Not all horizontal lines are Kerley B lines. Radiologists must differentiate them from:
When interpreting Kerley B lines on a CXR, consider the patient's clinical history and symptoms, such as:
| Line Type | Description | Location | Significance | | :--- | :--- | :--- | :--- | | | Long (2–6 cm), non-branching lines. | Central/Radiating from the hila. | Deep septal thickening; often seen in acute pulmonary edema or sarcoidosis. | | Kerley B Lines | Short (1–2 cm), horizontal lines. | Peripheral/Subpleural (base of lungs). | Interlobular septal thickening; classic sign of pulmonary edema. | | Kerley C Lines | Fine, reticular (net-like) interlacing lines. | Basal lung zones. | Likely represent a superimposition of many Kerley B lines. |
They extend all the way to the edge of the lung (the visceral pleura). Pathophysiology
The identification of Kerley B lines often serves as an early warning sign in clinical practice.
Understanding why Kerley B lines appear requires an understanding of lung anatomy: