Acute pulmonary edema on CT

Case contributed by Andrew Dixon
Diagnosis certain


Cardiac arrest.

Patient Data

Age: 45 years
Gender: Female

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

CT Pulmonary Angiogram


Airspace opacity in a central peribronchovascular distribution classic of acute pulmonary edema. There is also smooth thickening of the interlobular septae in the lung bases and apices consistent with interstitial pulmonary edema 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 edema 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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