Protocol:
(1) Based on examination of the antero-posterior (AP) and lateral chest radiographs.
(2) The antero-posterior lung fields are divided into 4 quadrants (right upper, right lower, left upper, left lower)
Parameters (total of 19 measures):
(1) chest configuration (3 measures)
(2) bronchial line shadows (4 measures, based on each quadrant of the AP view)
(3) mottled shadows (4 measures, based on each quadrant of the AP view)
(4) ring shadows (4 measures, based on each quadrant of the AP view)
(5) large shadows (4 measures, based on each quadrant of the AP view)
The findings associated with chest configuration reflect changes associated with pulmonary over-distention as seen in the AP and lateral radiographs:
(1) sternal bowing
(2) diaphragmatic depression
(3) spinal kyphosis
Basis of observed shadows:
(1) bronchial line shadows: prominence of the bronchial shadows, which may be straight or branching when seen from the side or as a ring when viewed from on-end.
(2) mottled shadows: presence of multiple, small rounded shadows with ill-defined edges.
(3) ring shadows: formed by a central area of increased lucency circumscribed by a discrete shadow. The shadows commonly are about 0.5 cm in width and are observed in the peripheral lung fields.
(4) large shadows: caused by confluent lung collapse and/or consolidation affecting the entire lobe or one or more segments.
|
Finding
|
Points
|
|
not present
|
0
|
|
present but not marked
|
1
|
|
marked
|
2
|
score =
= SUM(points for all 19 measures)
Interpretation:
• minimum score: 0
• maximum score: 38
• The higher the score, the more extensive the radiographic findings.
Some features not included in scoring:
(1) changes in cardiac configuration
(2) partial deflation of a lung
(3) reticular shadowing associated with bronchovascular markings
Performance:
• The authors demonstrated good test-retest reliability.
