Fuerst Jason A, Hostnik Eric T
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio.
Vet Radiol Ultrasound. 2019 Nov;60(6):689-695. doi: 10.1111/vru.12806. Epub 2019 Sep 8.
Gallbladder mucoceles are potentially fatal in dogs. Multiphase CT angiography was performed to evaluate the canine gallbladder in three conditions: no sludge, sludge occupying ≥25% of the lumen, and mucoceles. Twenty dogs with normal hepatobiliary bloodwork and no-to-minimal gallbladder sludge, 13 dogs with normal bloodwork and ≥25% sludge in the gallbladder lumen, and 18 dogs with histologically confirmed gallbladder mucoceles were enrolled in a prospective, observational diagnostic accuracy study. Three regions of interest (ROI) were stratified in the dorsal-ventral orientation and a single ROI was measured within the hepatic parenchyma. Mean attenuation and presence of mineral were recorded. Average Hounsfield units (HU) were recorded for precontrast, arterial, portovenous, and late venous phases. The overall median HU value for mucoceles was significantly higher than gallbladders without sludge and with sludge; precontrast median overall attenuation was 49.3, 35.8, and 39.7 HU, respectively (P < .000004). Mineral was seen in four (20%) dogs with no sludge, seven (56%) dogs with sludge, and nine (50%) dogs with mucoceles. Mineral in the dogs with mucoceles was located within the central aspect of the gallbladder lumen in 67% of mucoceles; this mineral distribution was not seen in any dog without a mucocele. Computed tomography can differentiate a subset of gallbladder mucoceles from dogs with and without gallbladder sludge, especially in the precontrast series. An HU value of 48.6 is 52% sensitive and 96% specific for a gallbladder mucocele. A hyperattenuating gallbladder on precontrast CT images and centrally distributed mineral can be a gallbladder mucocele.
胆囊黏液囊肿对犬类有潜在致命性。进行了多期CT血管造影以评估犬胆囊在三种情况下的状况：无胆汁淤积、胆汁淤积占据管腔≥25%以及黏液囊肿。20只肝胆血液检查正常且胆囊无至轻度胆汁淤积的犬、13只血液检查正常且胆囊管腔胆汁淤积≥25%的犬以及18只经组织学证实有胆囊黏液囊肿的犬被纳入一项前瞻性观察性诊断准确性研究。在背腹方向分层设置三个感兴趣区（ROI），并在肝实质内测量单个ROI。记录平均衰减值和矿物质情况。记录平扫、动脉期、门静脉期和延迟静脉期的平均亨氏单位（HU）。黏液囊肿的总体中位HU值显著高于无胆汁淤积和有胆汁淤积的胆囊；平扫时总体中位衰减值分别为49.3、35.8和39.7 HU（P <.000004）。在无胆汁淤积的4只（20%）犬、有胆汁淤积的7只（56%）犬和有黏液囊肿的9只（50%）犬中发现了矿物质。有黏液囊肿的犬中，67%的黏液囊肿矿物质位于胆囊管腔中央；在无黏液囊肿的犬中未发现这种矿物质分布情况。计算机断层扫描能够区分有胆囊黏液囊肿的犬与有和无胆囊胆汁淤积的犬，尤其是在平扫系列中。HU值为48.6时，对胆囊黏液囊肿的敏感性为52%，特异性为96%。平扫CT图像上胆囊高密度以及矿物质中央分布可能提示胆囊黏液囊肿。
