• 1.

    Lichtenstein D, Meziere G, Biderman P, et al. The comet-tail artifact: an ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 1997;156:16401646.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultra-sound. Intensive Care Med 2012;38:577591.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Prosen G, Klemen P, Štrnad M, et al. Combination of lung ultrasound (a comet-tail sign) and N-terminal pro-brain natriuretic peptide in differentiating acute heart failure from chronic obstructive pulmonary disease and asthma as cause of acute dyspnea in prehospital emergency setting. Crit Care 2011;15:R114.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Ward JL, Lisciandro GR, Keene BW, et al. Accuracy of point-of-care lung ultrasonography for the diagnosis of cardiogenic pulmonary edema in dogs and cats with acute dyspnea. J Am Vet Med Assoc 2017;250:666675.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Ward JL, Lisciandro GR, Ware WA, et al. Evaluation of point-of-care thoracic ultrasound and NT-proBNP for the diagnosis of congestive heart failure in cats with respiratory distress. J Vet Intern Med 2018;32:15301540.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Ward JL, Lisciandro GR, Ware WA, et al. Lung ultrasonography findings in dogs with various underlying causes of cough. J Am Vet Med Assoc 2019;255:574583.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Vitturi N, Soattin M, Allemand E, et al. Thoracic ultrasonography: a new method for the work-up of patients with dyspnea. J Ultrasound 2011;14:147151.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Gargani L. Lung ultrasound: a new tool for the cardiologist. Cardiovasc Ultrasound 2011;9:6.

  • 9.

    Gargani L, Frassi F, Soldati G, et al. Ultrasound lung comets for the differential diagnosis of acute cardiogenic dyspnoea: a comparison with natriuretic peptides. Eur J Heart Fail 2008;10:7077.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Lisciandro GR, Fulton RM, Fosgate GT, et al. Frequency and number of B-lines using a regionally based lung ultrasound examination in cats with radiographically normal lungs compared to cats with left-sided congestive heart failure. J Vet Emerg Crit Care (San Antonio) 2017;27:499505.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Manson WC, Bonz JW, Carmody K, et al. Identification of sonographic B-lines with linear transducer predicts elevated B-type natriuretic peptide level. West J Emerg Med 2011;12:102106.

    • Search Google Scholar
    • Export Citation
  • 12.

    Liteplo AS, Marill KA, Villen T, et al. Emergency thoracic ultra-sound in the differentiation of the etiology of shortness of breath (ETUDES): sonographic B-lines and N-terminal pro-brain-type natriuretic peptide in diagnosing congestive heart failure. Acad Emerg Med 2009;16:201210.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Volpicelli G, Mussa A, Garofalo G, et al. Bedside lung ultra-sound in the assessment of alveolar-interstitial syndrome. Am J Emerg Med 2006;24:689696.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Peris A, Tutino L, Zagli G, et al. The use of point-of-care bedside lung ultrasound significantly reduces the number of radiographs and computed tomography scans in critically ill patients. Anesth Analg 2010;111:687692.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Gargani L, Lionetti V, DiCristofano C, et al. Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets. Crit Care Med 2007;35:27692774.

    • Search Google Scholar
    • Export Citation
  • 16.

    Ward JL, Lisciandro GR, DeFrancesco TC. Distribution of alveolar-interstitial syndrome in dogs and cats with respiratory distress as assessed by lung ultrasound versus thoracic radio-graphs. J Vet Emerg Crit Care (San Antonio) 2018;28:415 428.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Al Deeb M, Barbic S, Featherstone R, et al. Point-of-care ultra-sonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med 2014;21:843852.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Lichtenstein D. Lung ultrasound in acute respiratory failure an introduction to the BLUE-protocol. Minerva Anestesiol 2009;75:313317.

    • Search Google Scholar
    • Export Citation
  • 19.

    Jambrik Z, Monti S, Coppola V, et al. Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 2004;93:12651270.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Platz E, Pivetta E, Merz AA, et al. Impact of device selection and clip duration on lung ultrasound assessment in patients with heart failure. Am J Emerg Med 2015;33:15521556.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Lisciandro GR, Fosgate GT, Fulton RM. Frequency and number of ultrasound lung rockets (B-lines) using a regionally based lung ultrasound examination named Vet BLUE (Veterinary Bedside Lung Ultrasound Exam) in dogs with radio-graphically normal lung findings. Vet Radiol Ultrasound 2014;55:315322.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Armenise A, Boysen RS, Rudloff E, et al. Veterinary-focused assessment with sonography for trauma—airway, breathing, circulation, disability and exposure: a prospective observational study in 64 canine trauma patients. J Small Anim Pract 2019;60:173182.

    • Search Google Scholar
    • Export Citation
  • 23.

    Rademacher N, Pariaut R, Pate J, et al. Transthoracic lung ultrasound in normal dogs and dogs with cardiogenic pulmonary edema: a pilot study. Vet Radiol Ultrasound 2014;55:447452.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Vezzosi T, Mannucci T, Pistoresi A, et al. Assessment of lung ultrasound B-lines in dogs with different stages of chronic valvular heart disease. J Vet Intern Med 2017;31:700704.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Hori Y, Yamashita Y, Sakakibara K, et al. Usefulness of pericardial lung ultrasonography for the diagnosis of cardiogenic pulmonary edema in dogs. Am J Vet Res 2020;81:227232.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Neelis D, Mattoon J, Nyland T. Thorax. In: Mattoon J, Nyland T, eds. Small animal diagnostic ultrasound. 3rd ed. St Louis: Elsevier, 2015;188216.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Lisciandro GR. The Vet BLUE lung scan. In: Lisciandro GR, ed. Focused ultrasound techniques for the small animal practitioner. Ames, Iowa: Wiley-Blackwell, 2014;166187.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Mattoon J, Nyland T. Fundamentals of diagnostic ultrasound. In: Mattoon J, Nyland T, ed. Small animal diagnostic ultra-sound. 3rd ed. St Louis: Elsevier, 2015;149.

