Lamb Christopher R, Pope Elizabeth H W, Lee Karla C L
Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hertfordshire AL9 7TA, UK.
Vet Radiol Ultrasound. 2017 Mar;58(2):144-150. doi: 10.1111/vru.12457. Epub 2016 Dec 1.
Detection of wooden foreign bodies in dogs can be challenging. A retrospective, cross-sectional study was done to describe computed tomographic (CT) signs associated with wooden foreign bodies, and to estimate the accuracy of CT for detection of wooden foreign bodies. Patient records and CT images were reviewed for 72 dogs that had a history of suspected stick injury and CT of the affected body part, or possible wooden foreign object reported on CT, and had surgical exploration during the same period of hospitalization. Duration of clinical signs was acute in 48 (67%) dogs and chronic in 24 (33%). Wood was removed from 55 dogs, including a piece of a tree or shrub in 33 (60%) instances, kebab stick in 8 (15%), piece of bamboo garden cane in 2 (4%), cocktail stick in 2 (4%), thorn in 1 (2%), and unidentified wood in the remaining nine instances. Based on review of CT images with knowledge of the surgical findings, sensitivity of CT for wooden foreign bodies was 79% (95% CI 65%-89%), specificity 93% (78%-98%), positive likelihood ratio 11.5 (2.9-44.1), and negative likelihood ratio 0.23 (0.13-0.41). Wooden foreign bodies were predominantly rectangular or linear, with median length 48 mm (range 2-270 mm), median thickness 3 mm (range 1-22 mm), and median attenuation 111 HU (range -344 to +640 HU). A CT finding of gas in soft tissues was significantly associated with acute cases, whereas suspected foreign material, cavitary lesions, fat stranding, and periosteal reaction on adjacent bones were associated with chronic cases.
犬类体内木质异物的检测颇具挑战性。本研究开展了一项回顾性横断面研究，以描述与木质异物相关的计算机断层扫描（CT）征象，并评估CT检测木质异物的准确性。对72只犬的病历和CT图像进行了回顾，这些犬均有疑似棍棒损伤史，且对受影响身体部位进行了CT检查，或者CT报告显示可能存在木质异物，并在同一住院期间接受了手术探查。48只（67%）犬的临床症状持续时间为急性，24只（33%）为慢性。从55只犬体内取出了木质异物，其中33例（60%）为树枝或灌木碎片，8例（15%）为烤肉串签子，2例（4%）为竹制园艺杆碎片，2例（4%）为鸡尾酒签子，1例（2%）为刺，其余9例为不明木质。基于对CT图像的回顾并结合手术结果，CT检测木质异物的敏感性为79%（95%CI 65%-89%），特异性为93%（78%-98%），阳性似然比为11.5（2.9-44.1），阴性似然比为0.23（0.13-0.41）。木质异物主要呈长方形或线性，中位长度为48毫米（范围2-270毫米），中位厚度为3毫米（范围1-22毫米），中位衰减值为111HU（范围-344至+640HU）。软组织内气体的CT表现与急性病例显著相关，而疑似异物、空洞性病变、脂肪条索和相邻骨骼的骨膜反应则与慢性病例相关。
