Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure

• 作者: Cardinale L Moretti F Priola AM Volpicelli G
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: 呼吸困难 ULTRASONOGRAPHY 紧急情况部门 肺疾病 Interstitial/ultrasonography 肺的浮肿 /X 光线照相术 肺的 edema/ultrasonography 心失败 / 复杂并发症 心 Failure/ultrasonography
• 年，卷（期）: 2014,（6）
• 页码范围: 230-237
• 页数: 8页
• 分类号: R

摘要

Hydrostatic pulmonary edema is as an abnormal in-crease in extravascular water secondary to elevatedpressure in the pulmonary circulation, due to conges-tive heart failure or intravascular volume overload.Diagnosis of hydrostatic pulmonary edema is usuallybased on clinical signs associated to conventional ra-diography findings. Interpretation of radiologic signsof cardiogenic pulmonary edema are often question-able and subject. For a bedside prompt evaluation,lung ultrasound(LUS) may assess pulmonary conges-tion through the evaluation of vertical reverberationartifacts, known as B-lines. These artifacts are relatedto multiple minimal acoustic interfaces between smallwater-rich structures and alveolar air, as it happens incase of thickened interlobular septa due to increase of extravascular lung water. The number, diffusion and in-tensity of B lines correlates with both the radiologic andinvasive estimate of extravascular lung water. The inte-gration of conventional chest radiograph with LUS canbe very helpful to obtain the correct diagnosis. Com-puted tomography(CT) is of limited use in the work upof cardiogenic pulmonary edema, due to its high cost,little use in the emergencies and radiation exposure.However, a deep knowledge of CT signs of pulmonaryedema is crucial when other similar pulmonary condi-tions may occasionally be in the differential diagnosis.