Storto M L, Kee S T, Golden J A, Webb W R
Department of Radiology, Ospedale SS. Annunziata, Chieti, Italy.
AJR Am J Roentgenol. 1995 Oct;165(4):817-20. doi: 10.2214/ajr.165.4.7676973.
Hydrostatic pulmonary edema can be defined as an abnormal increase in extravascular water secondary to elevated pressure in the pulmonary circulation, as in congestive heart failure or intravascular volume overload. The diagnosis of hydrostatic pulmonary edema is usually based on clinical information, conventional chest radiograph findings, and response to treatment and does not require high-resolution CT. However, recognizing the appearance of hydrostatic pulmonary edema on high-resolution CT can be important, as the edema can mimic other diseases or can occur as an unsuspected finding in patients having high-resolution CT for other indications, and a misdiagnosis may lead to unnecessary lung biopsy. Although the CT appearances of pulmonary edema have been described in several studies [1-3], to date, the high-resolution CT appearances of hydrostatic pulmonary edema have been described only in isolated cases [4-6] or in experimental studies of phantom or animal models [7, 8]. This essay illustrates the spectrum of high-resolution CT findings seen in adult patients with hydrostatic pulmonary edema secondary to cardiac disease.
静水压性肺水肿可定义为肺循环压力升高继发的血管外水分异常增加,如在充血性心力衰竭或血管内容量超负荷时。静水压性肺水肿的诊断通常基于临床信息、传统胸部X线片表现以及对治疗的反应,并不需要高分辨率CT。然而,认识高分辨率CT上静水压性肺水肿的表现可能很重要,因为这种水肿可能会模仿其他疾病,或者在因其他指征进行高分辨率CT检查的患者中作为意外发现出现,误诊可能导致不必要的肺活检。尽管多项研究[1-3]描述了肺水肿的CT表现,但迄今为止,仅在个别病例[4-6]或模型或动物模型的实验研究[7, 8]中描述了静水压性肺水肿的高分辨率CT表现。本文阐述了成年心脏病患者继发静水压性肺水肿时高分辨率CT表现的范围。