Gudinchet F, Rodoni P, Sarraj A, Payot M, Schnyder P
Department of Radiology, University Hospital (CHUV), CH-1011 Lausanne, Switzerland.
Pediatr Radiol. 1998 Apr;28(4):260-2. doi: 10.1007/s002470050346.
To evaluate the hypothesis that pulmonary venous congestion and oedema manifested predominantly in the right upper lobe in children with mitral regurgitation occur more frequently than previously thought.
Three radiologists retrospectively and independently reviewed the plain chest radiographs of 54 children (26 girls, 28 boys, age range 2 days-18 years, median 9.5 years) with mitral regurgitation admitted to our institution during a 5-year period. Radiographs showing pulmonary venous congestion and oedema manifested predominantly in the right upper lobe were identified. Clinical records of these patients were studied to exclude other causes of pulmonary disease.
Radiographic signs of pulmonary venous congestion and oedema were present in all patients, with redistribution of flow and interstitial oedema in 39 patients (72 %) and alveolar oedema in 15 children (28 %). In 12 (22 %) of 54 children, these findings were localised or predominant in the upper lobe of the right lung; none of the children had predominantly left-sided involvement.
Pulmonary venous congestion and oedema involving predominantly the upper lobe of the right lung in children with mitral regurgitation occur more frequently than previously thought. This finding is useful in the differential diagnosis of right upper lobe abnormalities, such as pneumonia.
评估关于二尖瓣反流患儿中主要表现为右上叶肺静脉充血和水肿的发生率比以往认为的更高这一假说。
三位放射科医生回顾性且独立地审查了5年间我院收治的54例二尖瓣反流患儿（26例女孩，28例男孩，年龄范围2天至18岁，中位数9.5岁）的胸部X线平片。识别出显示主要表现为右上叶肺静脉充血和水肿的X线片。研究这些患者的临床记录以排除肺部疾病的其他病因。
所有患者均有肺静脉充血和水肿的影像学表现，39例患者（72%）有血流重新分布和间质水肿，15例患儿（28%）有肺泡水肿。在54例患儿中的12例（22%），这些表现局限于或主要位于右肺上叶；没有患儿主要累及左肺。
二尖瓣反流患儿中主要累及右肺上叶的肺静脉充血和水肿比以往认为的更常见。这一发现有助于鉴别右上叶异常，如肺炎。
