Giguère Steeve, Roberts Gregory D
Department of Large Animal Medicine, University of Georgia, Athens, GA, USA.
Vet Radiol Ultrasound. 2012 Nov-Dec;53(6):601-4. doi: 10.1111/j.1740-8261.2012.01964.x. Epub 2012 Jun 29.
Our objective was to characterize the association between types of radiographic findings and outcome in foals with pneumonia caused by Rhodococcus equi. Admission lateral thoracic radiographs of 62 foals with culture-confirmed R. equi pneumonia were reviewed retrospectively. A scoring system was developed to individually assess the severity of alveolar pattern, interstitial pattern, tracheobronchial lymphadenopathy, pleural effusion, and the number of nodular opacities and cavitary lesions. Individual scores were added to obtain a total radiographic score ranging from 0 (normal) to 22. Forty-three of 62 foals (69%) survived to discharge. The median total radiographic score of nonsurvivors (14; range, 9-16) was significantly (P = 0.007) higher than that of survivors (11; range, 4-15). Foals with a total radiographic score of greater than or equal to 15 were 6.15 times (95% CI: 1.35 to 28.2) less likely to survive than foals with a lower score (P = 0.019). A multivariate logistic regression model was used to identify the potential associations between specific types of radiographic lesions and outcome. The model was statistically significant (P = 0.002) and correctly classified 75.8% of foals. Only severity of alveolar pattern and number of cavitary lesions made statistically significant contributions to the model. There was no significant association between concurrent isolation of other bacteria along with R. equi and the types or severity of radiographic lesions. Based on the results of this study, severity of alveolar pattern and number of cavitary lesions are the radiographic findings significantly associated with a poor outcome in foals with R. equi pneumonia.
我们的目的是描述马红球菌引起的驹肺炎的影像学表现类型与预后之间的关联。对62匹经培养确诊为马红球菌肺炎的驹的入院时胸部侧位X线片进行回顾性分析。开发了一种评分系统，以分别评估肺泡型、间质型、气管支气管淋巴结肿大、胸腔积液的严重程度，以及结节状opacity和空洞性病变的数量。将各个评分相加，得到总影像学评分，范围从0（正常）到22。62匹驹中有43匹（69%）存活至出院。非存活驹的总影像学评分中位数（14；范围9 - 16）显著高于存活驹（11；范围4 - 15）（P = 0.007）。总影像学评分大于或等于15的驹存活的可能性比评分较低的驹低6.15倍（95%CI：1.35至28.2）（P = 0.019）。使用多因素逻辑回归模型来确定特定类型的影像学病变与预后之间的潜在关联。该模型具有统计学意义（P = 0.002），正确分类了75.8%的驹。只有肺泡型严重程度和空洞性病变数量对模型有统计学意义的贡献。同时分离出其他细菌与马红球菌以及影像学病变的类型或严重程度之间没有显著关联。基于本研究结果，肺泡型严重程度和空洞性病变数量是与马红球菌肺炎驹预后不良显著相关的影像学表现。
