School of Veterinary Sciences, University of Bristol, Bristol, UK.
The Feline Centre, Langford Vets, University of Bristol, Bristol, UK.
J Feline Med Surg. 2020 Oct;22(10):966-976. doi: 10.1177/1098612X19900408. Epub 2020 Feb 21.
Radioiodine (RAI) treatment for hyperthyroidism is becoming increasingly available in the UK. Pretreatment assessment is commonly performed, as patient handling is limited once RAI has been administered. The aims of this study were to determine the prevalence of thoracic pathology using thoracic radiography in hyperthyroid cats referred for RAI treatment and to determine the value of this technique pretreatment.
The hospital databases were searched for hyperthyroid cats referred for RAI treatment at the Feline Centre, Langford Vets, between January 2012 and July 2016. Radiographs were reviewed by Diplomates of the European College of Veterinary Diagnostic Imaging at the time of treatment and each set of radiographs was subsequently reviewed by one radiologist for the study. Cardiorespiratory signs were recorded, if present, and any change in treatment plan or suitability for RAI treatment was documented.
Two hundred and fifty-two cats were included in the study. Thoracic pathology was identified in 77% (n = 194/252) of the cats, of which 59% (n = 115/194) had pulmonary abnormalities with bronchial and bronchointerstitial patterns most frequently; 57% (n = 111/194) had skeletal abnormalities and 43% (n = 84/194) had cardiac abnormalities, with mild-to-moderate cardiomegaly most prevalent. Other abnormalities included sternal lymphadenomegaly (7%; n = 13/194), mediastinal pathology (3%; n = 5/194), oesophageal pathology (2%; n = 4/194) and pleural space disease (0.5%; n = 1/194).Twelve cases (6%) had a change in their treatment plan as a result of thoracic radiographic abnormalities, of which five subsequently underwent RAI treatment.
A low prevalence of significant thoracic pathology was identified on radiographs in hyperthyroid cats referred for RAI treatment. Incidental thoracic abnormalities were found much more commonly; hence, results of thoracic radiology need to be combined with the clinical picture, to decide whether further investigations or alterations to the treatment plan are required pre-RAI.
放射性碘（RAI）治疗甲状腺功能亢进症在英国越来越普及。由于RAI 给药后患者处理受限，通常会进行治疗前评估。本研究的目的是确定在因 RAI 治疗而转介至 Feline Centre，Langford Vets 的甲状腺功能亢进猫中，使用胸部 X 射线检查发现的胸病理患病率，并确定该技术在治疗前的价值。
在 2012 年 1 月至 2016 年 7 月期间，检索 Feline Centre，Langford Vets 因 RAI 治疗而转介的甲状腺功能亢进猫的医院数据库。在治疗时，由欧洲兽医诊断影像学学院的院士对 X 射线进行回顾，并由一位放射科医生对每组 X 射线进行后续回顾。记录存在的心肺体征，并记录治疗计划的任何改变或是否适合 RAI 治疗。
本研究共纳入 252 只猫。77%（n=194/252）的猫存在胸部病理，其中 59%（n=115/194）有肺部异常，以支气管和细支气管模式最常见；57%（n=111/194）有骨骼异常，43%（n=84/194）有心脏异常，以轻度至中度心脏扩大最常见。其他异常包括胸骨淋巴结肿大（7%；n=13/194）、纵隔病变（3%；n=5/194）、食管病变（2%；n=4/194）和胸膜腔疾病（0.5%；n=1/194）。12 例（6%）因胸部放射异常改变治疗计划，其中 5 例随后接受 RAI 治疗。
在因 RAI 治疗而转介的甲状腺功能亢进猫的胸部 X 射线片中，发现的严重胸部病理的患病率较低。偶然发现的胸部异常更为常见；因此，胸部放射学的结果需要与临床情况相结合，以决定是否需要在 RAI 前进行进一步检查或改变治疗计划。
