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Original Research |

Diffuse Parenchymal Lung Disease on Chest Radiographs and CT

Theodore J. Dubinsky, MD, FSRU, FSAR; Hardik Shah, MD; Rachelle Sonneborn, BA; Daniel S. Hippe, MS
Author and Funding Information

The authors have no conflicts of interest to disclose

Laurence A. Mack Endowed Professor of Radiology, Obstetrics and Gynecology University of Washington Department of Radiology

Department of Radiology

Department of Radiology

Department of Radiology

Corresponding author: Theodore J. Dubinsky MD, FSRU,FSAR Laurence A. Mack Endowed Professor of Radiology, Obstetrics and Gynecology University of Washington Department of Radiology; Box 357115 Pacific Ave NW Seattle WA 98195, .


Copyright 2017, . All Rights Reserved.


Chest. 2017. doi:10.1016/j.chest.2017.05.003
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Published online

Abstract

Background  We prospectively identified B-lines in patients undergoing ultrasound examinations following liver transplants who also had a chest x-ray (CXR) and/or chest CT scan on the same day to determine if an association between the presence of B-lines s from the thorax on ultrasound images correlates with the presence of pulmonary abnormalities on chest radiographs.

Materials and Methods  Following IRB approval, patients undergoing routine postoperative liver transplant ultrasound examinations and a CXR and/or CT scan on the same day between 1/1/2015 through 7/1/2016 were prospectively identified.Two readers blinded to CXR and CT images and reports independently reviewed the US. Inter-reader agreement for presence/absence of the B-lines was evaluated for the presence or absence of diffuse parenchymal lung disease on CXR and CT, as well as on clinical evaluation. Receiver operating characteristic (ROC) curves were constructed.

Results  There was good agreement between the two readers on the presence/absence of B-lines (kappa: 0.94) The area under the ROC curve (AUC) for discriminating between DPLD+ and DPLD- for both readers was 0.79 (95% CI: 0.71-0.87.

Conclusion  There is an association between the presence of extensive B-lines to the point of confluence and “dirty shadowing” on ultrasound examinations of the chest and associated findings on chest radiographs and CT scans of diffuse parenchymal lung disease. Conversely, isolated B-lines do not always correlate with abnormalities on chest X-ray or and in fact appear sometimes to be a normal variant.


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