Bronchography

Bronchography is a radiographic imaging technique used to visualize the bronchial tree by introducing radiopaque contrast material into the airways. The procedure is intended to delineate the anatomy of the bronchi and to identify abnormalities such as bronchial stenosis, obstructions, fistulas, bronchiectasis, or other bronchial pathology that may influence diagnosis or treatment.

Technique and materials vary, but traditional bronchography involves delivering contrast through the trachea or a bronchoscope into specific bronchi. Historically oil-based or water-soluble iodinated contrast agents were used, and radiographs were obtained in multiple configurations to outline the bronchial generations. The advent of fiberoptic bronchoscopy allowed selective instillation into targeted bronchi, enhancing image quality and safety.

Modern practice has shifted toward noninvasive imaging modalities. CT bronchography and MR bronchography use computed tomography or magnetic resonance imaging, often with contrast, to render three-dimensional views of the airways. These techniques provide detailed airway visualization with reduced invasiveness compared with conventional bronchography and are frequently preferred for preoperative planning, evaluation of bronchial anomalies, or assessment of bronchial stenosis.

Indications for bronchography historically included investigation of unexplained cough, recurrent infections, or suspected bronchial fistulas or congenital anomalies. Today, conventional bronchography is less common and largely supplanted by CT or MR bronchography, though it may still be encountered in certain clinical settings or historical discussions. Risks of bronchography include radiation exposure, contrast reactions, infection, bronchospasm, and potential aspiration of contrast material.