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吞咽困难猫的对比视频荧光镜评估

Contrast videofluoroscopic assessment of dysphagic cats.

作者信息

Levine Jonathan S, Pollard Rachel E, Marks Stanley L

机构信息

School of Veterinary Medicine, Veterinary Medical Teaching Hospital, University of California, Davis, CA, 95616.

出版信息

Vet Radiol Ultrasound. 2014 Sep-Oct;55(5):465-71. doi: 10.1111/vru.12150. Epub 2014 Feb 18.

Abstract

The diagnostic utility of contrast-enhanced videofluoroscopic esophagography in dysphagic cats has been rarely studied relative to dogs. Current literature regarding feline dysphagia typically consists of individual case reports or small case series. This retrospective study analyzed the imaging findings in 11 cats undergoing 15 videofluoroscopic swallow studies. Hiatal hernia (n = 5), esophageal stricture (n = 3), and esophageal dysmotility (n = 7) were the most common diagnoses (some cats having more than 1 diagnosis) in dysphagic cats that underwent videofluoroscopic swallow studies. Esophageal dysmotility appeared to be associated with a higher percentage of swallows from which no peristaltic waves were generated. Oropharyngeal and cricopharyngeal causes of dysphagia were not identified in any cat and quantitative assessment of the swallowing reflex (pharyngeal constriction ratio = 0.17 ± 0.09; time to maximum pharyngeal contraction = 0.13 ± 0.02 s; time to proximal esophageal sphincter opening = 0.07 ± 0.02 s; time to proximal esophageal sphincter closed = 0.23 ± 0.05 s; time to opening of the epiglottis = 0.27 ± 0.04 s) was similar to quantitative swallowing parameters previously reported in healthy dogs. In conclusion, videofluoroscopy is a diagnostic tool that can identify esophageal abnormalities that are not readily apparent on survey radiographs. Limitations include the potential need for multiple studies, and the possibility of poor compliance in the feline patient. Results of this study are intended to help veterinarians define a prioritized differential diagnosis list for dysphagic cats.

摘要

与犬相比,关于吞咽困难猫的对比增强视频荧光透视食管造影的诊断效用研究较少。目前有关猫吞咽困难的文献通常由个别病例报告或小病例系列组成。这项回顾性研究分析了11只猫接受15次视频荧光透视吞咽研究的影像学结果。食管裂孔疝(n = 5)、食管狭窄(n = 3)和食管运动障碍(n = 7)是接受视频荧光透视吞咽研究的吞咽困难猫中最常见的诊断(有些猫有不止一种诊断)。食管运动障碍似乎与未产生蠕动波的吞咽比例较高有关。在任何猫中均未发现口咽和环咽肌导致吞咽困难的原因,吞咽反射的定量评估(咽收缩率 = 0.17±0.09;最大咽收缩时间 = 0.13±0.02秒;食管近端括约肌开放时间 = 0.07±0.02秒;食管近端括约肌关闭时间 = 0.23±0.05秒;会厌开放时间 = 0.27±0.04秒)与先前报道的健康犬的定量吞咽参数相似。总之,视频荧光透视是一种诊断工具,可以识别在X线平片上不易发现的食管异常。局限性包括可能需要多次检查,以及猫科动物患者可能依从性差。本研究结果旨在帮助兽医为吞咽困难的猫确定优先的鉴别诊断清单。

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