Adin Christopher A, Herrgesell Eric J, Nyland Thomas G, Hughes Joanne M, Gregory Clare R, Kyles Andrew E, Cowgill Larry D, Ling Gerald V
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
J Am Vet Med Assoc. 2003 Jun 1;222(11):1576-81. doi: 10.2460/javma.2003.222.1576.
To determine sensitivity and specificity of radiography, ultrasonography, and antegrade pyelography for detection of ureteral obstructions in cats.
Retrospective study.
11 cats.
Medical records of cats that had radiography, ultrasonography, and antegrade pyelography performed for suspected ureteral obstructions were examined. Ultrasound-guided pyelocentesis and fluoroscopic-assisted antegrade pyelography were performed on 18 kidneys in 11 cats. Obstructive ureteral lesions were confirmed in all cats by surgical or necropsy examination. Sensitivity and specificity of survey radiography, ultrasonography, and antegrade pyelography for identification of ureteral obstructions were calculated. Surgical or necropsy findings were used as the standard for comparison.
All cats were azotemic. Mean +/- SD serum creatinine and BUN concentrations were 10.2 +/- 6.1 and 149 +/- 82 mg/dL, respectively. Fifteen of 18 ureters were found to be obstructed at surgery or necropsy. Sensitivity and specificity were 60 and 100% for radiography and 100 and 33% for ultrasonography, respectively, in identification of ureteral obstructions. Leakage of contrast material developed in 8 of 18 kidneys during antegrade pyelography and prevented diagnostic interpretation in 5 of 18 studies. For the 13 diagnostic studies, specificity and sensitivity were 100% by use of the antegrade pyelography technique. Correct identification of the anatomic location of the ureteral obstruction was obtained in 100% of diagnostic antegrade pyelography studies and in 60% of radiography or ultrasonography studies.
Antegrade pyelography can be a useful alternative in the diagnosis and localization of ureteral obstructions in azotemic cats, although leakage of contrast material may prevent interpretation of the study.
确定X线摄影、超声检查和顺行肾盂造影对检测猫输尿管梗阻的敏感性和特异性。
回顾性研究。
11只猫。
检查因怀疑输尿管梗阻而进行了X线摄影、超声检查和顺行肾盂造影的猫的病历。对11只猫的18个肾脏进行了超声引导下肾盂穿刺和顺行肾盂造影。通过手术或尸检检查确认所有猫存在梗阻性输尿管病变。计算X线摄影、超声检查和顺行肾盂造影识别输尿管梗阻的敏感性和特异性。以手术或尸检结果作为比较标准。
所有猫均有氮质血症。血清肌酐和尿素氮浓度的平均值±标准差分别为10.2±6.1和149±82mg/dL。在手术或尸检中发现18条输尿管中有15条存在梗阻。在识别输尿管梗阻方面，X线摄影的敏感性和特异性分别为60%和100%，超声检查分别为100%和33%。顺行肾盂造影期间，18个肾脏中有8个出现造影剂渗漏，18项研究中有5项无法进行诊断性解读。对于13项诊断性研究，顺行肾盂造影技术的特异性和敏感性均为100%。在所有诊断性顺行肾盂造影研究中，100%能够正确识别输尿管梗阻的解剖位置，而在X线摄影或超声检查研究中这一比例为60%。
顺行肾盂造影在氮质血症猫输尿管梗阻的诊断和定位中可能是一种有用的替代方法，尽管造影剂渗漏可能妨碍对检查结果的解读。
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