional hyperemia. This recruits systemic bronchial collaterals, which shunt high-pressure blood into the pulmonary artery, creating heterogeneous flow stasis (smoke phenomenon) on early phase CTA.
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