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猫血清胰腺脂肪酶免疫活性升高时胰腺的超声表现。

Ultrasonographic findings of the pancreas in cats with elevated serum pancreatic lipase immunoreactivity.

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA.

出版信息

J Vet Intern Med. 2013 Jul-Aug;27(4):913-8. doi: 10.1111/jvim.12117. Epub 2013 Jun 3.

Abstract

BACKGROUND

Pancreatitis is a common disease in cats that is difficult to diagnose.

HYPOTHESIS/OBJECTIVES: To determine the sensitivity and specificity of ultrasonographic changes of the pancreas with serum feline pancreatic lipase immunoreactivity (fPLI) as the standard for diagnosis of pancreatitis.

ANIMALS

35 cats with clinical signs consistent with pancreatitis with an abdominal ultrasound examination and serum fPLI concentration measured within 3 days of the ultrasound.

METHODS

Retrospective study: Pancreatic thickness, pancreatic margination, pancreatic echogenicity, and peripancreatic fat echogenicity were evaluated. Sensitivity and specificity were calculated with an elevated serum fPLI concentration indicative of pancreatitis as the standard for diagnosis.

RESULTS

Serum fPLI was elevated and diagnostic for pancreatitis in 19 of 35 cats. The single ultrasound characteristic with the highest sensitivity was hyperechoic peripancreatic fat at 68% (95% confidence interval = 44-87%), indicating a moderate probability that cats with pancreatitis will have this abnormality on ultrasonographic examination. Specificity was >90% for each of increased pancreatic thickness, abnormal pancreatic margin, and hyperechoic peripancreatic fat. The sensitivity and specificity of ultrasound were 84% (95% confidence interval = 60-97%) and 75% (95% confidence interval = 48-93%), respectively, in cats with elevated serum fPLI indicative of pancreatitis.

CONCLUSIONS AND CLINICAL IMPORTANCE

The presence of a thick left limb of the pancreas, severely irregular pancreatic margins, and hyperechoic peripancreatic fat in cats with appropriate clinical signs and elevated serum fPLI are highly supportive of pancreatitis.

摘要

背景

胰腺炎是一种常见于猫的疾病,难以诊断。

假设/目的:确定胰腺超声变化与血清猫胰脂肪酶免疫反应性(fPLI)作为胰腺炎诊断标准的敏感性和特异性。

动物

35 只具有与胰腺炎一致的临床症状的猫,在超声检查和血清 fPLI 浓度测量的 3 天内进行了腹部超声检查。

方法

回顾性研究:评估胰腺厚度、胰腺边缘、胰腺回声和胰周脂肪回声。以血清 fPLI 浓度升高提示胰腺炎为诊断标准,计算敏感性和特异性。

结果

血清 fPLI 升高且诊断为胰腺炎的 35 只猫中有 19 只。敏感性最高的单一超声特征是胰周脂肪回声增强,为 68%(95%置信区间=44-87%),表明患有胰腺炎的猫在超声检查中更有可能出现这种异常。对于胰腺厚度增加、胰腺边缘异常和胰周脂肪回声增强,特异性均>90%。在血清 fPLI 升高提示胰腺炎的猫中,超声的敏感性和特异性分别为 84%(95%置信区间=60-97%)和 75%(95%置信区间=48-93%)。

结论和临床意义

在具有适当临床症状和血清 fPLI 升高的猫中,胰腺左叶增厚、胰腺边缘严重不规则和胰周脂肪回声增强的存在高度提示胰腺炎。

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