Kim Stanley E, Giglio Robson F, Reese David J, Reese Shona L, Bacon Nicholas J, Ellison Gary W
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610.
Vet Radiol Ultrasound. 2013 Nov-Dec;54(6):569-74. doi: 10.1111/vru.12059. Epub 2013 Jun 13.
The purpose of this retrospective study was to compare the accuracy of computed tomographic angiography (CTA) and abdominal ultrasonography in detecting and characterizing portosystemic shunts (PSS) in dogs. Medical records of 76 dogs that underwent CTA and/or abdominal ultrasonography suspected to have PSS were reviewed. Presence or absence, and characterization of PSS (when present) on CTA were reviewed by a board-certified veterinary radiologist that was blinded to the clinical findings. The abdominal ultrasonography findings were reviewed from the medical records. Visualization and description of the origin and insertion of PSS on CTA and abdominal ultrasonography were related with laboratory, surgical, or mesenteric portographic confirmation of the presence or absence of PSS. The sensitivity for detection of PSS with CTA (96%) was significantly higher than abdominal ultrasonography (68%; P < 0.001). The specificities for CTA and abdominal ultrasonography were 89% and 84%, respectively (P = 0.727). Computed tomographic angiography detected the correct origin in 15 of 16 dogs and correct insertion in 15 of 16 dogs with congenital PSS. Abdominal ultrasonography detected the correct origin in 24 of 30 dogs and correct insertion in 20 of 33 dogs with congenital PSS. Multiple acquired PSS were seen in four of five dogs and in one of six dogs on CTA and abdominal ultrasonography, respectively. Computed tomographic angiography was 5.5 times more likely to correctly ascertain the presence or absence of PSS when compared to abdominal ultrasonography (P = 0.02). Findings indicated that CTA is a noninvasive diagnostic modality that is superior to abdominal ultrasonography for the detection and characterization of PSS in dogs.
这项回顾性研究的目的是比较计算机断层血管造影（CTA）和腹部超声在检测和鉴别犬门静脉分流（PSS）方面的准确性。对76只接受CTA和/或腹部超声检查且疑似患有PSS的犬的病历进行了回顾。一名对临床结果不知情的经过委员会认证的兽医放射科医生对CTA上PSS的存在与否及其特征进行了评估。从病历中回顾腹部超声检查结果。CTA和腹部超声上PSS的起源和插入部位的可视化及描述与PSS存在与否的实验室、手术或肠系膜门静脉造影确认相关。CTA检测PSS的敏感性（96%）显著高于腹部超声（68%；P<0.001）。CTA和腹部超声的特异性分别为89%和84%（P=0.727）。CTA在16只患有先天性PSS的犬中，有15只检测到了正确的起源，16只中有15只检测到了正确的插入部位。腹部超声在30只患有先天性PSS的犬中，有24只检测到了正确的起源，33只中有20只检测到了正确的插入部位。在五只犬中有四只以及六只犬中有一只在CTA和腹部超声上分别发现了多个后天性PSS。与腹部超声相比，CTA正确确定PSS存在与否的可能性高出5.5倍（P=0.02）。研究结果表明，CTA是一种非侵入性诊断方法，在检测和鉴别犬PSS方面优于腹部超声。
