Comparison of computed tomographic angiography and ultrasonography for the detection and characterization of portosystemic shunts in dogs.
Comparison of computed tomographic angiography and ultrasonography for the detection and characterization of portosystemic shunts in dogs.
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DOI：
10.1111/vru.12059
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发表时间：
2013-11-01
期刊：
影响因子：
--
通讯作者：
Ellison, Gary W
中科院分区：
文献类型：
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作者：
Kim, Stanley E;Giglio, Robson F;Ellison, Gary W
本回顾性研究的目的是比较计算机断层血管造影（CTA）和腹部超声在检测和表征犬门静脉系统分流（PSS）方面的准确性。本文回顾了76只疑似患有PSS的犬行CTA和/或腹部超声检查的病历。CTA上PSS的存在或不存在，以及PSS的特征（当存在时）由委员会认证的兽医放射科医生审查，该专家对临床结果不知情。从医疗记录中回顾腹部超声检查结果。在CTA和腹部超声上对PSS起源和插入的可视化和描述与实验室、手术或肠系膜门静脉造影证实PSS存在或不存在有关。CTA检测PSS的灵敏度（96%）显著高于腹部超声（68%,P < 0.001）。CTA和腹部超声检查特异性分别为89%和84% （P = 0.727）。计算机断层血管造影在16只犬中发现了15只犬的正确起源，在16只犬中发现了15只犬的正确插入。30只先天性PSS犬中，腹部超声检查发现24只犬的正确起源，33只犬中有20只犬的正确插入。在CTA和腹部超声检查中，5只狗中有4只狗和6只狗中有1只狗分别出现多发性获得性PSS。与腹部超声相比，计算机断层血管造影正确判断PSS存在与否的可能性高5.5倍（P = 0.02）。结果表明，CTA是一种非侵入性的诊断方式，在犬PSS的检测和表征方面优于腹部超声检查。
The purpose of this retrospective study was to compare the accuracy of computed tomographic angiography (CTA) and abdominal ultrasonography in detecting and characterizing portosystemic shunts (PSS) in dogs. Medical records of 76 dogs that underwent CTA and/or abdominal ultrasonography suspected to have PSS were reviewed. Presence or absence, and characterization of PSS (when present) on CTA were reviewed by a board-certified veterinary radiologist that was blinded to the clinical findings. The abdominal ultrasonography findings were reviewed from the medical records. Visualization and description of the origin and insertion of PSS on CTA and abdominal ultrasonography were related with laboratory, surgical, or mesenteric portographic confirmation of the presence or absence of PSS. The sensitivity for detection of PSS with CTA (96%) was significantly higher than abdominal ultrasonography (68%; P < 0.001). The specificities for CTA and abdominal ultrasonography were 89% and 84%, respectively (P = 0.727). Computed tomographic angiography detected the correct origin in 15 of 16 dogs and correct insertion in 15 of 16 dogs with congenital PSS. Abdominal ultrasonography detected the correct origin in 24 of 30 dogs and correct insertion in 20 of 33 dogs with congenital PSS. Multiple acquired PSS were seen in four of five dogs and in one of six dogs on CTA and abdominal ultrasonography, respectively. Computed tomographic angiography was 5.5 times more likely to correctly ascertain the presence or absence of PSS when compared to abdominal ultrasonography (P = 0.02). Findings indicated that CTA is a noninvasive diagnostic modality that is superior to abdominal ultrasonography for the detection and characterization of PSS in dogs.