Roentgen examination plays an important role in the diagnosis and differential diagnosis of pulmonary edema of different types. Especially in the pulmonary edema in uremic patients, the diagnosis is mandatory. The first roentgenologic description of this type of edema in uremic patients was given by ROUBIER and PLAUCHAU (1934). Contributions by many authors, since then (HODSON 1950, SCHINZ et coll. 1952, ZALDIVAR & FARIGAS 1954, OLSSON 1954), have clearly distinguished it from congestive pulmonary changes in heart failure. The uremic pulmonary edema is characterized by central changes, surrounded by a free peripheral zone of normal lung parenchyma, 2 to 4 cm in thickness and slightly broader at the lobe limits (Fig. 1). I t has been called 'butterfly edema' or 'bat's wing shadow edema'. Such pictorial names obviously do not belong in scientific radiology, and in this case do not correspond to the most characteristic roentgenologic feature, i. e. the central location of the changes, which are very marked in the hilar region around the tracheal bifurcation and corresponding parts of the esophagus. The initial changes are therefore usually best demonstrated in a lateral view. The heart size is often normal.
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