Winter Matthew D, Barry Katie S, Johnson Matthew D, Berry Clifford R, Case J Brad
J Am Vet Med Assoc. 2017 Aug 1;251(3):315-321. doi: 10.2460/javma.251.3.315.
OBJECTIVE To evaluate the usefulness of noncontrast abdominal CT and abdominal ultrasonography for the detection of mechanical gastrointestinal obstruction in dogs and compare intestinal diameter ratios between dogs with and without obstruction. DESIGN Controlled trial. ANIMALS 16 client-owned dogs with physical and radiographic findings consistent with mechanical gastrointestinal obstruction. PROCEDURES Abdominal ultrasonography and CT were performed for all dogs, followed by laparoscopy and exploratory laparotomy. Time required for image acquisition and presence and location of gastrointestinal obstruction were assessed with both imaging modalities. Findings were compared with those of exploratory surgery. Maximum and minimum intestinal diameters were recorded on CT scans; values were converted to a ratio and compared between dogs with and without obstruction. RESULTS Results of abdominal CT and exploratory surgery for the diagnosis of mechanical obstruction agreed for all 16 dogs; 10 dogs had complete obstruction, 3 had partial obstruction, and 3 had no obstruction. In 1 dog with functional ileus, abdominal ultrasonography resulted in an incorrect diagnosis of mechanical obstruction. Median (interquartile range) image acquisition time for abdominal CT (2.5 minutes [2.0 to 3.8 minutes]) was markedly and significantly shorter than that for ultrasonography (26.0 minutes [22.0 to 35.8 minutes]). In both dorsal and transverse CT planes, dogs with gastrointestinal obstruction (partial or complete) had significantly larger intestinal diameter ratios than dogs without obstruction. CONCLUSIONS AND CLINICAL RELEVANCE Abdominal CT was feasible, rapid, and accurate for the diagnosis of mechanical obstruction in dogs with clinical signs and physical examination findings consistent with partial or complete gastrointestinal obstruction.
目的 评估非增强腹部CT和腹部超声对检测犬机械性胃肠梗阻的效用,并比较有梗阻和无梗阻犬的肠径比。 设计 对照试验。 动物 16只客户拥有的犬,其体格检查和影像学检查结果与机械性胃肠梗阻相符。 方法 对所有犬进行腹部超声和CT检查,随后进行腹腔镜检查和剖腹探查术。用两种成像方式评估图像采集所需时间以及胃肠梗阻的存在和位置。将结果与剖腹探查术的结果进行比较。在CT扫描上记录最大和最小肠径;将数值转换为比值,并在有梗阻和无梗阻的犬之间进行比较。 结果 16只犬的腹部CT诊断结果与剖腹探查术对机械性梗阻的诊断结果一致;10只犬为完全梗阻,3只为部分梗阻,3只无梗阻。1只功能性肠梗阻犬的腹部超声诊断为机械性梗阻有误。腹部CT的中位(四分位间距)图像采集时间(2.5分钟[2.0至3.8分钟])明显且显著短于超声检查(26.0分钟[22.0至35.8分钟])。在CT的背侧和横断面上,有胃肠梗阻(部分或完全)的犬的肠径比均显著大于无梗阻的犬。 结论及临床意义 对于有与部分或完全胃肠梗阻相符的临床症状和体格检查结果的犬,腹部CT对机械性梗阻的诊断可行、快速且准确。