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Therefore, based on chest CT features of COVID-19 mentioned, it might be a promising means for identifying COVID-19. Kerley lines are described as types A, B or C. Kerley A lines are linear opacities extending from the periphery to the hila caused by distention of anastomotic channels between peripheral and central lymphatics; Kerley B lines are small, horizontal, peripheral straight lines demonstrated at the lung bases that represent thickened interlobular septa on CXR. Histologic study disclosed the presence of tumor infiltration of small endothelial-lined … Heart Failure Kerley B lines: In these images. They represent thickening of the interlobular septa that contain lymphatic connections between the perivenous and bronchoarterial lymphatics deep within the lung parenchyma. AJR Am J Roentgenol. Thickened septal lines may occur from a variety of processes, including fibrosis, pigment deposition, and pulmonary hemosiderosis. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. 2. This is an excellent example of Kerley B lines.These lines are created by interlobular septal thickening, typically created by fluid collecting within the pulmonary interstitium.Classically Kerley B lines are seen with cardiogenic pulmonary edema, where left ventricular failure causes increased intravascular hydrostatic pressure at the level of the pulmonary capillaries. Septal lines, also known as Kerley lines, are seen when the interlobular septa in the pulmonary interstitium become prominent. These are (a) interlobular septal thickening, (b) honeycombing, and (c) intralobular interstitial thickening, also described as intralobular lines by its HRCT appearance . sarcoid, lymphangitic carcinomatosis, pulmonary edema). The most common cause of interlobular septal thickening, producing Kerley A and B lines, is pulmonary edema, as a result of pulmonary venous hypertension and distension of the lymphatics (Figs. These are more properly referred to as septal lines. On HRCT, numerous clearly visible septal lines usually indicates the presence of some interstitial abnormality. Disease Interlobular Septa This image is a panoramic view of the lung showing almost rectangular secondary lobules surrounded by interlobular septa (cream borders) The distal bronchioles (teal) and pulmonary arteriole (royal blue are shown in the centre of a lobule in the right lower corner. There are many causes of interlobular septal thickening, and this should be distinguished from intralobular septal thickening. Kerley D lines are exactly the same as Kerley B lines, except that they are seen on lateral chest radiographs in the retrosternal air gap 2. These are 2-6 cm long oblique lines that are <1 mm thick and course towards the hila. septal lines: radiographic images of thickened interlobular septa, most often along the lateral border of lung, extending to pleura; Kerley A and B lines; usually caused by septal … Interlobular (Septal) Lines. Asbestosis (peripheral interlobular septal thickening, subpleural findings, parenchymal lines, pleural plaques) Peripheral. Kerley lines are named after Sir Peter James Kerley (1900-1979), an Irish radiologist who in addition to describing the interstitial lines now known as Kerley lines, was a co-founder of the Faculty of Radiology (later to become the Royal College of Radiologists), and also attended to King George VI 3,4. Sekar T, Swan KG, Vietrogoski RA. This may be because of lymphatic engorgement or edema of the connective tissues of the interlobular septa. Thickening of the interlobular septa can be smooth, nodular or irregular, with many entities able to cause more than one pattern. It represents an inward extension of the peripheral interstitium, described by Weibel , which extends over the surface of the lung beneath the visceral pleura. Multiple reticular patterns are shown in the right lung, and small consolidations are shown in the left lung. ภาพที่ 1 แสดงให้เห็น Kerley's B lines ซึ่งเป็นเส้นตรงสั้นๆ ตั้งฉากกับ chest wall ที่ right lower lobe ในผู้ป่วยที่มี interstitial pulmonary edema Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. They may be very subtle, but if seen in the context of clinical suspicion of heart failure, then septal lines are a strong indicator of interstitial oedema. The originally described Kerley C lines are now designated as due to overlapping Kerley C lines. Unable to process the form. They usually occur when pulmonary capillary wedge pressure reaches 20-25 mmHg. Kerley lines are described as types A, B or C. 1. Septal lines (Kerley B lines) Horizontal lines at the edge of the lungs They are actually thickened interlobular septa at the peripheries of the lungs. Kirchner J. 1. Septal lines represent thickening of the interlobular septa – interstitial tissue which separates the secondary lobules at the peripheries of the lungs Septal lines are a specific sign of interstitial oedema in the context of suspected left ventricular failure This may be because of lymphatic engorgement or edema of the connective tissues of the interlobular septa. The term is no longer used . Septal lines, also known as Kerley lines, are seen when the interlobular septa in the pulmonary interstitium become prominent. They usually occur when pulmonary capillary wedge pressure reaches 20-25 mmHg. FIGURE 3-1 Linear and reticular opacities visible on HRCT. B-lines represent the interlobular and/or intralobular septal thickening, most associated with pulmonary edema and interstitial disorders. The Kerley lines represent interlobular sheets of abnormally thickened or widened connective tissue that are tangential to the x-ray beam (Fig. The first two of these are most easily recognized and have a limited differential diagnosis. 6) and consolidation (Figs. The polyedric shape of these lobules explains that the 6-/7-mm distance is an average; it can be less, depending on the section. Conclusion: Interlobular septal thickening (Kerley B lines) in the lung apex is a specific sign for pulmonary congestion, although not exclusive (since in ILD there may be apical reticulation). These are 2-6 cm long oblique lines that … They usually occur when pulmonary capillary wedge pressure reaches 20-25 mmHg. It is one of the sign indicating interstitial oedema in the context of suspected left ventricular failure The airspace shadowing is indicative of pulmonary alveolar oedema. 36.4). They represent thickened subpleural interlobular septa and are usually seen at the lung bases. Although ILST is often seen in association with other CT findings, such as consolidation and ground-glass opacities, it can be the predominant (or sole) … MedGen UID: 909861 • Concept ID: C4280727 • Finding. Kerley Blines are small, horizontal, peripheral straight lines demonstrated at the lung bases that represent thickened interlobular septa on CXR. On the contrary, in antibiotic-induced pneumonitis, predominant radiographic findings were patchy ground-glass opacities with centrilobular opacities and interlobular septal lines. 3. 3.2 and 3.3). Kerley C lines are short lines which do not reach the pleura (i.e. Reed JC. Thieme Medical Pub. GGO, vascular enlargement, interlobular septal thickening more frequently occurred in patients with COVID-19, which distribution features were peripheral, bilateral, involved lobes > 2. Interlobular septal thickening is a common sign on thin-slice chest CT; it may be seen in the presence of interstitial fluid, cellular infiltration, or fibrosis. 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