Adult respiratory distress syndrome profiles by computed tomography

Ten patients with full-blown ARDS, on mechanical ventilation with PEEP underwent lung CT. Seven normal subjects were also studied. Three tomographic levels (apex, hilum, and base) were selected. The most consistent morphologic finding in ARDS was the presence of densities in the dependent regions of the lung. Assuming that the three levels were a representative sample of the whole lung, the lung weight was computed from the mean CT number and lung gas volume. Analysis of the CT number frequency distribution revealed three definite patterns of distribution: type 1, bimodal, with one mode in the normal CT number range; type 2, unimodal narrow distribution, with the mode in the CT range of water; and type 3, unimodal broad distribution in the abnormal CT number range.