title: Objective radiographic criteria to differentiate cardiac, renal, and injury lung edema.
abstract: To assess the value of the chest radiograph in differentiating various types of pulmonary edema, we retrospectively analyzed 119 films of patients with pulmonary edema caused by left heart decompensation (group 1;N = 56), renal failure (group 2; N = 19), and lung microvascular injury (group 3; N = 44). Chest radiographs were examined independently by two trained observers, unaware of the clinical diagnosis, according to a standardized reading table. The two observers assigned chest films to the corresponding group with an accuracy of 86% and 90%, respectively. To test the observers' objectivity, we used radiographic findings as input variables for discriminant analysis. Computer-generated numerical functions identified pulmonary edema etiology with an accuracy of 88% when considering the three groups together. When groups were compared as pairs, percentages of correct classification were 91% (group 1 vs. group 2), 93% (group 1 vs. group 3), and 100% (group 2 vs. group 3). Thus, a standardized reading of chest radiographs may be considered a reliable clinical method for identifying pulmonary edema etiology.
authors.affiliation: CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Miniati
authors.forename: M
authors.initials: M
authors.lastname: Pistolesi
authors.forename: P
authors.initials: P
authors.lastname: Paoletti
authors.forename: C
authors.initials: C
authors.lastname: Giuntini
authors.forename: M D
authors.initials: MD
authors.lastname: Lebowitz
authors.forename: A E
authors.initials: AE
authors.lastname: Taylor
authors.forename: E N
authors.initials: EN
authors.lastname: Milne
mesh_terms: D006333:Heart Failure / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D011654:Pulmonary Edema / Q000000981:diagnostic imaging* / Q000209:etiology; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000150:complications; D012189:Retrospective Studies; D013223:Statistics as Topic