Characteristics of images from CT scans in elderly patients with acute cardiogenic pulmonary edema

Abstract

<b>Purpose:</b> Heart failure as a comorbidity with pneumonia is highly prevalent in elderly patients. We conducted a study to evaluate the patterns images from CT scans in elderly patients with acute cardiogenic pulmonary edema (ACPE). <b>Materials and Methods:</b> From January 1, 2015, through December 31, 2017, we studied 92 elderly patients, aged 75 years old or more, who were admitted to our hospital, and diagnosed with ACPE upon admission. The patients were categorized in two groups: those with an ejection fraction of less than 50 percent (heart failure with reduced ejection fraction; HFrEF) and those with an ejection fraction of more than 50 percent (heart failure with preserved ejection fraction; HFpEF). The mean diameters of the ostial pulmonary vein (PV) were measured, and the images from CT scans were evaluated. The cutoff value of the diameter of the ostial PV for differentiating patients with ACPE from age- an sex- matches controlled patients was evaluated by a receiver operating curve (ROC) analysis. <b>Results:</b> ROC analysis found that an ostial PV cutoff of 13 mm had a sensitivity of 100%, a specificity of 99.8%, an accuracy of 98.8%, and an area under the ROC curve of 0.99. Approximately 90% of the ACPE patients showed bilateral pleural effusions. Forty-seven percent of the patients had an EF of more than 50%. Patients with HFpEF were less likely to have interlobular thickening. <b>Conclusions:</b> Dilating ostial PV and bilateral pleural effusions are useful for recognizing ACPE in images from CT scans.

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