Gambaran Radiologi yang ditemukan: 1. Pelebaran atau penebalan hilus (dilatasi vascular di hilus)

2. Coarakan paru meningkat (lebih dari 1/3 lateral)

3. Hilus suram (batas tidak jelas)

4. Interstitial fibrosis (gambaran seperti granuloma-granuloma kecil atau nodul milier)

Pulmonary edema on CT-scan (coronal MPR)

Figure 1. Increased hydrostatic pressure edema ina 33-year-old man with acute myelocytic leukemiawho was admitted for fluid overload with renal andcardiac failure. Successive chest radiographs demonstrateprogressive lobar vessel enlargement, peribronchialcuffing (arrows in b), bilateral Kerley lines (arrowheadsin c), and late alveolar edema with nodularareas of increased opacity. The fluid overload is confirmedby the increasing size of the azygos vein.

Figure 2. Increased hydrostatic pressureedema in a 53-year-old man withpostoperative fluid overload. Pulmonarycapillary wedge pressure was 20mm Hg. High-resolution computedtomographic (CT) scan demonstratesinter- and intralobar septal lines predominatingin the anterior portion ofthe left lung field with some peribronchialcuffing (arrow). Both lungs displaydiffuse ground-glass areas of increasedattenuation with a gravitationalanteroposterior gradient.

Figures 3, 4. (3) Bat wing edema in a 71-year-old woman with fluid overload and cardiac failure. Chest radiograph(a) and high-resolution CT scan (b) demonstrate bat wing alveolar edema with a central distribution andsparing of the lung cortex. The infiltrates resolved within 32 hours. (4) Bat wing edema in a 66-year-old womanwith fluid overload of renal origin who was undergoing hemodialysis for hypertensive nephroangiosclerosis.The patient was found unconscious after lying on her right side for several hours. Chest radiograph shows unusualrecumbent bat wing pulmonary edema with associated right-sided pleural effusion.

Figures 5, 6. (5) Asymmetric pulmonary edema in a male patient with marked chronic obstructive pulmonarydisease. Unenhanced CT scans obtained with lung parenchymal (a) and mediastinal (b) windows depict the edemaas areas of diffuse ground-glass attenuation with an anteroposterior gradient. Fluid-filled subpleural bullae arebest seen in b (lower left). (Courtesy of Prof J. Remy, Department of Radiology, Hopital Calmette, Lille, France.)(6) Asymmetric pulmonary edema in a 70-year-old man with end-stage fibrosis and bullous emphysema due to asbestosiswho was admitted for cardiac failure. On a chest radiograph, the pulmonary edema infiltrates predominateat the lung bases because pulmonary blood flow is diverted to these regions by the upper lobe bullae. Thefibrotic interstitial changes from asbestosis facilitate the entry of edema into the alveolar spaces.

Pulmonary edema with acute asthma

Figure 8. Asymmetric pulmonary edema in a 37-yearoldwoman who had undergone orthopedic interventionof the femur in the right lateral decubitus position.The patient received 12 liters of blood during surgery.Chest radiograph demonstrates right-sided predominanceof the pulmonary edema.

Figure 9. Pulmonary edema with acute asthma in a3-year-old child. Chest radiograph demonstrates heterogeneouspulmonary edema associated with peribronchialcuffing, ill-defined vessels, enlarged and illdefinedhila, and alveolar areas of increased opacity.

Figure 7. Asymmetric pulmonary edemain a 64-year-old woman with grade 3 mitralinsufficiency. High-resolution CT scanshows pulmonary edema predominantlywithin the right upper lobe.

Figure 13. Pulmonary edema in a 5-year-old boy whowas admitted 1 hour after nearly drowning in chlorinatedwater. (a) Chest radiograph obtained at the timeof admission reveals cardiac enlargement, diffuse confluentalveolar patterns of pulmonary edema, and peribronchialcuffing. (b, c) Chest radiograph (b) and highresolutionCT scan (c) obtained 3 hours later demonstratea marked decrease in pulmonary edema, althoughit still predominates in the dependent portions of thelungs. The cortical lung is remarkably free of interstitialedema, a finding that may suggest either direct alveolardamage from the inhaled water or edema followinglaryngospasm rather than secondary damage from theassociated hypoxia. The laryngospasm was probablythe major component given the rapid clearing of theareas of increased opacity.

Figure 20. Neurogenic pulmonary edema in a 54-year-old woman who was admitted for intracranial hemorrhagedue to arterial hypertension. (a) Chest radiograph obtained at the time of admission shows airspace consolidations

predominantly at the apices. There are no pleural effusions or Kerley lines, and heart size is normal.(b) High-resolution CT scan obtained at the same time demonstrates confluent alveolar consolidations in thecentral portions of the lungs. A few thickened interlobular septa are also seen (arrows).