Mediastinal lymphadenopathy in congestive heart failure: a sequential CT evaluation with clinical and echocardiographic correlations

被引:29
作者
Chabbert, V
Canevet, G
Baixas, C
Galinier, M
Deken, V
Duhamel, A
Otal, P
Joffre, F
Remy, J
Remy-Jardin, M
机构
[1] Univ Toulouse, Dept Radiol, F-31403 Toulouse, France
[2] Univ Toulouse, Dept Cardiol, F-31403 Toulouse, France
[3] Univ Lille, Dept Med Stat, F-59037 Lille, France
关键词
mediastinal lymph nodes; congestive heart failure; CT;
D O I
10.1007/s00330-003-2168-1
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
The aim of this study was to evaluate the frequency and evolution after treatment of mediastinal lymphadenopathy associated with congestive left heart failure on CT scans in correlation with clinical and echocardiographic findings. Thirty-one consecutive patients with subacute left heart failure underwent a clinical evaluation using the NYHA classification, a CT examination, and transthoracic echocardiography at the time of initial presentation (T1). After initiation of medical treatment (T2), follow-up CT scans were systematically obtained together with a clinical evaluation. At T1, all patients showed severe (type III: n=12, 39%; type IV: n=12, 39%) to moderate (type I, n=1, 3%; type II, n=6, 19%) dyspnea with a mean ejection fraction of 39% (range 22-74%). On initial CT scans, enlarged mediastinal lymph nodes were seen in 13 patients (42%) with blurred contours in 5 patients (16%) and hazy mediastinal fat in 1 patient (3%). Significant decrease in the size of lymphadenopathy was observed between T1 and T2 (T1, n=13, 42% vs T2, n=10, 32%; p<0.05) with a concurrent decrease in the severity of dyspnea (grade III-IV dyspnea at T1, n=24, 78% vs grade I-II dyspnea at T2, n=26, 83.5%). Patients with enlarged lymph nodes at T1 showed: (a) a significantly lower ejection fraction at echocardiography than those without lymphadenopathy (mean+/-SD value: 34+/-12.9 vs 43+/-13.8%; p=0.04); (b) a significantly larger diameter of the right superior pulmonary vein (mean+/-SD value: 17+/-2.75 vs 14+/-3.9 mm; p=0.04); and (c) a higher frequency of abnormal peribronchovascular thickening (n=5 vs n=1; p=0.06). Mediastinal lymphadenopathy associated with subacute left heart failure was observed in 13 patients (42%), showing regression after initiation of treatment in 8 of 13 patients (62%).
引用
收藏
页码:881 / 889
页数:9
相关论文
共 12 条
[1]   CAPTOPRIL-ASSOCIATED LYMPHADENOPATHY [J].
ABERG, H ;
MORLIN, C ;
FRITHZ, G .
BRITISH MEDICAL JOURNAL, 1981, 283 (6302) :1297-1298
[2]   Lymph flow in sheep with rapid cardiac ventricular pacing [J].
Drake, RE ;
Dhother, S ;
Teague, RA ;
Gabel, JC .
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, 1997, 272 (05) :R1595-R1598
[3]  
FRASER RS, 1999, DIS CHEST, V3, P1946
[4]   COMPARISON OF MAGNETIC-RESONANCE IMAGING AND ECHOCARDIOGRAPHY IN DETERMINATION OF CARDIAC DIMENSIONS IN NORMAL SUBJECTS [J].
FRIEDMAN, BJ ;
WATERS, J ;
KWAN, OL ;
DEMARIA, AN .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1985, 5 (06) :1369-1376
[5]   NORMAL MEDIASTINAL LYMPH-NODES - NUMBER AND SIZE ACCORDING TO AMERICAN-THORACIC-SOCIETY MAPPING [J].
GLAZER, GM ;
GROSS, BH ;
QUINT, LE ;
FRANCIS, IR ;
BOOKSTEIN, FL ;
ORRINGER, MB .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1985, 144 (02) :261-265
[6]   DIRECT CANNULATION AND INJECTION LYMPHANGIOGRAPHY OF THE CANINE CARDIAC AND PULMONARY EFFERENT MEDIASTINAL LYMPHATICS IN EXPERIMENTAL CONGESTIVE HEART-FAILURE [J].
LEEDS, SE ;
UHLEY, HN ;
TELESZKY, LB .
INVESTIGATIVE RADIOLOGY, 1981, 16 (03) :193-200
[7]   Transient mediastinal enlargement: An unusual computed tomographic manifestation of pulmonary venous hypertension and congestive heart failure [J].
Miller, JA ;
Contractor, S ;
Maldjian, P ;
Wolansky, L .
RESPIRATION, 2000, 67 (02) :216-218
[8]   Benign mediastinal lymphadenopathy in congestive heart failure [J].
Ngom, A ;
Dumont, P ;
Diot, P ;
Lemarié, E .
CHEST, 2001, 119 (02) :653-656
[9]   Nonmalignant diagnoses in patients - Case 1. Mediastinal lymphadenopathy associated with congestive heart failure [J].
Partridge, A ;
Nasser, S ;
Dzik, S .
JOURNAL OF CLINICAL ONCOLOGY, 2000, 18 (13) :2635-2636
[10]   PULMONARY PARENCHYMAL ABNORMALITIES OF VASCULAR ORIGIN - HIGH-RESOLUTION CT FINDINGS [J].
PRIMACK, SL ;
MULLER, NL ;
MAYO, JR ;
MAYO, JR ;
REMYJARDIN, M ;
REMY, J .
RADIOGRAPHICS, 1994, 14 (04) :739-746