Acute pulmonary oedema on CT

Case contributed by Dr Andrew Dixon

Presentation

Cardiac arrest.

Patient Data

Age: 45
Gender: Female
X-ray

Bilateral perihilar (batwing) airspace opacity typical of acute pulmonary oedema. Kerley B lines are also well seen consistent with interstitial oedema. The main pulmonary artery is dilated. ETT and NGT are appropriately positioned. 

CT

CT Pulmonary Angiogram

Airspace opacity in a central peribronchovascular distribution classic of acute pulmonary oedema. There is also smooth thickening of the interlobular septae in the lung bases and apices consistent with interstitial pulmonary oedema and correlating with the radiographic finding of Kerley lines. There is dilatation of the main pulmonary artery and right heart enlargement / strain with straightening of the interventricular septum. Pulmonary hypertension was subsequently confirmed. 

Case Discussion

Nice example of acute pulmonary oedema on CT which helps explain the typical chest radiograph appearance of this important condition. This patient had a cardiac arrest precipitated by previously undiagnosed primary pulmonary hypertension.  

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Case information

rID: 33582
Case created: 16th Jan 2015
Last edited: 24th Nov 2015
System: Chest
Inclusion in quiz mode: Included

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