Szabo David, Sutherland-Smith James, Barton Bruce, Rozanski Elizabeth A, Taeymans Olivier
Cummings School of Veterinary Medicine at Tufts University, Department of Clinical Sciences, 200 Westboro Road, North Grafton, MA, 01536.
Vet Radiol Ultrasound. 2015 May-Jun;56(3):264-71. doi: 10.1111/vru.12216. Epub 2014 Nov 7.
Computed tomography is increasingly being used in veterinary medicine to evaluate animals with pulmonary signs such as coughing, tachypnea, and exercise intolerance, however, a quantitative measure of bronchial wall thickening has yet to be validated in veterinary medicine. Canine chronic bronchitis is a disease that is characterized histologically by thickening of the bronchial walls. Thoracic CT images of 16 dogs with chronic bronchitis and 72 dogs presenting for conditions unrelated to cough were evaluated. A ratio comparing the bronchial wall thickness to the adjacent pulmonary artery diameter was obtained in the right and left cranial and caudal lung lobes. There was no significant difference in dogs with chronic bronchitis or unaffected dogs between the left and right hemithorax, patient weight, patient age, image slice thickness, or CT machine used. Dogs with chronic bronchitis were found to have a significantly greater ratio than unaffected dogs (P < 0.001). The ratios in the cranial lung lobes were found to be significantly greater than the caudal lung lobes in both chronic bronchitis and unaffected dogs (P < 0.001). A receiver operating characteristic curve of the ratios in the cranial lung lobes had an area under the curve of 0.912, indicating high accuracy in predicting for bronchial wall thickening. A ratio of ≥ 0.6 in the cranial lung lobes was found to have a sensitivity of 77% and specificity of 100% in predicting for the presence of chronic bronchitis, and we propose using this cut-off as supportive of bronchial wall thickening on CT.
计算机断层扫描在兽医学中越来越多地用于评估出现咳嗽、呼吸急促和运动不耐受等肺部症状的动物,然而,支气管壁增厚的定量测量在兽医学中尚未得到验证。犬慢性支气管炎是一种在组织学上以支气管壁增厚为特征的疾病。对16只患有慢性支气管炎的犬和72只因与咳嗽无关的病症前来就诊的犬的胸部CT图像进行了评估。在左右头侧和尾侧肺叶中获得了支气管壁厚度与相邻肺动脉直径的比值。患有慢性支气管炎的犬与未受影响的犬在左右半胸、体重、年龄、图像切片厚度或所用CT机器方面没有显著差异。发现患有慢性支气管炎的犬的比值显著高于未受影响的犬(P < 0.001)。在慢性支气管炎犬和未受影响的犬中,头侧肺叶的比值均显著高于尾侧肺叶(P < 0.001)。头侧肺叶比值的受试者工作特征曲线下面积为0.912,表明在预测支气管壁增厚方面具有较高的准确性。发现在预测慢性支气管炎的存在时,头侧肺叶比值≥0.6的敏感性为77%,特异性为100%,我们建议使用这个临界值来支持CT上的支气管壁增厚。