CTICasesAcquired Systemic Arterial Supply in Bronchiectasis
Imaging findings
CT and coronal MIP images show severe bronchiectasis in the right lower lobe. Multiple hypertrophied systemic arterial collaterals arise from the celiac axis and the base of the right brachiocephalic artery, tracking through the diaphragm and mediastinum to supply the diseased right lung parenchyma.
Key takeaways
Chronic inflammatory lung diseases (such as severe bronchiectasis or chronic infections) can stimulate neovascularization, leading to acquired systemic arterial collateral supply (pseudo-sequestration). These collaterals can arise from the abdominal aorta, celiac axis, or brachiocephalic vessels, mimicking congenital sequestration.
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