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Objective To compare the chest computed tomography (CT) images of patients with acute respiratory distress syndrome (ARDS) and acute cardiogenic pulmonary edema (ACPE).Methods 30 cases of patients with ARDS and 30 cases of patients with ACPE from August 2016 to August 2018 were randomly selected.All patients underwent thoracic CT examination.The distributions of grinded glass density shadow (GGO) in the lungs and changes of extrapulmonary structure were statistically analyzed.Results The differences of distributions of GGO in the upper lobe,middle lobe,lower lobe and diffuse distribution between patients with ARDS and ACPE were not significant [16.7％ (5/30),0,16.7％ (5/30),66.7％ (20/30) vs 20.0％ (6/30),0,20.0％ (6/30),60.0％ (18/30),P ＞0.05].The distributions of GGO in center lung [13.3％ (4/30)] was significantly lower than patients with ACPE [46.7％ (14/30)] (P ＜0.05),while the uniform distribution rate [76.7％ (23/30)] was significantly higher than patients with ACPE [46.7％ (14/30)] (P ＜ 0.05),but distribution of GGO in the right side,left side,bilateral even in peripheral distribution of GGO in lung between patients with ARDS and ACPE were not significant [10.0％ (3/30),6.7％ (2/30),16.7％ (5/30),23.3％ (7/30),60.0％ (18/30) vs 23.3％ (7/30),16.7％ (5/30) and 60.0％ (18/30),P ＞ 0.05].The small boundary opacity of patients with ARDS [76.7％ (23/30)] was significantly higher than patients with ACPE [26.7％ (8/30)] (P ＜ 0.05),while the bronchial blood bundle thickening,pulmonary vascular shadow thickening,cardiac shadow enlargement,pericardial effusion were significantly lower than patients with ACPE [33.3％ (10/30),16.7％ (5/30),30.0％ (9/30),23.3％ (7/30) vs 23.3％ (7/30),100.0％ (30/30),70.0％ (21/30),73.3％ (22/30),53.3％ (16/30),P ＜0.05].Conclusions The chest CT images of patients with ARDS and ACPE are different,mainly manifestated in small boundary opacity,bronchial blood bundle thickening,pulmonary vascular opacity,cardiac opacity,pericardial effusion.
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Objective@#To compare the chest computed tomography (CT) images of patients with acute respiratory distress syndrome (ARDS) and acute cardiogenic pulmonary edema (ACPE).@*Methods@#30 cases of patients with ARDS and 30 cases of patients with ACPE from August 2016 to August 2018 were randomly selected. All patients underwent thoracic CT examination. The distributions of grinded glass density shadow (GGO) in the lungs and changes of extrapulmonary structure were statistically analyzed.@*Results@#The differences of distributions of GGO in the upper lobe, middle lobe, lower lobe and diffuse distribution between patients with ARDS and ACPE were not significant [16.7%(5/30), 0, 16.7%(5/30), 66.7%(20/30) vs 20.0%(6/30), 0, 20.0%(6/30), 60.0%(18/30), P>0.05]. The distributions of GGO in center lung [13.3%(4/30)] was significantly lower than patients with ACPE [46.7%(14/30)] (P<0.05), while the uniform distribution rate [76.7%(23/30)] was significantly higher than patients with ACPE [46.7%(14/30)] (P<0.05), but distribution of GGO in the right side, left side, bilateral even in peripheral distribution of GGO in lung between patients with ARDS and ACPE were not significant [10.0%(3/30), 6.7%(2/30), 16.7%(5/30), 23.3%(7/30), 60.0%(18/30) vs 23.3%(7/30), 16.7%(5/30) and 60.0%(18/30), P>0.05]. The small boundary opacity of patients with ARDS [76.7%(23/30)] was significantly higher than patients with ACPE [26.7%(8/30)] (P<0.05), while the bronchial blood bundle thickening, pulmonary vascular shadow thickening, cardiac shadow enlargement, pericardial effusion were significantly lower than patients with ACPE [33.3% (10/30), 16.7%(5/30), 30.0%(9/30), 23.3%(7/30) vs 23.3%(7/30), 100.0%(30/30), 70.0%(21/30), 73.3%(22/30), 53.3%(16/30), P<0.05].@*Conclusions@#The chest CT images of patients with ARDS and ACPE are different, mainly manifestated in small boundary opacity, bronchial blood bundle thickening, pulmonary vascular opacity, cardiac opacity, pericardial effusion.
