You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Computed Tomography Findings in Septic Patients With Acute Respiratory Distress Syndrome: Correlation With Survival and Pulmonary Versus Extrapulmonary Septic Focus

Stelter, Lars MD*; Steffen, Ingo MD*; Pinkernelle, Jens G. MD*; von Dossow-Hanfstingl, Vera MD; Kastrup, Marc MD; Denecke, Timm MD*; Grieser, Christian MD*

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e318295d0c8
Thoracic Imaging

Objective: The objective of this study was to evaluate computed tomography (CT) findings in patients with sepsis with unknown inflammatory focus and acute respiratory distress syndrome.

Methods: Acute respiratory distress syndrome findings on CT of 36 patients with sepsis were graded on a 6-point scale, and the percentage of affected lung was estimated. Resulting CT scores were correlated to intensive care scores and survival.

Results: Forty-four percent of the patients died, revealing a significantly higher CT score than survivors (P = 0.01). Survivors showed larger areas of unaffected lung (P < 0.001), whereas patients with fatal outcome had more ground-glass opacities (P = 0.002; sensitivity, 73%; specificity, 57%) and traction bronchiectasis (P = 0.009; sensitivity, 54%; specificity, 68%). Pulmonary findings on CT did not allow discriminating between a pulmonary and extrapulmonary focus. No significant coherence between CT score and intensive care scores could be revealed.

Conclusions: A CT scoring system based on pulmonary findings in patients with sepsis with acute respiratory distress syndrome comprises prognostic implications in terms of the patients’ survival.

Author Information

From the *Klinik für Radiologie, Charité–Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin; †Klinik für Anaesthesiologie, Klinikum der Universität München, Ludwig-Maximilian-Universität München, München; and ‡Klinik für Anästhesiologie mit Schwerpunkt Operative Intensivmedizin, Charité–Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.

Received for publication February 5, 2013; accepted April 2, 2013.

Reprints: Lars Stelter, MD, Klinik für Radiologie, Charité–Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany (e-mail:

Drs Stelter and Steffen contributed equally to this work.

All authors disclose no potential conflict of interest.

© 2013 by Lippincott Williams & Wilkins