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患有猫支气管疾病的猫的放射学异常及放射学解读中的观察者内和观察者间变异性:40例病例(1999 - 2006年)

Radiographic abnormalities in cats with feline bronchial disease and intra- and interobserver variability in radiographic interpretation: 40 cases (1999-2006).

作者信息

Gadbois Julie, d'Anjou Marc-André, Dunn Marilyn, Alexander Kate, Beauregard Guy, D'Astous Jérôme, De Carufel Myriam, Breton Luc, Beauchamp Guy

机构信息

Companion Animal Research Group, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, QC J2S 7C6, Canada.

出版信息

J Am Vet Med Assoc. 2009 Feb 1;234(3):367-75. doi: 10.2460/javma.234.3.367.

Abstract

OBJECTIVE

To determine prevalence of various radiographic signs in cats with feline bronchial disease (FBD) and evaluate intra- and interobserver variability in radiographic interpretation for examiners with variable degrees of experience in radiographic interpretation.

DESIGN

Retrospective case series.

ANIMALS

40 cats with FBD and 40 control cats without thoracic disease.

PROCEDURES

Radiographic abnormalities in cats with FBD were scored by consensus of 2 radiologists. Radiographs of control cats and cats with FBD were examined twice by 5 other individuals, and diagnostic accuracy and observer agreement were assessed.

RESULTS

In cats with FBD, the most common radiographic signs were bronchial (n=37) and unstructured interstitial (30) lung patterns, lung hyperinflation (31) and hyperlucency (21), aerophagia (19), and lung soft tissue opacities (11). Ratios of lung inflation on ventrodorsal views were significantly higher in cats with FBD. For the 5 examiners, sensitivity ranged from 71% to 89% and specificity ranged from 43% to 74%. Intraobserver agreement was good (N=0.47 to 0.60), but the agreement between examiners was only poor to good (N=0.22 to 0.70). For most examiners, significant associations were found between examiner diagnosis (correct vs incorrect), level of examiner certainty, and bronchial pattern severity.

CONCLUSIONS AND CLINICAL RELEVANCE

Findings suggested that several radiographic abnormalities can commonly be seen in cats with FBD but highlighted the limitations of thoracic radiography. Examiner diagnosis and level of confidence were significantly associated with severity of a bronchial pattern.

摘要

目的

确定猫支气管疾病(FBD)患猫各种影像学征象的患病率,并评估不同影像学解读经验程度的检查者在影像学解读中的观察者内及观察者间变异性。

设计

回顾性病例系列研究。

动物

40只患有FBD的猫和40只无胸部疾病的对照猫。

方法

由2名放射科医生共同对患有FBD的猫的影像学异常进行评分。另外5人对对照猫和患有FBD的猫的X光片进行了两次检查,并评估了诊断准确性和观察者间的一致性。

结果

在患有FBD的猫中,最常见的影像学征象为支气管(n = 37)和无结构间质(30)肺纹理、肺过度充气(31)和透亮度增加(21)、吞气症(19)以及肺软组织浑浊(11)。患有FBD的猫在腹背位片上的肺充气比例显著更高。对于5名检查者,敏感度范围为71%至89%,特异度范围为43%至74%。观察者内一致性良好(κ = 0.47至0.60),但检查者之间的一致性仅为差至良好(κ = 0.22至0.70)。对于大多数检查者,在检查者诊断(正确与错误)、检查者确定程度和支气管纹理严重程度之间发现了显著关联。

结论及临床意义

研究结果表明,FBD患猫通常可见多种影像学异常,但也突显了胸部X光检查的局限性。检查者的诊断和信心水平与支气管纹理的严重程度显著相关。

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