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the radiology of heart failure before looking at any x-rays or cts its important to go back to basic anatomy this is the secondary pulmonary lobule which is about 1 to two centimeters in diameter in the center of the secondary pulmonary lobule youve got pulmonary artery and a bronchus and they are of the same magnitude in the periphery youve got the pulmonary vein and the lymphatics and the periphery includes the interlobular septum so the vein and the art and the lymphatics actually run in the interlobular septum and note that the vein is red because it carries oxygenated blood and the artery is blue because it carries deoxygenated blood so for the purposes of heart failure you need to remember the interlobular septum because this is where fluid is going to collect in the case of pulmonary venous hypertension so if youve got some resistance to pulmonary venous backflow back to the left atrium because of heart failure you get pulmonary venous hypertension and plasma and fluid leaks