Feeney Daniel A, Ober Christopher P, Snyder Laura A, Hill Sara A, Jessen Carl R
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1332 Boyd Avenue, St. Paul, MN, 55108.
Vet Radiol Ultrasound. 2013 Nov-Dec;54(6):638-45. doi: 10.1111/vru.12065. Epub 2013 Jun 14.
Peritoneal, mesenteric, and omental diseases are important causes of morbidity and mortality in humans and animals, although information in the veterinary literature is limited. The purposes of this retrospective study were to determine whether objectively applied ultrasound interpretive criteria are statistically useful in differentiating among cytologically defined normal, inflammatory, and neoplastic peritoneal conditions in dogs and cats. A second goal was to determine the cytologically interpretable yield on ultrasound-guided, fine-needle sampling of peritoneal, mesenteric, or omental structures. Sonographic criteria agreed upon by the authors were retrospectively and independently applied by two radiologists to the available ultrasound images without knowledge of the cytologic diagnosis and statistically compared to the ultrasound-guided, fine-needle aspiration cytologic interpretations. A total of 72 dogs and 49 cats with abdominal peritoneal, mesenteric, or omental (peritoneal) surface or effusive disease and 17 dogs and 3 cats with no cytologic evidence of inflammation or neoplasia were included. The optimized, ultrasound criteria-based statistical model created independently for each radiologist yielded an equation-based diagnostic category placement accuracy of 63.2-69.9% across the two involved radiologists. Regional organ-associated masses or nodules as well as aggregated bowel and peritoneal thickening were more associated with peritoneal neoplasia whereas localized, severely complex fluid collections were more associated with inflammatory peritoneal disease. The cytologically interpretable yield for ultrasound-guided fine-needle sampling was 72.3% with no difference between species, making this a worthwhile clinical procedure.
腹膜、肠系膜和网膜疾病是人和动物发病及死亡的重要原因,尽管兽医文献中的相关信息有限。这项回顾性研究的目的是确定客观应用的超声解释标准在区分犬猫细胞学定义的正常、炎症性和肿瘤性腹膜疾病方面是否具有统计学意义。第二个目标是确定超声引导下对腹膜、肠系膜或网膜结构进行细针采样的细胞学可解释率。作者商定的超声标准由两名放射科医生在不知细胞学诊断结果的情况下,对现有的超声图像进行回顾性和独立应用,并与超声引导下的细针穿刺细胞学解释进行统计学比较。共有72只犬和49只猫患有腹部腹膜、肠系膜或网膜(腹膜)表面或渗出性疾病,以及17只犬和3只猫没有炎症或肿瘤的细胞学证据。为每位放射科医生独立创建的基于超声标准的优化统计模型,在两名参与的放射科医生中,基于方程的诊断类别放置准确率为63.2%-69.9%。区域性器官相关肿块或结节以及聚集的肠管和腹膜增厚与腹膜肿瘤更相关,而局限性、严重复杂的液体积聚与炎症性腹膜疾病更相关。超声引导下细针采样的细胞学可解释率为72.3%,不同物种之间无差异,这使其成为一项值得进行的临床操作。