Slanetz P J, Truong M, Shepard J A, Trotman-Dickenson B, Drucker E, McLoud T C
Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
AJR Am J Roentgenol. 1998 Nov;171(5):1307-9. doi: 10.2214/ajr.171.5.9798869.
We describe two new CT findings of congestive heart failure (CHF): enlarged mediastinal lymph nodes and hazy heterogeneous mediastinal fat.
Forty-six patients were retrospectively identified who had major and minor clinical signs of congestive heart failure and had undergone chest CT during their symptomatic period. Two radiologists reviewed the CT studies and by consensus documented the presence or absence of imaging findings of CHF, including interstitial abnormalities, vascular redistribution, axial thickening, pleural effusions, cardiac enlargement, and mediastinal abnormalities.
Smooth septal thickening, bilateral pleural effusions, vascular redistribution, and cardiac enlargement were the most common CT findings in patients with CHF. Enlarged mediastinal lymph nodes and hazy mediastinal fat were seen in 55% and 33% of cases, respectively. In a cohort of 17 patients with elevated pressures in the pulmonary capillary wedge documented within 24 hr of CT, CT scans revealed lymphadenopathy in 14 patients (82%) and inhomogeneous fat in 10 patients (59%).
Enlarged mediastinal lymph nodes and hazy mediastinal fat occur in patients with CHF and are revealed by CT. Lymphadenopathy in patients with CHF does not necessarily indicate malignancy or an infectious process.
我们描述充血性心力衰竭（CHF）的两种新的CT表现：纵隔淋巴结肿大和纵隔脂肪模糊不均。
回顾性纳入46例有充血性心力衰竭主要和次要临床体征且在症状期接受胸部CT检查的患者。两位放射科医生对CT研究进行了评估，并通过共识记录了CHF影像学表现的有无，包括间质异常、血管再分布、轴位增厚、胸腔积液、心脏增大和纵隔异常。
平滑间隔增厚、双侧胸腔积液、血管再分布和心脏增大是CHF患者最常见的CT表现。纵隔淋巴结肿大和纵隔脂肪模糊分别见于55%和33%的病例。在CT检查后24小时内记录到肺毛细血管楔压升高的17例患者队列中，CT扫描显示14例患者（82%）有淋巴结病，10例患者（59%）有脂肪不均匀。
CHF患者会出现纵隔淋巴结肿大和纵隔脂肪模糊，CT可显示这些表现。CHF患者的淋巴结病不一定表明存在恶性肿瘤或感染性病变。
