Guillot Martin, Danjou Marc-André, Alexander Kate, Bédard Christian, Desnoyers Michel, Beauregard Guy, Del Castillo Jérôme R E
Department of Veterinary Biomedical Sciences, Faculté de Médecine Vetérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.
Vet Radiol Ultrasound. 2009 Sep-Oct;50(5):513-8. doi: 10.1111/j.1740-8261.2009.01572.x.
While abdominal ultrasound and ultrasound-guided fine-needle aspiration cytology are often combined to help determine the type of liver disease in dogs, little is known about the relationship that may exist between the results of these tests. We hypothesized that specific sonographic findings, or combinations of findings, may predict results of liver ultrasound-guided fine-needle aspiration cytology. Hepatic and extrahepatic sonographic findings were recorded prospectively using a standardized form in 70 dogs with clinically suspected liver disease and in which liver ultrasound-guided fine-needle aspiration cytology was performed. The predictive value of sonographic findings in regard to the category of cytology results was assessed with stepwise logistic regression analysis. Sonographic detection of a hepatic mass (> or = 3cm; risk ratio [RR] 3.83, 95% Wald confidence intervals [95% CI] 2.42-3.93, P = 0.0036), ascites (RR 3.82, 95% CI 1.94-4.28, P = 0.0044), abnormal hepatic lymph node(s) (RR 3.01, 95% CI 1.22-4.88, P= 0.0262), and abnormal spleen (RR 3.26, 95% CI 1.20-3.85, P = 0.0274) were the most predictive of liver neoplasia on cytology. Conversely, sonographic detection of hepatic nodules (< 3cm; RR 1.97, 95% CI 0.95-2.96, P = 0.0666) was most predictive of vacuolar hepatopathy on cytology. In dogs with suspected liver disease, several sonographic findings, alone or combined, are thus predictive of liver ultrasound-guided fine-needle aspiration cytology results. In the light of the fact that ultrasound-guided fine-needle aspiration cytology of the liver has limitations, these predictabilities could influence the selection of diagnostic tests to reach a reliable diagnosis.
虽然腹部超声和超声引导下细针穿刺细胞学检查常结合使用以帮助确定犬类肝病的类型，但对于这些检查结果之间可能存在的关系却知之甚少。我们假设特定的超声检查结果或结果组合可能预测肝脏超声引导下细针穿刺细胞学检查的结果。前瞻性地使用标准化表格记录了70只临床怀疑患有肝病且进行了肝脏超声引导下细针穿刺细胞学检查的犬的肝脏和肝外超声检查结果。通过逐步逻辑回归分析评估超声检查结果对细胞学结果类别的预测价值。超声检查发现肝脏肿块（≥3cm；风险比[RR]3.83，95%Wald置信区间[95%CI]2.42 - 3.93，P = 0.0036）、腹水（RR 3.82，95%CI 1.94 - 4.28，P = 0.0044）、异常肝淋巴结（RR 3.01，95%CI 1.22 - 4.88，P = 0.0262）和异常脾脏（RR 3.26，95%CI 1.20 - 3.85，P = 0.0274）对细胞学检查中肝脏肿瘤的预测性最强。相反，超声检查发现肝脏结节（<3cm；RR 1.97，95%CI 0.95 - 2.96，P = 0.0666）对细胞学检查中空泡性肝病的预测性最强。因此，在怀疑患有肝病的犬中，单独或组合的几种超声检查结果可预测肝脏超声引导下细针穿刺细胞学检查的结果。鉴于肝脏超声引导下细针穿刺细胞学检查存在局限性，这些预测性可能会影响诊断检查的选择以获得可靠的诊断。
