B-Lines in Assessment of Pulmonary Hypertension in Patients With Interstitial Lung Diseases: Feasibility of Transthoracic Lung Sonographic Signs.
OBJECTIVE
This study was conducted to evaluate the value of sonographic B-lines (previously called "comet tail artifacts") in assessment of pulmonary hypertension in patients with interstitial lung diseases.


METHODS
One hundred thirty-four patients with clinically diagnosed interstitial lung diseases complicated by pulmonary hypertension underwent transthoracic lung sonography and Doppler echocardiography for assessment of the presence of B-lines, the distance between them, and the pulmonary artery (PA) systolic pressure. A correlation analysis and a receiver operating characteristic curve analysis were performed.


RESULTS
All patients had diffuse bilateral B-lines. The maximum number of B-lines seen in any positive zone (not a summation) was significantly correlated with the severity of PA systolic pressure (r= 0.812; P< .0001), and a linear regression equation could be demonstrated: that is, y = 6.06 x + 17.57, where x and y represent the number of B-lines and PA systolic pressure, respectively. A cutoff of more than 4 B-lines seen in any positive zone had 89.5% sensitivity, 85.0% specificity, and 87.2% accuracy in predicting elevated PA pressure (>30 mm Hg).


CONCLUSIONS
The number of B-lines is useful in assessment of pulmonary hypertension, especially when tricuspid regurgitation and pulmonary valve regurgitation do not exist or cannot be satisfactorily measured by Doppler echocardiography.
Departments of Ultrasound (X.-Z.Z.) and Cardiology (Q.Z.), First People's Hospital of Yancheng, Yancheng, China; Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China (X.-Z.Z., B.Y.); and Department of Ultrasound, Third People's Hospital of Yancheng, Yancheng, China (J.Z.).
Xiao-Zhi
XZ
Zheng
Departments of Ultrasound (X.-Z.Z.) and Cardiology (Q.Z.), First People's Hospital of Yancheng, Yancheng, China; Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China (X.-Z.Z., B.Y.); and Department of Ultrasound, Third People's Hospital of Yancheng, Yancheng, China (J.Z.).
Quan
Q
Zheng
Departments of Ultrasound (X.-Z.Z.) and Cardiology (Q.Z.), First People's Hospital of Yancheng, Yancheng, China; Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China (X.-Z.Z., B.Y.); and Department of Ultrasound, Third People's Hospital of Yancheng, Yancheng, China (J.Z.).
Jing
J
Zhou
Departments of Ultrasound (X.-Z.Z.) and Cardiology (Q.Z.), First People's Hospital of Yancheng, Yancheng, China; Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China (X.-Z.Z., B.Y.); and Department of Ultrasound, Third People's Hospital of Yancheng, Yancheng, China (J.Z.). jsnjyb59@163.com.
Bin
B
Yang
D000368:Aged; D004452:Echocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000209:etiology*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008168:Lung / Q000000981:diagnostic imaging*; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
comet tail artifacts; echocardiography; interstitial diseases; lung; pulmonary artery systolic pressure; sonography