J Korean Soc Radiol.  2019 Jul;80(4):740-749. 10.3348/jksr.2019.80.4.740.

Computed Tomographic Features of Lung Parenchyma Over Time after Cardiopulmonary Resuscitation

• Ryu HM
• Yoo JY
• Kim SJ

• KMID: 2457451
• DOI: http://doi.org/10.3348/jksr.2019.80.4.740

Abstract

PURPOSE
To identify the key CT features of lung parenchyma over time after cardiopulmonary resuscitation (CPR).
MATERIALS AND METHODS
In total, 72 patients underwent CT after CPR. Because the median time from return of spontaneous circulation (ROSC) to CT was 1 h 3 min, we divided patients into two groups: ≤ 1 h (group 1) and > 1 h (group 2), based on the ROSC to CT time. We analyzed and compared various lung parenchymal CT findings between groups.
RESULTS
Each group included 36 patients. Using statistical analysis, we identified seven statistically significant imaging features. Gradient (p = 0.010), lobular gradient (p = 0.017), diffuse pattern (p = 0.000), upper distribution (p = 0.032), and peripheral portion sparing (p = 0.000) were more common in group 1 than in group 2. Dependent density (p = 0.010) and lobular consolidation (p = 0.010) were more common in group 2 than in group 1.
CONCLUSION
The gradient and lobular gradient tended to disappear over time after ROSC. In terms of distribution, a diffuse pattern with upper predominance and peripheral portion sparing tended to disappear over time. However, the dependent density and lobular consolidation tended to increase over time in the lung parenchyma after CPR.

MeSH Terms

Cardiopulmonary Resuscitation*
Humans
Lung*

Figure

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  Fig. 1 CT features of a 91-year-old woman whose return of spontaneous circulation to CT interval was 17 min; lobular gradient in both upper lobes. On chest CT with lung setting, ground-glass attenuation is seen; this is nearly absent in the anterior part of the secondary pulmonary lobules and becomes thicker toward the dependent portion of the secondary pulmonary lobules (lobular gradient, arrows) in both upper lobes.

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  Fig. 2 CT features of a 53-year-old man whose return of spontaneous circulation to CT interval was 38 min; lobular gradient (arrow) and a gradient in the left upper lobe.

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  Fig. 3 CT features of a 1-year-old boy whose return of spontaneous circulation to CT interval was 1 h 22 min; lobular consolidation in the right middle and both lower lobes. On chest CT with lung setting, consolidation fills the secondary pulmonary lobules, without a gradient (arrows).

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  Fig. 4 CT features of a 79-year-old woman whose return of spontaneous circulation to CT interval was 2 h 21 min, with only dependent density in both lower lobes. On chest CT with lung settings, there are consolidations in dependent portion of both lower lobes (arrows).

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