CT predictors of mortality in pathology confirmed ARDS
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Jonathan H. Chung & Richard L. Kradin & Reginald E. Greene & Jo-Anne O. Shepard & Subba R. Digumarthy
- چاپ و سال / کشور: 2010
Description
Objectives To identify CT findings that predict mortality in acute respiratory distress syndrome (ARDS) and to identify CT findings that differentiate diffuse alveolar damage (DAD) from DAD with prominent histopathological features of organizing pneumonia (DAD-OP). Methods Twenty-eight patients with ARDS (corroborated by open biopsy) and chest CT within 2 weeks of biopsy were included in our study. Differences in CT findings in patients with survivors versus nonsurvivors as well as for DAD versus DAD-OP were compared using Fisher’s exact test. Results Lung involvement of greater than 80%, RA/LA ratio >1, and varicoid traction bronchiectasis were statistically more common in nonsurvivors than in survivors (respective p values of 0.001, 0.008, and 0.038). PA dilation greater than 3 cm and RV/LV ratio greater than 0.9 were also more common in nonsurvivors than in survivors but these factors did not achieve significance. CT findings did not differentiate DAD from DAD-OP. Conclusion Our study suggests that >80% of lung involvement, RA/LA ratio >1, and varicoid bronchiectasis predict mortality in patients with ARDS/DAD. Signs of right-sided heart failure (PA dilation greater than 3 cm and RV/LV ratio greater than 0.9) approached significance. CT findings did not differentiate DAD from DAD-OP.
Eur Radiol (2011) 21:730–737 DOI 10.1007/s00330-010-1979-0 Received: 26 June 2010 / Revised: 11 August 2010 / Accepted: 7 September 2010 / Published online: 7 October 2010
