Reexpansion Pulmonary Edema

Abstract

To determine the computed tomography (CT) imaging features of reexpansion pulmonary edema. A retrospective review was performed of 22 consecutive patients with clinical and radiologic features consistent with reexpansion pulmonary edema (14 male, 8 female; mean age, 56±22.8 y; range, 19 to 82 y) and with available CT scan images within 3 days of drainage of pleural effusion or pneumothorax. The CT images were reviewed by 2 chest radiologists with consensus for the presence, extent, and distribution of ground-glass opacities, septal thickening, consolidation, presence of persistent areas of atelectasis, vascular caliber, linear opacities, residual midline shift, and trapped lung. CT findings included ipsilateral ground-glass opacities (n=21, 95%), smooth septal thickening (n=17, 77%), consolidation (n=14, 68%), and persistent foci of atelectasis (n=19, 86%). Less commonly seen features included air-bronchograms (n=6, 27%) and nodules (n=5, 23%) [centrilobular, n=4 (18%); random, n=1 (4.5%)]. Contralateral abnormalities were seen in 8 cases (36%) and included ground-glass opacities in 6 patients, interlobular septal thickening in 3 patients (13.6%), and consolidation in 3 patients. The most common CT findings of reexpansion pulmonary edema include ipsilateral ground-glass opacities, septal thickening, foci of consolidation, and areas of atelectasis.