A patient with decompensated left ventricular failure has symmetrical perihilar airspace opacity with relative sparing of the lung bases. What is this radiographic pattern called?
- A Miliary pattern
- B Bat-wing (butterfly) pattern of pulmonary oedema ✓
- C Air bronchogram of consolidation
- D Reverse bat-wing pattern
Correct answer: B. Bat-wing (butterfly) pattern of pulmonary oedema
Explanation
Cardiogenic pulmonary oedema classically produces symmetric perihilar alveolar opacity with basal sparing, termed the bat-wing or butterfly pattern, reflecting gravity-dependent distribution of hydrostatic oedema. The reverse bat-wing pattern describes peripheral consolidation with perihilar sparing, typical of organising pneumonia or chronic eosinophilic pneumonia, which distinguishes it from option D.
Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.
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