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INTRODUÇÃO: A cardiopatia chagásica (CC) é um importante problema de saúde pública na América do Sul e a patogênese desta doença ainda não é totalmente compreendida, mas a inflamação e a fibrose miocárdica participam de forma central no processo crônico e progressivo de dano miocárdico. Trabalho prévio de nosso grupo demonstrou a capacidade da Ressonância Magnética Cardiovascular (RMC) de identificar precisamente a fibrose miocárdica em pacientes com Doença de Chagas. A RMC demonstrou ser eficaz para avaliar edema miocárdico, como marcador de inflamação, e ser altamente sensível para a detecção de trombos intracavitários, especialmente no ventrículo esquerdo, e em outras patologias, como miocardites e infartos. A avaliação de edema miocárdio pela RMC em pacientes com CC não foi ainda avaliada na literatura. Nosso objetivo foi investigar a presença de edema e fibrose miocárdica nas três formas clínicas da CC, o que julgamos ser de potencial valor diagnóstico e prognóstico. MÉTODOS: Cinquenta e quatro pacientes com doença de chagas foram analisados: 16 pacientes com a forma indeterminada (FI), 17 pacientes com CC-SD e 21 pacientes com CC-CD. Todos os pacientes foram submetidos a exame de RMC em equipamento de 1,5 T, utilizando a sequência de realce tardio do miocárdio (RTM), a sequência de edema miocárdico (Spin-eco ponderado em T2) e a sequência de realce global precoce ponderado T1 pós-contraste, para identificar fibrose, edema e hiperemia miocárdicos, respectivamente. RESULTADOS: A fibrose miocárdica foi encontrada em 39 indivíduos, 72,2% de toda a amostra. A fibrose miocárdica foi detectada em 2 pacientes (12,5%) na forma indeterminada, com uma massa de fibrose média de 0,85 ± 2,47g. Os pacientes da forma CC-SD em sua quase totalidade - 16 pacientes (94,1%) - apresentaram fibrose, com uma massa média de 13,0 ± 10,8g. Todos os pacientes com a forma CC-CD apresentaram fibrose miocárdica (21 pacientes) e adicionalmente detinham a maior massa de fibrose média,...
BACKGROUND AND PURPOSE: Chagas' heart disease (CHD) is a major public health problem in South America, and the pathogenesis of this disease is not yet fully understood, but inflammation and myocardial fibrosis seem to play a central role in the process of chronic and progressive myocardial damage. Previous descriptions from our group demonstrated the ability of Cardiovascular Magnetic Resonance (CMR) accurately identify myocardial fibrosis in patients with CHD. CMR shown to be effective for assessing myocardial edema, a marker of inflammation, and is highly sensitive for the detection of thrombi, especially in the left ventricle in other pathologies such as myocarditis and myocardial infarct. The assessment of myocardial edema by CMR in patients with CHD has not been evaluated. We believe to be of potential diagnostic and prognostic value to investigate the presence of myocardial edema and fibrosis in patients in the three clinical forms of this disease. METHODS: Fifty-four patients with Chagas' disease were analyzed: 16 patients with the indeterminate phase (IF), 17 patients with the cardiac form without left ventricular systolic dysfunction (CFWO), and 21 patients with the cardiac form with left ventricular systolic dysfunctional form (CFSD). All patients underwent 1.5-T cardiac magnetic resonance (CMR) using the myocardial delayed enhancement sequence (MDE), T2-weighted sequence and the T1 weighted global enhancement after contrast sequence, to identify fibrosis, edema and hyperemia, respectively. RESULTS: Myocardial fibrosis was found in 39 subjects, 72.2% of the entire sample. Myocardial fibrosis was detected in 2 patients (12.5%) with the indeterminate form, representing an average mass of fibrosis of 0.85 ± 2.47 g. Patients with the CFWO almost entirely, 16 patients (94.1%) showed fibrosis, representing an average mass of fibrosis of 13.0 ± 10.8 g. All patients with the CFSD had myocardial fibrosis (21 patients) additionally had greater average mass...
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Humans , Male , Female , Adult , Chagas Cardiomyopathy , Chagas Disease , Edema, Cardiac , Fibrosis , Hyperemia , Magnetic Resonance ImagingABSTRACT
Objective: To evaluate the therapeutic effect of acupoint sticking with Chinese herbs for edema due to chronic cardiac failure. Methods: One hundred and seventy patients in conformity with the diagnostic criteria of edema due to chronic cardiac failure were randomly divided into two groups, 85 cases in each group. The observation group was treated by oral administration of diuretics plus acupoint sticking with Chinese herbs. The control group was treated just by oral administration of diuretics same as the observation group. The therapeutic effects were evaluated after continuous intervention for 14 d. Results: The total effective rate was 90.6% in the observation group, remarkably higher than 67.1% in the control group. The difference of overall therapeutic effect between the two groups was statistically significant (P Conclusion: The therapeutic effect of acupoint sticking with Chinese herbs plus oral administration of diuretics is better than simple oral administration of diuretics in treatment of edema due to chronic cardiac failure.