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接受头部磁共振成像检查的犬类中疑似脑微出血:一项关于人口统计学、临床关联及与病例结局关系的回顾性研究

Putative Cerebral Microbleeds in Dogs Undergoing Magnetic Resonance Imaging of the Head: A Retrospective Study of Demographics, Clinical Associations, and Relationship to Case Outcome.

作者信息

Kerwin S C, Levine J M, Budke C M, Griffin J F, Boudreau C E

机构信息

Department of Small Animal Clinical Sciences, Texas A&M College of Veterinary Medicine and Biomedical Sciences, College Station, TX.

Department of Veterinary Integrative Biosciences, Texas A&M College of Veterinary Medicine and Biomedical Sciences, College Station, TX.

出版信息

J Vet Intern Med. 2017 Jul;31(4):1140-1148. doi: 10.1111/jvim.14730. Epub 2017 May 27.

Abstract

BACKGROUND

Cerebral microbleeds (CMBs) are focal intraparenchymal signal voids on gradient-echo magnetic resonance imaging (MRI), corresponding to regions of chronic hemorrhage. In humans, they are associated with systemic disease and shorter survival times. Although similar findings have been identified in dogs, their epidemiology and clinical correlations have not been investigated.

OBJECTIVE

To determine epidemiological features, clinical associations, and associations with outcome for putative CMB-like foci (putative microbleeds [pMBs]) identified by T2*-weighted MRI in dogs.

ANIMALS

Five hundred and eighty-two dogs undergoing 3T brain MRI between 2011 and 2016.

METHODS

Retrospective case-control study. Demographic, diagnostic, and clinicopathological data were obtained from medical records and phone follow-up. Demographic variables were compared between dogs with and without evidence of pMBs. For dogs with such evidence, and a subset of matched controls, associations with clinical presentation, concurrent disease, and survival times were evaluated.

RESULTS

Dogs with pMBs were older (P < .001) and smaller (P = .004) than unaffected dogs. Compared to matched controls, they presented more frequently for vestibular signs (P = .030). Cortical atrophy occurred concurrently with pMBs in 26% (14/54) of dogs. Diagnosed renal disease was not significantly associated with pMBs, but proteinuria was more common in dogs with pMBs than in matched controls (odds ratio = 3.01, P = .005). Dogs with pMBs had a shorter median survival time than did matched controls (P = .011).

CONCLUSIONS AND CLINICAL IMPORTANCE

Putative microbleeds occurred in 54 of 582 (9.3%) of dogs undergoing brain MRI, but may not be a normal consequence of aging. They were associated with shorter survival time and proteinuria in the study population.

摘要

背景

脑微出血(CMB)是梯度回波磁共振成像(MRI)上脑实质内的局灶性信号缺失,对应于慢性出血区域。在人类中,它们与全身性疾病和较短的生存时间相关。尽管在犬类中也发现了类似的结果,但其流行病学和临床相关性尚未得到研究。

目的

确定通过T2*加权MRI在犬类中识别出的疑似CMB样病灶(疑似微出血 [pMB])的流行病学特征、临床关联以及与预后的关联。

动物

2011年至2016年间接受3T脑MRI检查的582只犬。

方法

回顾性病例对照研究。从病历和电话随访中获取人口统计学、诊断和临床病理数据。比较有和没有pMB证据的犬的人口统计学变量。对于有此类证据的犬以及一组匹配的对照犬,评估其与临床表现、并发疾病和生存时间的关联。

结果

有pMB的犬比未受影响的犬年龄更大(P <.001)且体型更小(P =.004)。与匹配的对照犬相比,它们出现前庭症状的频率更高(P =.030)。26%(14/54)的犬同时出现皮质萎缩和pMB。诊断出的肾病与pMB无显著关联,但有pMB的犬蛋白尿比匹配的对照犬更常见(优势比 = 3.01,P =.005)。有pMB的犬的中位生存时间比匹配的对照犬短(P =.011)。

结论及临床意义

在接受脑MRI检查的582只犬中,有54只(9.3%)出现疑似微出血,但这可能不是衰老的正常结果。在研究人群中,它们与较短的生存时间和蛋白尿相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a878/5508348/03a0457bf7b9/JVIM-31-1140-g001.jpg

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