Rick Thorsten, Kleiter Miriam, Schwendenwein Ilse, Ludewig Eberhard, Reifinger Martin, Hittmair Katharina M
Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria.
Department for Pathobiology, University of Veterinary Medicine, Vienna, Austria.
Vet Radiol Ultrasound. 2019 Jan;60(1):56-64. doi: 10.1111/vru.12698. Epub 2018 Nov 26.
Contrast-enhanced ultrasonography (CEUS) is increasingly available for veterinary patients, however limited studies describe the use of this method for characterizing intrathoracic mass lesions. The aim of this prospective, observational study was to describe CEUS enhancement patterns for intrathoracic mass lesions in a sample of cats and dogs. Sixty patients (36 dogs, 24 cats) were included. Standardized CEUS examinations were performed for 41 pulmonary masses (68%) and 19 mediastinal masses (32%). Final diagnosis was based on cytology and/or histopathology. Absolute time to enhancement (TTE) values were recorded for the intrathoracic mass lesions and spleen. The spleen was used as a reference parenchymal organ to calculate relative TTE (rTTE) values. Absolute TTE of the spleen and intrathoracic mass lesions differed for dogs and cats (P = 0.001). The rTTE values significantly differed between lesions of neoplastic versus non-neoplastic origin (P = 0.004). The majority of neoplastic pulmonary masses were supplied by bronchial arteries (63%), while most nonneoplastic pulmonary masses were supplied by pulmonary arteries (78%). The sensitivity and specificity for detecting pulmonary neoplastic masses with rTTE were 63% and 78%, respectively. Enhancement patterns for mediastinal thymomas and lymphomas significantly differed (P = 0.002). Thymomas enhanced heterogeneously in a centripetal pattern (86%), whereas lymphomas typically enhanced uniformly in a centrifugal pattern (75%). Findings indicated that CEUS is a feasible method for characterizing intrathoracic mass lesions in dogs and cats, however, the diagnostic sensitivity for detecting neoplastic pulmonary masses was low.
超声造影(CEUS)在兽医临床中越来越常用,然而,关于该方法用于鉴别胸腔内肿块病变的研究却很有限。本前瞻性观察性研究旨在描述猫和狗胸腔内肿块病变的CEUS增强模式。共纳入60例患者(36只狗,24只猫)。对41个肺部肿块(68%)和19个纵隔肿块(32%)进行了标准化的CEUS检查。最终诊断基于细胞学和/或组织病理学。记录胸腔内肿块病变和脾脏的绝对增强时间(TTE)值。脾脏作为参考实质器官计算相对TTE(rTTE)值。狗和猫的脾脏及胸腔内肿块病变的绝对TTE存在差异(P = 0.001)。肿瘤性与非肿瘤性病变的rTTE值存在显著差异(P = 0.004)。大多数肿瘤性肺部肿块由支气管动脉供血(63%),而大多数非肿瘤性肺部肿块由肺动脉供血(78%)。rTTE检测肺部肿瘤性肿块的敏感性和特异性分别为63%和78%。纵隔胸腺瘤和淋巴瘤的增强模式存在显著差异(P = 0.002)。胸腺瘤以向心性模式不均匀增强(86%),而淋巴瘤通常以离心性模式均匀增强(75%)。研究结果表明,CEUS是一种鉴别猫和狗胸腔内肿块病变的可行方法,然而,检测肿瘤性肺部肿块的诊断敏感性较低。