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腹部超声检查筛查对患有神经系统疾病犬只进行高级诊断测试和治疗决策的影响。

Effect of screening abdominal ultrasound examination on the decision to pursue advanced diagnostic tests and treatment in dogs with neurologic disease.

作者信息

Tong N M, Zwingenberger A L, Blair W H, Taylor S L, Chen R X, Sturges B K

机构信息

William R. Pritchard Veterinary Medical Teaching Hospital, University of California School of Veterinary Medicine, Davis, CA.

Department of Surgical and Radiological Sciences, University of California School of Veterinary Medicine, Davis, CA.

出版信息

J Vet Intern Med. 2015 May-Jun;29(3):893-9. doi: 10.1111/jvim.12602. Epub 2015 Apr 21.

Abstract

BACKGROUND

Abdominal ultrasound examinations (AUS) are commonly performed before advanced neurodiagnostics to screen for diseases that might affect diagnostic plans and prognosis.

OBJECTIVES

Describe the type and frequency of abnormalities found by AUS in dogs presenting with a neurological condition, identify risk factors associated with abnormalities, and evaluate treatment decisions based on findings.

ANIMALS

Seven hundred and fifty-nine hospitalized dogs.

METHODS

Retrospective study. Medical records of dogs presented from 2007 to 2009 for neurologic disease were searched for signalment, neuroanatomic localization, and AUS findings. Whether dogs had advanced neurodiagnostics and treatment was analyzed.

RESULTS

Fifty-eight percent of dogs had abnormal findings on AUS. Probability of abnormalities increased with age (P < 0.001). Nondachshund breeds had higher probability of abnormal AUS than dachshunds (odds ratio [OR] = 1.87). Eleven percent of dogs did not have advanced neurodiagnostics and in 1.3%, this was because of abnormal AUS. Dogs with ultrasonographic abnormalities were less likely than dogs without to have advanced neurodiagnostics (OR = 0.3 [95% confidence interval [CI]: 0.17, 0.52]), however, the probability of performing advanced diagnostics was high regardless of normal (OR = 0.95 [95% CI: 0.92, 0.97]) or abnormal (OR = 0.85 [95% CI: 0.81, 0.88]) AUS. Treatment was more often pursued in small dogs and less often in dogs with brain disease.

CONCLUSIONS AND CLINICAL IMPORTANCE

Findings from screening AUS had a small negative effect on the likelihood of pursuing advanced neurodiagnostics. Although it should be included in the extracranial diagnostic workup in dogs with significant history or physical examination abnormalities, AUS is considered a low-yield diagnostic test in young dogs and dachshunds.

摘要

背景

在进行高级神经诊断之前,通常会进行腹部超声检查(AUS),以筛查可能影响诊断计划和预后的疾病。

目的

描述在患有神经系统疾病的犬只中通过AUS发现的异常类型和频率,确定与异常相关的风险因素,并根据检查结果评估治疗决策。

动物

759只住院犬。

方法

回顾性研究。检索2007年至2009年因神经疾病就诊的犬只的病历,以获取其特征、神经解剖定位和AUS检查结果。分析犬只是否进行了高级神经诊断和治疗。

结果

58%的犬只AUS检查结果异常。异常的概率随年龄增加而升高(P < 0.001)。非腊肠犬品种的AUS异常概率高于腊肠犬(优势比[OR]=1.87)。11%的犬只未进行高级神经诊断,其中1.3%是因为AUS异常。与无超声异常的犬只相比,有超声异常的犬只进行高级神经诊断的可能性较小(OR = 0.3[95%置信区间[CI]:0.17,0.52]),然而,无论AUS正常(OR = 0.95[95%CI:0.92,0.97])还是异常(OR = 0.85[95%CI:0.81,0.88]),进行高级诊断的概率都很高。小型犬更常接受治疗,而患有脑部疾病的犬只接受治疗的频率较低。

结论及临床意义

筛查AUS的结果对进行高级神经诊断的可能性有较小的负面影响。虽然在有明显病史或体格检查异常的犬只的颅外诊断检查中应包括AUS,但在幼犬和腊肠犬中,AUS被认为是一种低收益的诊断测试。

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