Acute respiratory distress syndrome caused by pulmonary and extrapulmonary injury: A comparative CT study

被引:72
作者
Desai, SR
Wells, AU
Suntharalingam, G
Rubens, MB
Evans, TW
Hansell, DM
机构
[1] Royal Brompton Hosp, Dept Radiol, London SW3 6NP, England
[2] Royal Brompton Hosp, Interstitial Lung Dis Unit, London SW3 6NP, England
[3] Royal Brompton Hosp, Intens Care Unit, London SW3 6NP, England
关键词
computed tomography (CT); electron beam; lung; CT; respiratory distress syndrome; adult; (ARDS);
D O I
10.1148/radiology.218.3.r01mr31689
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To determine computed tomographic (CT) differences between acute respiratory distress syndrome (ARDS) due to pulmonary injury (ARDS(p)) and extrapulmonary injury (ARDS(ex)). MATERIALS AND METHODS: CT appearances in 41 patients (27 male, 14 female; mean age, 47.1 years +/- 17.1 [SD]; age range, 17-79 years; those with ARDS(p), n = 16; those with ARDS(ex), n = 25) were categorized as typical or atypical of ARDS by two observers. The extent of individual CT patterns was also quantified. RESULTS: Typical CT appearances were more frequent in ARDS(ex) than ARDS(p) (18 [72%] of 25 vs five [31%] of 16 patients, respectively; P < .01). Sensitivity, specificity, and accuracy of a typical CT pattern for the diagnosis of ARDS(ex) were 72%, 69%, and 71%, respectively. Atypical appearances were characterized by more extensive nondependent intense parenchymal opacification (IPO) (P = .03) and cysts (P = .05), whereas typical CT appearances had more extensive dependent IPO (P = .01). Typical appearances at CT were independently related to the cause of ARDS (odds ratio, 8.9; 95% CI: 1.8, 44.2; P < .01) but were independent of the time from intubation. Foci of nondependent IPO were more extensive in ARDS(p) (P = .05) than ARDS(ex), but this finding was ascribable to differences in time to CT (after intubation) between ARDS(p) and ARDS(ex). CONCLUSION: The differentiation between ARDS(p) and ARDS(ex) can, with some caveats, be based on whether the CT appearances are typical or atypical of ARDS but not on any individual CT pattern in isolation.
引用
收藏
页码:689 / 693
页数:5
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