The advent of helical computerized tomography (CT) has allowed for volumetric data acquisition with markedly improved multiplanar reconstruction as well as three dimensional rendering. Post-processing software has permitted changing the viewer frame of reference thus allowing direct visualization of the inside of large airways or so called virtual bronchoscopy. Air within the lumen supplies contrast; however, in bronchial tree branches, the walls are thin thereby reducing contrast and resolution. We hypothesized that the instillation of a dose of liquid perflubron (LiquiVent®, Alliance Pharm Corp, San Diego, CA) would increase airway contrast and therefore increase airway resolution. To test this hypothesis, we compared helical CT images in an anesthetized, intubated, adolescent New Zealand rabbit model during mechanical gas ventilation at end inspiration and expiration. Imaging was performed without and with 15 ml/kg of perflubron in the lungs. A Picker PQ 5000 helical CT scanner was used and targeted 10 cm FOV, 3mm slice thickness, with a pitch of 1.25, images reconstructed every 3mm with a smooth spatial reconstruction algorithm, and mA/kVp of 200/120. The bronchoscopic CT without perflubron only allowed visualization of the first 2 generations with poor resolution of 3rd order branches and beyond. In contrast, images with perflubron permitted improved resolution of the tracheobronchial tree to the 5th order branches. These preliminary studies demonstrate that perflubron liquid in the lungs can enhance bronchoscopic CT images of the tracheobronchial tree by improving contrast and resolution of more distal generations of airways. This new innovation represents a potentially favorable combination of perfluorochemicals as contrast medium with the emerging technology of virtual bronchoscopy. (Perflubron provided by Alliance Pharm Corp & Hoechst Marion Roussel)