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患有各种潜在咳嗽病因的犬只的肺部超声检查结果。

Lung ultrasonography findings in dogs with various underlying causes of cough.

作者信息

Ward Jessica L, Lisciandro Gregory R, Ware Wendy A, Miles Kristina G, Viall Austin K, DeFrancesco Teresa C

出版信息

J Am Vet Med Assoc. 2019 Sep 1;255(5):574-583. doi: 10.2460/javma.255.5.574.

Abstract

OBJECTIVE

To characterize lung ultrasonography (LUS) findings in dogs with a primary clinical complaint of cough.

ANIMALS

100 client-owned coughing dogs.

PROCEDURES

A standardized LUS examination was performed for all dogs to quantify the number of B lines and identify subpleural abnormalities at 4 sites on each hemithorax. The final clinical diagnosis (reference standard) was determined by medical record review, and sensitivity and specificity of LUS for the diagnosis of selected causes of cough was determined.

RESULTS

Common underlying causes of cough included dynamic airway collapse (n = 37), cardiogenic pulmonary edema (CPE; 12), and bronchitis (10). Compared with dogs with other causes of cough, dogs with bacterial pneumonia (n = 7) were more likely to have subpleural shred signs, whereas dogs with pulmonary neoplasia (4) were more likely to have subpleural nodule signs. Dogs with CPE had higher total B-line scores and higher numbers of LUS sites strongly positive for B lines (> 3 B lines/site) than other dogs. The LUS criteria of total B-line score ≥ 10 and presence of ≥ 2 sites strongly positive for B lines were each 92% sensitive and 94% specific for CPE diagnosis. Notably, 18% (16/88) of dogs with noncardiac causes of cough had been treated previously with diuretics because of prior CPE misdiagnosis.

CONCLUSIONS AND CLINICAL RELEVANCE

LUS profiles in dogs with cough differed by the underlying cause. In dogs with a clinical history of cough, this imaging modality could be diagnostically useful, particularly to help exclude the possibility of underlying CPE.

摘要

目的

描述以咳嗽为主要临床症状的犬的肺部超声(LUS)检查结果。

动物

100只客户拥有的咳嗽犬。

方法

对所有犬进行标准化的LUS检查,以量化B线数量,并识别每个半侧胸腔4个部位的胸膜下异常。通过病历回顾确定最终临床诊断(参考标准),并确定LUS对所选咳嗽病因诊断的敏感性和特异性。

结果

咳嗽的常见潜在病因包括动态气道塌陷(n = 37)、心源性肺水肿(CPE;12)和支气管炎(10)。与其他咳嗽病因的犬相比,细菌性肺炎犬(n = 7)更易出现胸膜下条索征,而肺肿瘤犬(4)更易出现胸膜下结节征。CPE犬的总B线评分更高,且B线强阳性(> 3条B线/部位)的LUS部位数量多于其他犬。总B线评分≥10且存在≥2个B线强阳性部位的LUS标准对CPE诊断的敏感性和特异性均为92%。值得注意的是,18%(16/88)非心源性咳嗽犬因先前CPE误诊而接受过利尿剂治疗。

结论及临床意义

咳嗽犬的LUS特征因潜在病因而异。对于有咳嗽临床病史的犬,这种成像方式可能具有诊断价值,特别是有助于排除潜在CPE的可能性。

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