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Fat Embolism Syndrome: Lung Computed Tomography Findings in 18 Patients
Marco Piolanti1, Giorgia Dalpiaz, Mariano Scaglione
1From the *UOC Radiologia Ospedale Maggiore Area Nord Ovest; †Radiologia Ospedale Bellaria, AUSL Bologna, Bologna; and ‡Department of Imaging, Pineta Grande Medical Center, Castel Volturno, Italy; §Dartford & Gravesham NHS Trust, Dartford, UK; ∥Rianimazione e 118 and ¶Dipartimento di Ortopedia, Ospedale Maggiore, AUSL Bologna; and #Struttura Complessa di Pneumologia Interventistica, Dipartimento Cardio-Toraco-Vascolare, AOSP Bologna, Bologna, Italy.
Objective:
The purpose of this study was to evaluate the lung computed tomography (CT) findings in fat embolism (FE) syndrome.
Methods:
We retrospectively evaluated 19 CT examinations of 18 patients with FE syndrome, diagnosed clinically using the Gurd and Wilson criteria.
Result:
Fat embolism syndrome showed 3 patterns: negative examination, bilateral interstitial-alveolar involvement, and adult respiratory distress syndrome like. Frequent findings included consolidations (17 patients), mostly with gravity dependent distribution, and ground-glass opacities (17 patients), mostly with patchy distribution. Fifteen patients showed an overlapping random nodular pattern. Less common findings included lobular ground-glass opacities and lobular consolidations, smooth septal thickening, thickening of the bronchial wall, and areas of crazy paving. The extension of the consolidations correlates with the duration of assisted ventilation.
Conclusions:
In FE syndrome, pulmonary CT findings are ground-glass opacities and dependent consolidations, associated with other variably overlapping signs, such as lobular opacities, random nodules, septal thickening, and bronchial wall thickening.
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