Comparative study of CT radiopathology of high altitude pulmonary edema

    WANG Wei1,CHEN Huiª²Wu2,WEI Jingª²Guo1,WANG Jinª²Wu2,GONG Li3,LU Zhou1,LIU Ziª²Hui2,ZHAO Yao2,TAN Jian2

    1Department of Radiology,3Department of Pathology,Tangdu Hospital,Fourth Military Medical University,Xi¬ðan 710038£¬China,2Department of Radiology,General Hospital of Tibet Command,Lasa 850003,China

    ¡¾Abstract¡¿ AIM: To explore the CT radiological features and the pathology of the high altitude pulmonary edema (HAPE).METHODS: Thirtyª²two patients with HAPE and 35 patients with lobular pneumonia were included in this study.The manifestations and changes of different stages of the course were observed continuously with regular chest CT and thin layer CT.The pulmonary tissue samples were collected from 6 subjects,whose HAPEª²caused deaths were confirmed by autopsy.The lung was incised coronally at the hilum level and the samples were taken from the internal,central and external zones including the upper,middle and lower dimensions in sequence.The pathological changes were then compared between the pulmonary samples and the HRCT images of the same tissue structure.RESULTS: Twentyª²eight of the 32 patients with HAPE demonstrated significant pathological changes in their right lungs while only 14 of the 35 patients with lobular pneumonia did (P<0ª±01).In the early and recovery stages of AHAPE,the subjects mainly showed abnormal interstitial tissues in the lungs (32/32 and 25/32,respectively) while in the developing and stable stages,the consolidation of the lung tissue was the main manifestation (30/32 and 32/32,respectively).The manifestation of the consolidation in the course of HAPE developed gradually from ¡°groundedª²glass¡± appearance in the lobules to nodular consolidation,and then to large area consolidation.Pathological examination showed the exudates along with fibril,erythrocytes and inflammatory cells in the alveoli and with broadened interª²alveolar space and stasis of blood in the dilated capillaries.Three subjects showed fibrin embolus,4 subjects had transparent membrane formation in the lungs and 5 subjects demonstrated patchy or localized bleeding.CONCLUSION: The early stage of HAPE can be detected with the CT scan,which can also accurately determine the course of the disease and assess the treatment effects. ......