Sharma Ajay, Thompson Margret S, Scrivani Peter V, Dykes Nathan L, Yeager Amy E, Freer Sean R, Erb Hollis N
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
Vet Radiol Ultrasound. 2011 May-Jun;52(3):248-55. doi: 10.1111/j.1740-8261.2010.01791.x. Epub 2010 Dec 28.
A cross-sectional study was performed on acutely vomiting dogs to compare the accuracy of radiography and ultrasonography for the diagnosis of small-intestinal mechanical obstruction and to describe several radiographic and ultrasonographic signs to identify their contribution to the final diagnosis. The sample population consisted of 82 adult dogs and small-intestinal obstruction by foreign body was confirmed in 27/82 (33%) dogs by surgery or necropsy. Radiography produced a definitive result (obstructed or not obstructed) in 58/82 (70%) of dogs; ultrasonography produced a definitive result in 80/82 (97%) of dogs. On radiographs, a diagnosis of obstruction was based on detection of segmental small-intestinal dilatation, plication, or detection of a foreign body. Approximately 30% (8/27) of obstructed dogs did not have radiographic signs of segmental small-intestinal dilatation, of which 50% (4/8) were due to linear foreign bodies. The ultrasonographic diagnosis of small-intestinal obstruction was based on detection of an obstructive lesion, sonographic signs of plication or segmental, small-intestinal dilatation. The ultrasonographic presence or absence of moderate-to-severe intestinal diameter enlargement (due to lumen dilatation) of the jejunum (>1.5 cm) was a useful discriminatory finding and, when present, should prompt a thorough search for a cause of small-intestinal obstruction. In conclusion, both abdominal radiography and abdominal ultrasonography are accurate for diagnosing small-intestinal obstruction in vomiting dogs and either may be used depending on availability and examiner choice. Abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence compared with radiography.
对急性呕吐的犬只进行了一项横断面研究，以比较放射成像和超声检查对诊断小肠机械性梗阻的准确性，并描述几种放射成像和超声检查征象，以确定它们对最终诊断的贡献。样本群体由82只成年犬组成，通过手术或尸检在27/82（33%）的犬只中确诊有异物导致的小肠梗阻。放射成像在58/82（70%）的犬只中得出了明确结果（梗阻或未梗阻）；超声检查在80/82（97%）的犬只中得出了明确结果。在放射影像上，梗阻的诊断基于节段性小肠扩张、肠襻或异物的检测。约30%（8/27）的梗阻犬只没有节段性小肠扩张的放射影像征象，其中50%（4/8）是由于线状异物所致。小肠梗阻的超声诊断基于梗阻性病变的检测、肠襻或节段性小肠扩张的超声征象。空肠存在或不存在中度至重度肠径增大（由于管腔扩张）（>1.5 cm）是一个有用的鉴别发现，当存在时，应促使彻底寻找小肠梗阻的原因。总之，腹部放射成像和腹部超声检查在诊断呕吐犬只的小肠梗阻方面都很准确，可根据可用性和检查者的选择使用其中任何一种。与放射成像相比，腹部超声检查具有更高的准确性、更少的模糊结果，并提供了更高的诊断信心。
