Wormser Chloe, Reetz Jennifer A, Drobatz Kenneth J, Aronson Lillian R
J Am Vet Med Assoc. 2019 Mar 15;254(6):710-715. doi: 10.2460/javma.254.6.710.
OBJECTIVE To assess the utility of ultrasonography to detect the cause and location of ureteral obstruction in cats and to identify factors associated with agreement between ultrasonographic and surgical findings. STUDY DESIGN Retrospective case series. ANIMALS 71 cats. PROCEDURES Medical records were searched to identify cats that had ureteral obstruction diagnosed ultrasonographically and that subsequently underwent exploratory laparotomy. Patient signalment, ultrasonographic findings, interventions performed, and surgical findings were recorded. Cause and location of ureteral obstruction as assessed by ultrasonography were compared with surgical findings. Sensitivity, specificity, and positive predictive value of ultrasonography for detection of ureteroliths and strictures were calculated. Statistical analysis was performed to identify factors associated with agreement between ultrasonographic and surgical findings. RESULTS There was significant, moderate agreement between ultrasonographic and surgical findings for the cause and location of ureteral obstruction. Signalment variables, ureter affected (left vs right), and presence of retroperitoneal effusion were not associated with this agreement. Sensitivity was 98% and 44%, specificity was 96% and 98%, and positive predictive value was 98% and 88% for detection of ureteroliths and strictures, respectively, by ultrasonography. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasonography was highly sensitive for detection of ureteroliths that caused ureteral obstruction but was considerably less sensitive for detection of ureteral strictures in the study population. Future prospective studies are needed to determine the role of advanced imaging in assessing cats with ureteral abnormalities. (J Am Vet Med Assoc 2019;254:710-715).
目的 评估超声检查在检测猫输尿管梗阻病因及部位方面的效用，并确定与超声检查结果和手术结果一致性相关的因素。 研究设计 回顾性病例系列研究。 动物 71只猫。 方法 检索病历，以确定经超声诊断为输尿管梗阻且随后接受剖腹探查术的猫。记录患猫的信号、超声检查结果、实施的干预措施和手术结果。将超声检查评估的输尿管梗阻病因及部位与手术结果进行比较。计算超声检查对输尿管结石和狭窄检测的敏感性、特异性和阳性预测值。进行统计分析以确定与超声检查结果和手术结果一致性相关的因素。 结果 超声检查结果与手术结果在输尿管梗阻病因及部位方面存在显著的中度一致性。信号变量、受累输尿管（左侧与右侧）及腹膜后积液的存在与这种一致性无关。超声检查对输尿管结石和狭窄检测的敏感性分别为98%和44%，特异性分别为96%和98%，阳性预测值分别为98%和88%。 结论及临床意义 在本研究群体中，超声检查对导致输尿管梗阻的输尿管结石检测高度敏感，但对输尿管狭窄检测的敏感性则低得多。需要进一步的前瞻性研究来确定先进成像技术在评估输尿管异常猫中的作用。（《美国兽医医学协会杂志》2019年；254:710 - 715）
