High frequency linear transducer might be better for ER

Inter-rater agreement and characterization of pleural line and subpleural fields in canine lung ultrasound: a comparative pilot study between high-frequency linear and curvilinear transducers using B- and M-mode ultrasonographic profiles

Kyle L. Granger, Liz Guieu & Søren R. Boysen

Background
Lung ultrasound is a diagnostic tool used to evaluate pulmonary conditions in veterinary medicine. This study compares the effectiveness of high-frequency linear ultrasound transducers and curvilinear transducers in assessing pleural line and subpleural field characteristics in dogs. The goal was to determine which transducer provided more reliable results when used with two ultrasound modes: B-mode, which provides two-dimensional images, and M-mode, which visualizes motion over time.

Methods
Study Population: Nine dogs were studied, divided into three groups: control dogs without lung disease, dogs with cardiogenic pulmonary edema caused by heart failure, and dogs with non-cardiogenic alveolar-interstitial syndrome, a condition involving fluid and inflammation in the lungs.
Ultrasound Procedures: The lungs were scanned in different regions using both high-frequency linear transducers and curvilinear transducers. Ultrasound images were recorded in both B-mode and M-mode.
Data Review: Two blinded reviewers analyzed the ultrasound images to classify pleural lines as homogeneous or non-homogeneous and subpleural fields as horizontal or vertical. Statistical methods were used to measure agreement between reviewers and to assess links between findings and disease type.

Results
Reviewer Agreement:
-High-frequency linear transducers provided strong agreement between reviewers in B-mode imaging and near-perfect agreement in M-mode imaging.
-Curvilinear transducers had only minimal agreement between reviewers for both B-mode and M-mode imaging.

Findings in Disease Groups:
-Homogeneous pleural lines were observed in control dogs and those with cardiogenic pulmonary edema, while non-homogeneous pleural lines were associated with non-cardiogenic alveolar-interstitial syndrome.
-Vertical subpleural fields were linked to disease states, while horizontal subpleural fields were predominantly seen in healthy dogs.

Limitations
The study involved only nine dogs, which limits its general applicability. Biases may have occurred because reviewers could recognize which transducer was used based on image appearance. Differences in how the ultrasound was performed and patient movement might also have affected the results.

Conclusions
High-frequency linear transducers were more reliable than curvilinear transducers for characterizing pleural and subpleural features in canine lung ultrasound, especially using M-mode imaging. These transducers may improve the diagnostic accuracy for identifying and differentiating pulmonary diseases in dogs. Further research with larger sample sizes is recommended to confirm these findings and enhance the use of lung ultrasound in veterinary practice.

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