title: Pulmonary oedema associated with mitral regurgitation: prevalence of predominant right upper lobe involvement in children.
abstract: OBJECTIVE
  To evaluate the hypothesis that pulmonary venous congestion and oedema manifested predominantly in the right upper lobe in children with mitral regurgitation occur more frequently than previously thought.
  
  
  METHODS
  Three radiologists retrospectively and independently reviewed the plain chest radiographs of 54 children (26 girls, 28 boys, age range 2 days-18 years, median 9.5 years) with mitral regurgitation admitted to our institution during a 5-year period. Radiographs showing pulmonary venous congestion and oedema manifested predominantly in the right upper lobe were identified. Clinical records of these patients were studied to exclude other causes of pulmonary disease.
  
  
  RESULTS
  Radiographic signs of pulmonary venous congestion and oedema were present in all patients, with redistribution of flow and interstitial oedema in 39 patients (72 %) and alveolar oedema in 15 children (28 %). In 12 (22 %) of 54 children, these findings were localised or predominant in the upper lobe of the right lung; none of the children had predominantly left-sided involvement.
  
  
  CONCLUSIONS
  Pulmonary venous congestion and oedema involving predominantly the upper lobe of the right lung in children with mitral regurgitation occur more frequently than previously thought. This finding is useful in the differential diagnosis of right upper lobe abnormalities, such as pneumonia.
authors.affiliation: Department of Radiology, University Hospital (CHUV), CH-1011 Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Gudinchet
authors.forename: P
authors.initials: P
authors.lastname: Rodoni
authors.forename: A
authors.initials: A
authors.lastname: Sarraj
authors.forename: M
authors.initials: M
authors.lastname: Payot
authors.forename: P
authors.initials: P
authors.lastname: Schnyder
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications*; D011654:Pulmonary Edema / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D011859:Radiography