Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations
Adult respiratory distress syndrome due to pulmonary and extrapulmonary causes: CT, clinical, and functional correlations
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DOI：
10.1148/radiology.213.2.r99nv42545
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发表时间：
1999-11-01
期刊：
影响因子：
19.7
通讯作者：
Pesenti, A
中科院分区：
文献类型：
--
作者：
Goodman, LR;Fumagalli, R;Pesenti, A
目的：评估肺部疾病引起的成人呼吸窘迫综合征 (ARDS(p)) 和肺外疾病导致的成人呼吸窘迫综合征 (ARDS(EXP)) 之间 CT 表现的差异，并确定 ARDS 的不同表现是否部分归因于最初的肺部和全身原因。 材料和方法：33 名患者，其中 22 名患有 ARDS(p)，11 名患有 ARDS(EXP)，在术后不久接受了螺旋 CT插管。两名读者评估了图像中肺部混浊的类型、范围和分布；次要发现；以及与生存和生理参数的相关性。结果：在两种ARDS(p)中。和 ARDS(EXP) 中，大约 80% 的肺部出现异常。在 ARDS(P) 中，毛玻璃样混浊和实变同样普遍，而在 ARDS(EXP) 中，毛玻璃样混浊占主导地位。磨玻璃混浊分布均匀，而实变往往发生在背部和尾部。 ARDS(P) 经常引起不对称实变，而 ARDS(EXP) 则引起对称毛玻璃样混浊。空气支气管征几乎是普遍存在的。一半患者出现胸腔积液，Kerley B 线和气肿并不常见。肺实变与平均动脉氧分压与吸入氧分数的比率、分流分数和肺动脉压相关。死亡患者往往有更多的实变和不对称病变。结论：ARDS(P) 往往是不对称的，混合有实变和毛玻璃样混浊，而 ARDS(EXP) 主要有对称的毛玻璃样混浊。在两组中，胸腔积液和空气支气管征很常见，Kerley B 线和气肿不常见。
PURPOSE: To assess the differences in CT appearance between adult respiratory distress syndrome due to pulmonary disease (ARDS(p)) and that clue to extrapulmonary disease (ARDS(EXP)) and determine whether the variable appearances of ARDS are due, in part, to the initial pulmonary and systemic causes.MATERIALS AND METHODS: Thirty-three patients, 22 with ARDS(p) and 11 with ARDS(EXP), underwent helical CT shortly after intubation. Two readers evaluated images for the type, extent, and distribution of pulmonary opacities; secondary findings; and correlation with survival and physiologic parameters.RESULTS: In both ARDS(p). and ARDS(EXP), approximately 80% of the lung was abnormal. In ARDS(P), ground-glass opacification and consolidation were equally prevalent, whereas in ARDS(EXP) ground-glass opacification was dominant. Ground-glass opacification was evenly distributed, whereas consolidation tended to be dorsal and caudal. ARDS(P) often caused asymmetric consolidation, whereas ARDS(EXP) caused symmetric ground-glass opacification. Air bronchograms were almost universal. Pleural effusions were present in one-half of the patients, and Kerley B lines and pneumatoceles were uncommon. Lung consolidation correlated with the ratio of mean partial pressure of arterial oxygen to fraction of inspired oxygen, shunt fraction, and pulmonary arterial pressure. The patients who died tended to have more consolidation and asymmetric disease.CONCLUSION: ARDS(P) tends to be asymmetric, with a mix of consolidation and ground-glass opacification, whereas ARDS(EXP) has predominantly symmetric ground-glass opacification. In both groups, pleural effusions and air bronchograms are common, and Kerley B lines and pneumatoceles are uncommon.