A bronchoscopy is a medical procedure that provides a direct look inside the airways of the lungs using a thin, flexible instrument called a bronchoscope. The primary result is a real-time video feed that allows a physician to see the internal structures of the respiratory system. This visual information is used to diagnose and sometimes treat various lung conditions.
How Bronchoscopy Images Are Obtained
A flexible bronchoscope is a thin, maneuverable tube, typically less than half an inch wide, that houses a high-resolution camera and a light source. This design allows it to navigate the complex, branching pathways of the lungs. The light illuminates the airway walls, while the camera captures detailed images and transmits them to a monitor.
To begin the procedure, a patient is often given a sedative for comfort, and a local anesthetic is applied to the nose and throat to numb the area. The physician then guides the bronchoscope through the patient’s nose or mouth, past the vocal cords, and into the main windpipe, known as the trachea. From the trachea, the scope is advanced into the smaller bronchial tubes of the lungs.
As the bronchoscope moves deeper into the lungs, the live video feed provides a clear view of the airway passages. The physician can manipulate the tip of the scope to examine different areas, viewing the branching network of the bronchi in detail.
Visualizing the Airways
Bronchoscopy images provide a clear distinction between healthy and abnormal lung tissue. In a healthy individual, the airways appear open and unobstructed. The lining, or mucosa, is a pale pink color with a smooth, moist surface. The cartilage rings that give structure to the trachea and larger bronchi are often visible as C-shaped ridges beneath the mucosal layer. At points where the airways divide, called carinas, the edges appear sharp and well-defined.
In contrast, images of unhealthy airways can show a variety of abnormalities. Inflammation or infection often causes the mucosal lining to become red, swollen, and irritated. In cases of bronchitis or pneumonia, thick mucus or pus may be seen coating the airway walls or partially blocking the passages. These secretions can range in color from white and yellow to green.
Bronchoscopy is also effective at identifying structural problems. An image might reveal a tumor or growth as an irregular mass protruding into the airway, which can have a bumpy, uneven surface and may be discolored. Other potential findings include signs of bleeding, which can appear as fresh red blood or older, darker clots. In some cases, an inhaled foreign object, such as a small piece of food, can be clearly seen lodged within a bronchial tube.
Using Images to Guide Interventions
The visual feed from a bronchoscopy also guides physicians in performing targeted procedures. The bronchoscope contains a working channel, a hollow tube through which specialized instruments can be passed. This allows for interventions to be carried out with precision at the site of an identified abnormality.
One of the most common interventions is a biopsy, where a small sample of tissue is collected for laboratory analysis. Using the live images, a physician can guide tiny forceps or a needle through the working channel to the exact location of a suspicious growth or lesion. This ensures that the tissue sample is taken from the precise area of concern for an accurate diagnosis.
Another procedure guided by these images is a bronchoalveolar lavage, or bronchial washing. In this process, a saline solution is flushed through the bronchoscope into a specific segment of the lung and then suctioned back out. The images ensure the fluid is directed to the correct area, and the collected fluid, now containing cells and other materials from the small air sacs, can be tested for infections or other conditions. Visual guidance is also applied when removing obstructions, such as mucus plugs or foreign objects, using suction catheters or small grasping tools.