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Home / Equine Research Bank / J Vet Sci / Influence of bronchoalveolar lavage on thoracic radiography ...
Journal of veterinary science2018; 19(4); 563-569; doi: 10.4142/jvs.2018.19.4.563

Influence of bronchoalveolar lavage on thoracic radiography in the horse.

Abstract: Bronchoalveolar lavage (BAL) and thoracic radiography are routinely performed diagnostic procedures. We hypothesized that BAL increases the interstitial opacity of caudoventral and caudodorsal thoracic radiographs. Fifty-three horses, including 8 clinic owned and 45 from a referral hospital population, were classified as healthy controls (n = 12), severe equine asthma (recurrent airway obstruction, n = 12) or mild-to-moderate equine asthma (inflammatory airway disease, n = 21) based on the results of a clinical scoring system. Eight were excluded due to different diagnoses and poor image quality. Four randomized thoracic radiographs of each horse were scored by two blinded observers, who were also asked to identify the image as obtained before or after a BAL procedure. In severe equine asthma, the chance (adjusted odds) of misinterpretation of the correct imaging time was approximately 5 times higher than in controls (odds ratio [OR] = 5.373, = 0.028). The chance of misinterpretation was approximately 4 times lower in caudodorsal images than in caudoventral projections (OR = 0.241, = 0.004). Identification of the correct imaging time was highly correlated with an increase in interstitial opacity (OR = 9.976, ＜ 0.0001). In conclusion, we recommend performing BAL after thoracic radiography to avoid possible misinterpretation.
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Publication Date: 2018-02-28 PubMed ID: 29486534PubMed Central: PMC6070596DOI: 10.4142/jvs.2018.19.4.563Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study examines the impact of bronchoalveolar lavage (BAL), a diagnostic procedure, on thoracic radiography results in horses. The findings suggest performing a BAL after thoracic radiography to prevent potential inaccuracies in interpretation, particularly in cases of severe equine asthma.

Research Objectives and Methodology

  • The researchers hypothesized that bronchoalveolar lavage (BAL), an examination that involves inspecting and gathering samples from the lower respiratory tract, can affect the opacity on thoracic radiographs. The aim was to explore whether BAL could lead to misinterpretation of these imaging results, especially in horses with asthma.
  • To investigate this hypothesis, the researchers studied a sample group of 53 horses from a clinic and a referral hospital, which were then categorized into healthy controls, severe equine asthma, and mild-to-moderate equine asthma based on a clinical grading system.
  • Four randomized thoracic radiographs per horse were assessed by two blinded observers, who attempted to determine whether the image had been taken before or after the BAL procedure.

Findings

  • The study found that in cases of severe equine asthma, the likelihood of incorrectly identifying the timing of the image (before or after BAL) was about five times higher than in healthy controls.
  • Furthermore, misinterpretation was approximately four times less likely with caudodorsal images (views from the back and top of the horse) than with caudoventral projections (views from the back and bottom of the horse).
  • Importantly, these misinterpretations were closely tied to an increase in interstitial opacity, or cloudiness, on the radiographs – which was significantly more likely after a BAL procedure.

Conclusions and Recommendations

  • The findings suggest that BAL procedures can potentially introduce misinterpretations in thoracic radiography, especially in horses with severe asthma.
  • Due to the increased risk of misinterpretation associated with BAL, the researchers recommend performing thoracic radiography prior to BAL. This would ensure that the radiographs are not influenced by the procedure, thus improving diagnostic accuracy.

Cite This Article

APA
Barton AK, Schulze T, Doherr MG, Gehlen H. (2018). Influence of bronchoalveolar lavage on thoracic radiography in the horse. J Vet Sci, 19(4), 563-569. https://doi.org/10.4142/jvs.2018.19.4.563

Publication

Journal of veterinary science
ISSN: 1976-555X
NlmUniqueID: 100964185
Country: Korea (South)
Language: English
Volume: 19
Issue: 4
Pages: 563-569

Researcher Affiliations

Barton, Ann K
  • Equine Clinic for Veterinary Epidemiology & Biostatistics, Freie Universitaet Berlin, 14163 Berlin, Germany.
Schulze, Thorben
  • Equine Clinic for Veterinary Epidemiology & Biostatistics, Freie Universitaet Berlin, 14163 Berlin, Germany.
Doherr, Marcus G
  • Institute for Veterinary Epidemiology & Biostatistics, Freie Universitaet Berlin, 14163 Berlin, Germany.
Gehlen, Heidrun
  • Equine Clinic for Veterinary Epidemiology & Biostatistics, Freie Universitaet Berlin, 14163 Berlin, Germany.

MeSH Terms

  • Animals
  • Asthma / diagnostic imaging
  • Asthma / veterinary
  • Bronchoalveolar Lavage / methods
  • Bronchoalveolar Lavage / veterinary
  • Female
  • Horse Diseases / diagnostic imaging
  • Horses
  • Male
  • Radiography, Thoracic / statistics & numerical data
  • Radiography, Thoracic / veterinary
  • Reference Values

Conflict of Interest Statement

The authors declare no conflicts of interest.

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Citations

This article has been cited 3 times.
  1. Pei M, Jiang P, Wang T, Xia C, Hou R, Sun A, Zou H. Effect of bronchoalveolar lavage on the clinical efficacy, inflammatory factors, and immune function in the treatment of refractory pneumonia in children.. Transl Pediatr 2021 Apr;10(4):921-928.
    doi: 10.21037/tp-21-89pubmed: 34012841google scholar: lookup
  2. Mendoza DP, Kohli P, Nance JW, Singh R, Cho J, Griffith J, Harris RS, Kelly VJ, Luster AD, Medoff B, Digumarthy SR. Lung parenchymal and airway changes on CT imaging following allergen challenge and bronchoalveolar lavage in atopic and asthmatic subjects.. Ann Transl Med 2020 Jul;8(14):862.
    doi: 10.21037/atm-20-1719pubmed: 32793706google scholar: lookup
  3. Cothren SD, Meyer JN, Hartman JH. Blinded Visual Scoring of Images Using the Freely-available Software Blinder.. Bio Protoc 2018 Dec 5;8(23).
    doi: 10.21769/BioProtoc.3103pubmed: 30761327google scholar: lookup
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