Diagnostic imaging in acute interstitial pneumonia in foals: High variability of interpretation of chest radiographs and good conformity between ultrasonographic and post-mortem findings.
Abstract: Acute interstitial pneumonia (AIP) in foals is a rare but challenging syndrome. Diagnostic imaging is crucial for its diagnosis. While there are some reports on radiographic findings, ultrasound is sparsely described. Variability in the evaluation of radiographs in AIP has been well described in human literature. Part one of this study is a prospective, observational, observer agreement study investigating inter- and intraobserver agreement in the assessment of thoracic radiographs. Part two is a prospective, controlled, descriptive study on thoracic ultrasonography in foals with AIP. Eighteen foals with AIP were examined daily by thoracic ultrasound. Thoracic radiographs were taken on three successive occasions. Blinded radiographs were assessed by three observers based on two semi-quantitative scores (pattern recognition, subjective evaluation). Foals that died underwent postmortem examination (n = 9); postmortem findings were compared to ultrasound findings on the day of death. Ultrasonographic findings were consistent with postmortem findings. Comet tail scores in foals with AIP were significantly higher (p < 0.0001) than in control foals. Interrater agreement for the assessment of radiographs was none to moderate (κ = 0.07-0.65) for pattern recognition and weak to moderate (κ = 0.58-0.62) for subjective scoring. Intrarater agreement varied from minimal to strong (κ = 0.30-0.80) for pattern recognition but was strong (κ = 0.83) for subjective scoring. In conclusion, the diagnostic value of thoracic ultrasound in foals with AIP is high due to good conformity with postmortem findings. The evaluation of thoracic radiographs showed high variability in inter- and intra-agreement.
© 2021 American College of Veterinary Radiology.
Publication Date: 2021-04-06 PubMed ID: 33823075DOI: 10.1111/vru.12972Google Scholar: Lookup
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- Journal Article
- Observational Study
- Veterinary
Summary
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The research paper discusses the value of thoracic ultrasound as a diagnostic tool for acute interstitial pneumonia (AIP) in foals. The study also points out the high variability in the interpretation of chest radiographs among different observers.
Research Methodology
The study was divided into two parts.
- The first part was a prospective, observational, observer agreement study which assessed the agreement between different observers in interpreting chest radiographs of foals with AIP.
- The second part was a prospective, controlled, descriptive study that looked into how thoracic ultrasonography can help diagnose AIP in foals.
18 foals diagnosed with AIP were included in the study. They were examined daily using a thoracic ultrasound. Chest radiographs were taken on three different instances. These radiographs were blindly assessed by three separate observers using two semi-quantitative schemes: pattern recognition and subjective evaluation.
Out of the 18 foals, 9 of them died and underwent postmortem examination. The results of these examinations were then compared with the observations from the ultrasound on the day of their death.
Findings
The research findings indicated a strong correlation between the observations from the ultrasound and the postmortem findings. The study found ‘comet tail scores’ (a specific measure in thoracic ultrasound) in foals with AIP to be significantly higher than in control foals.
However, the assessments of the chest radiographs showed a high level of variability. The interrater agreement – the level of agreement between different observers – ranged from none to moderate for pattern recognition and was weak to moderate in subjective evaluation. Meanwhile, the intrarater agreement – the degree of agreement within the same observer – varied from minimal to strong for pattern recognition but was found to be strong for subjective evaluation.
Conclusions
The research concluded that the use of thoracic ultrasound as a diagnostic tool for AIP in foals is highly valuable because of its conformity with post-mortem findings. However, the interpretation of chest radiographs – another common diagnostic tool – showed a high level of variability, which may impact its diagnostic value for AIP in foals.
Cite This Article
APA
Punsmann S, Hellige M, Hoppe J, Freise F, Venner M.
(2021).
Diagnostic imaging in acute interstitial pneumonia in foals: High variability of interpretation of chest radiographs and good conformity between ultrasonographic and post-mortem findings.
Vet Radiol Ultrasound, 62(4), 490-497.
https://doi.org/10.1111/vru.12972 Publication
Researcher Affiliations
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
- Department of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.
- Institute for Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
- Veterinary Clinic, Destedt, Destedt, Germany.
MeSH Terms
- Animals
- Autopsy / veterinary
- Hamman-Rich Syndrome / diagnostic imaging
- Hamman-Rich Syndrome / pathology
- Hamman-Rich Syndrome / veterinary
- Horse Diseases / diagnostic imaging
- Horse Diseases / pathology
- Horses
- Humans
- Image Interpretation, Computer-Assisted
- Male
- Observer Variation
- Radiography, Thoracic / veterinary
- Ultrasonography / veterinary
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Citations
This article has been cited 2 times.- Officer K, Webster N, Rosenblatt AJ, Sorphea P, Warren K, Jackson B. Comparative thoracic radiography in healthy and tuberculosis-positive sun bears (Helarctos malayanus). Front Vet Sci 2024;11:1460140.
- Rakowska A, Czopowicz M, Bereznowski A, Witkowski L. Investigation of the relationship between pulmonary lesions based on lung ultrasound and respiratory clinical signs in foals with suspected pulmonary rhodococcosis. Sci Rep 2023 Nov 8;13(1):19401.
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