Textor Jamie A, Puchalski Sarah M, Affolter Verena K, MacDonald Melinda H, Galuppo Larry D, Wisner Erik R
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.
J Am Vet Med Assoc. 2012 Jun 1;240(11):1338-44. doi: 10.2460/javma.240.11.1338.
To determine whether CT provides unique information about the treatment or prognosis for horses with ethmoid hematoma (EH).
Retrospective case series.
16 horses with EH.
Horses with a diagnosis of EH that had undergone a diagnostic CT study were included. Clinical features, treatment, outcome, radiographic and CT images, and histologic specimens were reviewed.
CT provided new diagnostic information that affected treatment in 10 of 16 horses. Bilateral disease occurred in 8 of 16 horses and was undetected in 5 horses prior to CT. Paranasal sinus involvement occurred in all horses, but was incompletely defined prior to CT in 7 of 16 horses. The sphenopalatine sinus was affected in 6 of 16 horses as detected on CT; 4 of 6 of these were bilaterally affected. Medical and surgical treatments were performed. Six of 10 horses had a successful outcome, with recurrence in 4 of 10. Five of 6 patients in which treatment addressed all lesion sites identified by CT had a successful outcome. Bilateral disease did not confer a poor prognosis when all affected sites were treated. Sphenopalatine sinus involvement may have been associated with recurrence.
CT provided anatomic information that may facilitate effective treatment of horses with EH, particularly in patients with bilateral disease and paranasal sinus involvement. Computed tomography is recommended for patients in which the lesion cannot be viewed endoscopically, when sinus involvement or multifocal disease are suspected, or when the lesion has been unresponsive to treatment.
确定CT是否能为患有筛窦血肿(EH)的马匹的治疗或预后提供独特信息。
回顾性病例系列研究。
16匹患有EH的马。
纳入已接受诊断性CT检查且诊断为EH的马匹。对临床特征、治疗、结果、放射影像和CT图像以及组织学标本进行回顾。
CT提供了新的诊断信息,影响了16匹马中10匹马的治疗。16匹马中有8匹出现双侧病变,其中5匹马在CT检查前未被发现。所有马匹均有鼻旁窦受累,但16匹马中有7匹马在CT检查前受累情况未完全明确。CT检查发现16匹马中有6匹马蝶腭窦受累;其中6匹中的4匹为双侧受累。进行了药物和手术治疗。10匹马中有6匹治疗成功,10匹马中有4匹复发。6例治疗针对CT识别的所有病变部位的患者中有5例治疗成功。当所有受累部位均得到治疗时,双侧病变并未预示预后不良。蝶腭窦受累可能与复发有关。
CT提供的解剖学信息可能有助于有效治疗患有EH的马匹,特别是对于双侧病变和鼻旁窦受累的患者。对于无法通过内镜观察到病变、怀疑有鼻窦受累或多灶性病变,或病变对治疗无反应的患者,建议进行计算机断层扫描。