MEDIASTINAL LYMPHADENOPATHY AND HAZY MEDIASTINAL FAT - NEW CT FINDINGS OF CONGESTIVE-HEART-FAILURE

OBJECTIVE. We describe two new CT findings of congestive heart failure (CHF): enlarged mediastinal lymph nodes and hazy heterogeneous medias tinal fat. MATERIALS AND METHODS. Forty-six patients were retrospectiv ely identified who had major and minor clinical signs of congestive he art failure and had undergone chest CT during their symptomatic period . Two radiologists reviewed the CT studies and by consensus documented the presence or absence of imaging findings of CHF, including interst itial abnormalities, vascular redistribution, axial thickening, pleura l effusions, cardiac enlargement, and mediastinal abnormalities. RESUL TS. Smooth septal thickening, bilateral pleural effusions, vascular re distribution, and cardiac enlargement were the most common CT findings in patients with CHE Enlarged mediastinal lymph nodes and hazy medias tinal fat were seen in 55% and 33% of cases, respectively. In a cohort of 17 patients with elevated pressures in the pulmonary capillary wed ge documented within 24 hr of CT, CT scans revealed lymphadenopathy in 14 patients (82%) and inhomogeneous fat in 10 patients (59%). CONCLUS ION. Enlarged mediastinal lymph nodes and hazy mediastinal fat occur i n patients with CHF and are revealed by CT. Lymphadenopathy in patient s with CHF does not necessarily indicate malignancy or an infectious p rocess.