Jones Ian D, Lamb Christopher R, Drees Randi, Priestnall Simon L, Mantis Panagiotis
Department of Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK.
Department of Pathology and Pathogen Biology, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK.
Vet Radiol Ultrasound. 2016 Mar-Apr;57(2):144-53. doi: 10.1111/vru.12336. Epub 2016 Jan 13.
Ability to noninvasively differentiate malignant from nonmalignant abdominal masses would aid clinical decision making. The aim of this retrospective, cross-sectional study was to identify features in dual-phase computed tomographic (CT) studies that could be used to distinguish malignant from nonmalignant hepatic and splenic masses in dogs. Medical records were searched for dogs that had an abdominal dual-phase CT examination, a hepatic or splenic mass, and subsequent histopathologic diagnosis. Computed tomographic images for all included dogs were acquired prior to and <30 s (early phase) and >60 s (delayed phase) after intravenous contrast administration. Fifty-two dogs with 55 masses were studied: 24 hepatic, including 14 (58%) malignant and 10 (42%) non-malignant; 31 splenic, including 18 (58%) malignant and 13 (42%) nonmalignant. There was substantial overlap in the pre- and postcontrast CT features of malignant and nonmalignant hepatic and splenic masses. Regardless of histologic diagnosis, hepatic masses most frequently showed marked, generalized enhancement in early phase images that persisted in the delayed phase. Splenic hemangiosarcoma and nodular hyperplastic lesions most frequently showed marked, generalized enhancement in early phase images that persisted in delayed images whereas most splenic hematomas had slight enhancement in early phase images. All splenic hematomas and 77% of the hemangiosarcomas had contrast accumulation compatible with active hemorrhage. There were no other significant differences in quantitative or categorical CT data between malignant and nonmalignant hepatic or splenic masses. Dual-phase CT of dogs with hepatic or splenic masses provides limited specific diagnostic information.
非侵入性地区分腹部恶性肿块与非恶性肿块的能力将有助于临床决策。这项回顾性横断面研究的目的是确定双期计算机断层扫描(CT)研究中的特征,这些特征可用于区分犬肝脏和脾脏的恶性肿块与非恶性肿块。检索有腹部双期CT检查、肝脏或脾脏肿块以及后续组织病理学诊断的犬的病历。对所有纳入研究的犬,在静脉注射造影剂前以及注射后<30秒(早期)和>60秒(延迟期)采集CT图像。对52只患有55个肿块的犬进行了研究:24个肝脏肿块,其中14个(58%)为恶性,10个(42%)为非恶性;31个脾脏肿块,其中18个(58%)为恶性,13个(42%)为非恶性。肝脏和脾脏恶性肿块与非恶性肿块在造影前和造影后的CT特征有很大重叠。无论组织学诊断如何,肝脏肿块在早期图像中最常表现为明显的、弥漫性强化,并持续到延迟期。脾脏血管肉瘤和结节性增生性病变在早期图像中最常表现为明显的、弥漫性强化,并持续到延迟期图像,而大多数脾脏血肿在早期图像中强化轻微。所有脾脏血肿和77%的血管肉瘤都有与活动性出血相符的造影剂积聚。肝脏或脾脏恶性肿块与非恶性肿块在定量或分类CT数据上没有其他显著差异。患有肝脏或脾脏肿块的犬的双期CT提供的特异性诊断信息有限。