Carina angle measurements for diagnosis of patent ductus arteriosus in preterm infants.
BACKGROUND
Bedside diagnosis of patent ductus arteriosus (PDA) continues to be important, especially when echocardiography is not readily available.


OBJECTIVE
The aim of our study was to evaluate whether measurement of left main bronchus displacement portrayed on a chest X-ray as a widened carina angle (CA) may support the presumptive diagnosis of PDA.


METHODS
Displacement of the left bronchus was assessed by measuring the angle between the two main bronchi at the level of the carina in 47 infants with PDA and 73 with no evidence of ductus, all born before 32 weeks of gestation.


RESULTS
The PDA group had a significantly wider CA (99.9 ± 12.1°) compared to the no-ductus group (72.9 ± 15.7°; p < 0.001). Resolution of the PDA resulted in closure of the CA (62.3 ± 10.8°). We observed a significant and positive association between an increased CA measurement and PDA occurrence (OR = 1.7, 95% CI = 1.4-2.1). A CA cutoff point of 90° had the highest sensitivity (85%) and specificity (85%) for indicating the presence of PDA.


CONCLUSIONS
Measurement of the CA is an easily accessible and reliable tool that may assist in establishing the diagnosis of PDA.
Strauss
Tzipora
T
Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel. t.tzipi@gmail.com
Pessach
Itai
I
Jacoby
Elad
E
Schushan-Eisen
Irit
I
Mazkereth
Ram
R
Kuint
Jacob
J
D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016015:Logistic Models; D008297:Male; D011859:Radiography; D012189:Retrospective Studies