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Distribution of alveolar‐interstitial syndrome in dogs and cats with respiratory distress as assessed by lung ultrasound versus thoracic radiographs
Author(s) -
Ward Jessica L.,
Lisciandro Gregory R.,
DeFrancesco Teresa C.
Publication year - 2018
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12750
Subject(s) - medicine , quadrant (abdomen) , lung , lung ultrasound , ultrasound , radiography , tachypnea , respiratory distress , respiratory disease , radiology , nuclear medicine , surgery , tachycardia
Objective To assess distribution of alveolar‐interstitial syndrome (AIS) detected by lung ultrasound (LUS) compared to thoracic radiographs (TXR). Design Prospective study. Setting University teaching hospital. Animals Seventy‐six dogs and 24 cats with acute respiratory distress or tachypnea. Interventions Patients underwent LUS and TXR within 6 hours. Lung ultrasound images were scored for presence and quantity of B‐lines in 4 lung quadrants (right cranial, right caudal, left cranial, left caudal). An individual LUS quadrant was scored positive if > 3 B‐lines were observed within a single intercostal space. Dorsoventral TXR were scored for presence of AIS in the same 4 quadrants. An individual TXR quadrant was scored positive if infiltrate was present in ≥ 25% of the quadrant. Medical records were evaluated for final diagnosis. Measurements and Main Results Quadrant‐by‐quadrant spatial agreement in assigning AIS using LUS versus TXR was fair ( K = 0.24 – 0.56). Lung ultrasound scored a higher number of quadrants positive per patient (2.65 ± 1.59 vs. 2.13 ± 1.48; P = 0.012). Patterns of distribution of AIS differed significantly based on final diagnosis. Patients with left‐sided congestive heart failure were more likely to have diffuse AIS on LUS ( P < 0.001) or bilateral caudal AIS on TXR ( P = 0.04) while patients with noncardiac disease were more likely to have absence of AIS in all quadrants using either modality ( P < 0.001). Differences in spatial distribution of AIS were also noted among disease subcategories. Conclusions Lung ultrasound and TXR were both useful to detect and categorize distribution of alveolar or interstitial pulmonary pathology. Spatial agreement between modalities was only fair. Overall, LUS detected a higher incidence of AIS compared to TXR. Both modalities detected differences in distribution of AIS based on final diagnosis, suggesting that a regional pattern‐based approach to thoracic imaging may prove diagnostically useful.