    • Search Google Scholar
    • Export Citation
  • 29.

    Kremkau F. Transducers. In: Kremkau F, ed. Sonography: principles and instruments. 9th ed. St Louis: Elsevier, 2015;4261.

  • 30.

    Lisciandro G, Armenise A. Focused or COAST – Cardiopulmo-nary Resuscitation (CPR), Global FAST (GFAST) & the FAST-ABCDE Exam. In: Focused ultrasound for the small animal practitioner. Ames, Iowa: Wiley-Blackwell, 2014;269285.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Murphy SD, Ward JL, Viall AK, et al. Utility of point-of-care lung ultrasound for monitoring cardiogenic pulmonary edema in dogs. J Vet Intern Med 2021;35:6877.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 2008;134:117125.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Altman DG. Practical statistics for medical research. London: Chapman and Hall, 1991;404.

  • 34.

    Chavez MA, Shams N, Ellington LE, et al. Lung ultrasound for the diagnosis of pneumonia in adults: a systematic review and meta-analysis. Respir Res 2014;15:50.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Volpicelli G, Caramello V, Cardinale L, et al. Bedside ultra-sound of the lung for the monitoring of acute decompensated heart failure. Am J Emerg Med 2008;26:585591.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Cibinel GA, Casoli G, Elia F, et al. Diagnostic accuracy and reproducibility of pleural and lung ultrasound in discriminating cardiogenic causes of acute dyspnea in the emergency department. Intern Emerg Med 2012;7:6570.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Comparison of curvilinear-array (microconvex) and phased-array transducers for ultrasonography of the lungs in dogs

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  • 1 From the Department of Veterinary Clinical Sciences and Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA 50011
  • | 2 From the Department of Hill Country Veterinary Specialists, Spicewood, TX 78699
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27695

Abstract

OBJECTIVES

To compare the use of curvilinear-array (microconvex) and phased-array transducers for ultrasonographic examination of the lungs in dogs.

ANIMALS

13 client-owned dogs with left-sided congestive heart failure.

PROCEDURES

In a prospective methods comparison study, 24 ultrasonographic examinations of the lungs (4 sites/hemithorax) were performed with both curvilinear-array and phased-array transducers at 3 clinical time points. Two observers independently assessed the number of B lines (scored per site and in total), number of sites strongly positive for B lines (ie, those with > 3 B lines/site), and image quality (scored on a 5-point scale). Analyses included assessment of interobserver agreement with κ analysis, comparison of quality scores between transducers with mixed-effects modeling, and investigation of agreement and bias for B-line data and quality scores between transducers with Passing-Bablok regression.

RESULTS

Interobserver agreement for total B-line scores and number of strong-positive sites was excellent (κ > 0.80) for both transducers. There was no evidence of analytic bias for the number of B lines or strong-positive sites between transducers. Interobserver agreement for image quality scores was moderate (κ, 0.498 and 0.517 for the curvilinear-array and phased-array transducers, respectively). Both observers consistently assigned higher-quality scores to curvilinear-array images than to phased-array images.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated both curvilinear-array (microconvex) and phased-array transducers can be used by experienced sonographers to obtain diagnostic ultrasonographic images of the lungs in dogs with acute or resolving left-sided congestive heart failure and suggested the former transducer may be preferred, particularly to aid identification of anatomic landmarks for orientation.

Abstract

OBJECTIVES

To compare the use of curvilinear-array (microconvex) and phased-array transducers for ultrasonographic examination of the lungs in dogs.

ANIMALS

13 client-owned dogs with left-sided congestive heart failure.

PROCEDURES

In a prospective methods comparison study, 24 ultrasonographic examinations of the lungs (4 sites/hemithorax) were performed with both curvilinear-array and phased-array transducers at 3 clinical time points. Two observers independently assessed the number of B lines (scored per site and in total), number of sites strongly positive for B lines (ie, those with > 3 B lines/site), and image quality (scored on a 5-point scale). Analyses included assessment of interobserver agreement with κ analysis, comparison of quality scores between transducers with mixed-effects modeling, and investigation of agreement and bias for B-line data and quality scores between transducers with Passing-Bablok regression.

RESULTS

Interobserver agreement for total B-line scores and number of strong-positive sites was excellent (κ > 0.80) for both transducers. There was no evidence of analytic bias for the number of B lines or strong-positive sites between transducers. Interobserver agreement for image quality scores was moderate (κ, 0.498 and 0.517 for the curvilinear-array and phased-array transducers, respectively). Both observers consistently assigned higher-quality scores to curvilinear-array images than to phased-array images.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated both curvilinear-array (microconvex) and phased-array transducers can be used by experienced sonographers to obtain diagnostic ultrasonographic images of the lungs in dogs with acute or resolving left-sided congestive heart failure and suggested the former transducer may be preferred, particularly to aid identification of anatomic landmarks for orientation.

Contributor Notes

Address correspondence to Dr. Ward (jward@iastate.edu).