ICU Chest Films > Fluid in the Chest > Pulmonary Edema > Cephalization


The initial phase of cardiogenic pulmonary edema is manifested as redistribution of the pulmonary veins. This is know as cephalization because the pulmonary veins of the superior zone dilate due to increased pressure. This diagnosis is made when the upper lobe vessels are equal to or larger in diameter than the lower lobe vessels. The diagnosis of cephalization is more difficult in the supine patient due to gravitational effects.

This chest film demonstrates cephalization of the pulmonary vessels.

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