PULMONARY-EDEMA ASSOCIATED WITH MITRAL REGURGITATION - PREVALENCE OF PREDOMINANT RIGHT UPPER LOBE INVOLVEMENT IN CHILDREN

Objective. To evaluate the hypothesis that pulmonary venous congestion and oedema manifested predominantly in the right upper lobe in childr en with mitral regurgitation occur more frequently than previously tho ught. Materials and methods. Three radiologists retrospectively and in dependently reviewed the plain chest radiographs of 54 children (26 gi rls, 28 boys, age range 2 days-18 years, median 9.5 years) with mitral regurgitation admitted to our institution during a 5-year period. Rad iographs showing pulmonary venous congestion and oedema manifested pre dominantly in the right upper lobe were identified. Clinical records o f these patients were studied to exclude other causes of pulmonary dis ease. Results. Radiographic signs of pulmonary venous congestion and o edema were present in all patients, with redistribution of Row and int erstitial oedema in 39 patients (72 %) and alveolar oedema in 15 child ren (28 %). In 12 (22 %) of 54 children, these findings were localised or predominant in the upper lobe of the right lung; none of the child ren had predominantly left-sided involvement. Conclusions. Pulmonary v enous congestion and oedema involving predominantly the upper lobe of the right lung in children with mitral regurgitation occur more freque ntly than previously thought. This finding is useful in the differenti al diagnosis of right upper lobe abnormalities, such as pneumonia.