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May 1, 1985American Journal of Roentgenology

The radiologic distinction of cardiogenic and noncardiogenic edema

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Why the study?

Does evaluation of specific radiographic features on plain chest films accurately distinguish cardiogenic from noncardiogenic pulmonary edema in patients with pulmonary edema?

Population

119 patients with pulmonary edema with 216 chest radiographs

Design

Cross-sectional, independent two-observer study

Authors

MEMilne EnUniversity of California, Irvine Medical CenterMPMassimo PistolesiUniversity of FlorenceMMMassimo MiniatiUniversity of Florence

Discussion

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Implication

May aid radiographic differentiation of edema types; leaves open prospective validation before changing practice.

Key Points

  • To determine whether specific radiographic features on plain chest films can accurately distinguish between cardiogenic and noncardiogenic causes of pulmonary edema without invasive monitoring.
  • Conducted an independent two-observer evaluation of 216 chest radiographs from 119 patients: 61 with cardiac disease, 30 with renal failure or overhydration, and 28 with capillary permeability edema.
  • Evaluated three principal radiographic features (distribution of pulmonary flow, distribution of pulmonary edema, vascular pedicle width) and seven ancillary features (including pulmonary blood volume, septal lines, and heart size).
  • Overall diagnostic accuracy for determining the specific cause of pulmonary edema ranged from 86% to 89% between observers.
  • Diagnostic accuracy reached 91% for differentiating capillary permeability edema from other varieties, and 81% for distinguishing chronic cardiac failure from renal failure.

Structured PICO

Does evaluation of specific radiographic features on plain chest films accurately distinguish cardiogenic from noncardiogenic pulmonary edema in patients with pulmonary edema?

P
Population
119 patients with pulmonary edema (61 with cardiac disease, 30 with renal failure or overhydration, and 28 with capillary permeability edema) with 216 chest radiographs
I
Intervention
Evaluation of plain chest radiographs using 3 principal features (distribution of pulmonary flow, distribution of pulmonary edema, width of vascular pedicle) and 7 ancillary features
O
Outcome
Accuracy of determining the specific cause of pulmonary edemasurrogate

Careful evaluation of specific radiographic features on plain chest films can accurately distinguish between cardiogenic and noncardiogenic causes of pulmonary edema.

Cite This Study

En et al. (1985) studied this question.

synapsesocial.com/papers/6a7cfe04c54fa5ab9c3b3f74https://doi.org/10.2214/ajr.144.5.879
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