Farin P W, Youngquist R S, Parfet J R, Garverick H A
Department of Veterinary Medicine, University of Missouri, Columbia 65211.
J Am Vet Med Assoc. 1992 Apr 15;200(8):1085-9.
The purpose of this study was to determine and compare the accuracy of palpation per rectum and linear-array ultrasonography for diagnosing follicular vs luteal ovarian cysts in cows. Forty-seven examinations of ovarian cysts from 28 cows were diagnosed by palpation per rectum as either a firm, thick-walled structure (luteal cyst) or a soft, thin-walled structure (follicular cyst) during weekly herd examinations. The ovaries of each cow were then examined by ultrasonography. Ultrasonograms of cysts greater than 25 mm in diameter were diagnosed as luteal or follicular cysts and were recorded on videotape for evaluation by a second clinician. Serum progesterone concentrations at the time of examination were determined by radioimmunoassay and used to classify luteal (greater than 0.5 ng/ml) or follicular (less than or equal to 0.5 ng/ml) cysts. Selection of this discriminatory level was based on response of a proportion of cows with luteal cysts that were given 25 mg of prostaglandin F2 alpha at the time of diagnosis by ultrasonography. Sensitivity and specificity of palpation per rectum for diagnosis of type of ovarian cyst were low (43.3 and 64.7%, respectively). In contrast, sensitivity and specificity of ultrasonography were considerably higher (86.7 and 82.3%, respectively). Agreement between the 2 methods of diagnosis was 57.4%. Overall agreement between the 2 clinicians' diagnoses by ultrasonography was 85.1%. On the basis of our findings, we confirm that luteal and follicular cysts cannot be accurately differentiated by palpation per rectum alone. These data suggest that linear-array ultrasonography is more effective than palpation per rectum for diagnosing type of ovarian cyst in cows.
本研究的目的是确定并比较经直肠触诊和线性阵列超声检查对诊断奶牛卵泡性与黄体性卵巢囊肿的准确性。在每周的畜群检查中，通过经直肠触诊对28头奶牛的47次卵巢囊肿检查进行诊断，将其判定为坚实、壁厚的结构（黄体囊肿）或柔软、壁薄的结构（卵泡囊肿）。然后对每头奶牛的卵巢进行超声检查。直径大于25 mm的囊肿的超声图像被诊断为黄体囊肿或卵泡囊肿，并录制在录像带上以供另一位临床医生评估。检查时的血清孕酮浓度通过放射免疫测定法测定，并用于将囊肿分类为黄体性（大于0.5 ng/ml）或卵泡性（小于或等于0.5 ng/ml）。选择这个区分水平是基于一部分在超声检查诊断时给予25 mg前列腺素F2α的黄体囊肿奶牛的反应。经直肠触诊诊断卵巢囊肿类型的敏感性和特异性较低（分别为43.3%和64.7%）。相比之下，超声检查的敏感性和特异性要高得多（分别为86.7%和82.3%）。两种诊断方法之间的一致性为57.4%。两位临床医生通过超声检查诊断的总体一致性为85.1%。根据我们的研究结果，我们证实仅通过经直肠触诊不能准确区分黄体囊肿和卵泡囊肿。这些数据表明，线性阵列超声检查在诊断奶牛卵巢囊肿类型方面比经直肠触诊更有效。
