Bertal Mileva, Norman Carmel Eric, Diana Alessia, Desquilbet Loic, Specchi Swan, Pey Pascaline
1 Department of Medical Imaging, Paris-Est University, National Veterinary School of Alfort, Maisons-Alfort, France.
2 Department of Medical Imaging, Veterinary Centre Laval, Laval, QC, Canada.
J Feline Med Surg. 2018 Jan;20(1):23-29. doi: 10.1177/1098612X17697483. Epub 2017 Mar 21.
Objectives The purpose of this study was to determine whether the presence of a splenic mass or a diffusely moth-eaten parenchyma on ultrasonographic scans could represent potential criteria of malignancy in the feline spleen. Methods Feline patients with ultrasonographic images and cytological analysis of the spleen obtained by fine-needle aspiration were retrospectively included in a multicentre study. Results One hundred and ninety-five cats met our inclusion criteria. There was a lack of agreement between the moth-eaten ultrasonographic appearance of the spleen and the presence of a malignant neoplasia on cytological analysis. The sensitivity and specificity of a moth-eaten parenchyma for predicting malignant neoplastic disease were 13.2% and 84.8%, respectively. The sensitivity and specificity of a splenic mass >1 cm for predicting malignant neoplastic disease were 21.0% and 94.7%, respectively. A marbled appearance of the splenic parenchyma was significantly more frequent among patients examined with a high-frequency transducer (11-18 MHz) than among those examined with a low-frequency transducer (6.6-10 MHz) (27.6% vs 11.1%, respectively; P = 0.004). Similarly, although not statistically significant, a moth-eaten parenchyma was more frequent in the high-frequency transducer group than in the low-frequency group (17.1% vs 8.9%, respectively; P = 0.09). Conclusions and relevance Based on our findings, a moth-eaten ultrasonographic appearance of the spleen in cats does not necessarily reflect a lymphoma or another malignant neoplastic process on cytological analysis. The presence of a splenic mass >1 cm on ultrasound is suggestive of malignancy in cats. Finally, the transducer frequency must be taken into account when assessing the splenic parenchyma, as a high-frequency transducer seems to improve the detection of a marbled or moth-eaten parenchyma.
目的 本研究旨在确定超声扫描中脾脏肿块的存在或弥漫性虫蚀样实质是否可作为猫脾脏恶性肿瘤的潜在标准。方法 对有多中心研究纳入的具有脾脏超声图像及经细针穿刺获得的脾脏细胞学分析结果的猫科动物患者进行回顾性研究。结果 195只猫符合纳入标准。脾脏的虫蚀样超声表现与细胞学分析中恶性肿瘤的存在之间缺乏一致性。虫蚀样实质预测恶性肿瘤性疾病的敏感性和特异性分别为13.2%和84.8%。脾脏肿块>1 cm预测恶性肿瘤性疾病的敏感性和特异性分别为21.0%和94.7%。脾脏实质呈大理石样外观在使用高频探头(11 - 18 MHz)检查的患者中比使用低频探头(6.6 - 10 MHz)检查的患者中显著更常见(分别为27.6%和11.1%;P = 0.004)。同样,尽管无统计学意义,但虫蚀样实质在高频探头组中比低频组更常见(分别为17.1%和8.9%;P = 0.09)。结论及相关性 根据我们的研究结果,猫脾脏的虫蚀样超声表现不一定反映细胞学分析中的淋巴瘤或其他恶性肿瘤过程。超声检查中脾脏肿块>1 cm提示猫存在恶性肿瘤。最后,在评估脾脏实质时必须考虑探头频率,因为高频探头似乎能提高对大理石样或虫蚀样实质的检测。