Kerley b-lines

The Kerley lines are named after their first descriptor Sir Peter Kerley (27.10.1900 - 15.03.1979 [Maizlin 2007]) (Krombach 2015).

Kerley's lines are radiologically detectable fine lines that are caused by accumulation of fluid in the interstitium of the lung tissue. These lines are summation images of many orthograde affected, dilated lymphatic vessels or thickened interlobular septa.

We differentiate between Kerley A, Kerley B and Kerley C lines (Bücheler 2006).

Kerley A lines: These are lines of compression which are approx. 1 mm thick and 2 - 6 cm long. They are found in the perihilar space (Bücheler 2006):

• Kerley B-lines: These occur in the area of the pulmonary periphery of the middle lobe, the lingula and the lower lobe. In most cases they are found in the costophrenic angle. They are thin and horizontal lines of about 1 - 2 cm length. They appear as soon as the mean pressure in the left atrium exceeds 20 mmHg at rest [Kasper 2015].
• The Kerley B-lines can also occur continuously and are then an indication of a severe form of pulmonary venous hypertension, such as can occur in mitral valve stenosis (Bücheler 2006).
• Kerley C-lines: These are confluent Kerley B-lines which lead to a reticular interstitial lung pattern (Bücheler 2006).

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2. Kasper D L et al (2015) Harrison's Principles of Internal Medicine. Mc Graw Hill Education S 47 e- 4, 1540, 1544
3. Kasper D L et al (2015) Harrison's Internal Medicine. Georg Thieme Publisher S 1881
4. Krombach G A et al. (2015) Radiological Diagnostics Abdomen and Thorax: Image interpretation considering anatomical landmarks and clinical symptoms. Thieme Publisher 4.1.2.1.
5. Maizlin Z V (2007) Wonders of radiology: Not only for wondering radiologists. CreateSpace Independent Publishing Platform 76-79