[Contribution of radiology in nonhemodynamic pulmonary edemas]. / Apport de la radiologie dans les oedèmes pulmonaires non hémodynamiques

The radiological appearances of non-hemodynamic, lesional edema are univoco; interstitial-type pictures, alveolar-type pictures, either successively or combined, in terms of the intensity or duration of the alveolo-capillary membrane lesions. Inflation of the interstitial medium is reflected by the appearance of Kerley B lines, haziness of the vascular contours and sometimes an axillary bordering line due to subpleural edema. Capillary congestion with increase in permeability especially to proteins and the tearing of connective tissue explains these pictures. In the following stage, edema is alveolar with hazy diffuse, unorganised and confluent opacities. These opacities can predominate in the bases, or take on a butterfly-wing distribution. At this stage atelectatic lesions can be superadded due to inactivation of surfactant. Finally, in the later periods the appearance of interstitial pulmonary fibrosis with fibrinous deposits and fibroblastic proliferation can be noted. The chest X-ray is the objective reflection of the disorders; in enables the making of a diagnosis, and the drawing up of a complete check of the lesions and supervision of its course.