Hydrostatic pulmonary edema: high-resolution CT findings

Abstract

Hydrostatic pulmonary edema can be defined as an abnormal increase in extravascular water secondary to elevated pressure in the pulmonary circulation, as in congestive heart failure or intravascular volume overload. The diagnosis of hydrostatic pulmonary edema is usually based on clinical information, conventional chest radiograph findings, and response to treatment and does not require high-resolution CT. However, recognizing the appearance of hydrostatic pulmonary edema on high-resolution CT can be important, as the edema can mimic other diseases or can occur as an unsuspected finding in patients having high-resolution CT for other indications, and a misdiagnosis may lead to unnecessary lung biopsy. Although the CT appearances of pulmonary edema have been described in several studies [1-3], to date, the high-resolution CT appearances of hydrostatic pulmonary edema have been described only in isolated cases [4-6] or in experimental studies of phantom or animal models [7, 8]. This essay illustrates the spectrum of high-resolution CT findings seen in adult patients with hydrostatic pulmonary edema secondary to cardiac disease.