Patent ductus arteriosus in hyaline membrane disease: chest radiography

Sequential chest radiographs of 45 consecutive neonates with respiratory distress were reviewed prospectively. Nineteen had hyaline membrane disease, 16 had infiltrates of other etiology, three had transient tachypnea of the newborn, and seven had no pulmonary pathology on chest radiography. Ten of the 19 infants with hyaline membrane disease and one of the 16 with pulmonary infiltrates had clinical and radiologic evidence of a patient arteriosus; there was echocardiographic confirmation in seven. Radiologic evidence of the patent ductus arteriosus was detected in all cases with no false positives. The radiographic criterion of the patent ductus was the appearance in sequential frontal chest films of pulmonary plethora, that is, pulmonary vascular engorgement and perihilar edema "haze." The radiographic appearance of the patent ductus arteriosus was detected prior to the clinical signs in seven of 11 cases and simultaneously with the clinical picture in three cases. In one the radiographic abnormally occurred later. Chest radiography is a valuable adjunct in the early diagnosis of a patent ductus arteriosus in infants with hyaline membrane disease.