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以床旁肺部超声和胸部 X 线摄影与胸部计算机断层扫描对比诊断机动车创伤犬的肺挫裂伤:29 例病例报告(2017-2018 年)。

Diagnosis of pulmonary contusions with point-of-care lung ultrasonography and thoracic radiography compared to thoracic computed tomography in dogs with motor vehicle trauma: 29 cases (2017-2018).

机构信息

Ocean State Veterinary Specialists, East Greenwich, RI.

Hill Country Veterinary Specialists, Spicewood, TX.

出版信息

J Vet Emerg Crit Care (San Antonio). 2020 Nov;30(6):638-646. doi: 10.1111/vec.13021. Epub 2020 Oct 21.

Abstract

OBJECTIVE

To determine the accuracy of lung ultrasound (LUS) using the Veterinary Bedside Lung Ultrasound Examination (VetBLUE) protocol and 3-view thoracic radiographs (TXR) compared to thoracic computed tomography (TCT) for diagnosing the presence and quantification of pulmonary contusions (PC).

DESIGN

Prospective cohort study conducted from February 2017 to June 2018.

SETTING

Private emergency and referral center.

ANIMALS

Thirty-two dogs having sustained motor vehicle trauma were consecutively enrolled. Three dogs were excluded from statistical analysis. All dogs survived to hospital discharge.

INTERVENTIONS

Within 24 hours of sustaining trauma, dogs had LUS, TXR, and TCT performed. Using the VetBLUE protocol, LUS PC were scored according to the presence and number of B-lines and C-lines, indicating extravascular lung water. Thoracic radiographs and TCT were scored for PC in a similar topographical pattern to the VetBLUE protocol. Lung ultrasound and TXR were compared to "gold standard" TCT for the presence and quantification of PC.

MEASUREMENTS AND MAIN RESULTS

On TCT, 21 of 29 (72.4%) dogs were positive and 8 of 29 (27.6%) dogs were negative for PC. When LUS was compared to TCT, 19 of 21 dogs were positive for PC (90.5% sensitivity) and 7 of 8 dogs were negative (87.5% specificity) for PC. LUS PC score correlated strongly with TCT PC score (R = 0.8, P < 0.001). When TXR was compared to TCT, 14 of 21 dogs were positive for PC (66.7% sensitivity) and 7 of 8 dogs were negative (87.5% specificity) for PC. TXR PC score correlated strongly with TCT PC score (R = 0.74, P < 0.001).

CONCLUSIONS

In this population of dogs with motor vehicle trauma, LUS had high sensitivity for diagnosis of PC when compared to "gold standard" TCT. LUS provides reliable diagnosis of PC after trauma. More patients with PC were identified with LUS than with TXR, and additional studies are warranted to determine whether this increased sensitivity is statistically significant.

摘要

目的

使用兽医床边肺部超声检查(VetBLUE)方案和 3 视图胸部 X 光片(TXR),与胸部计算机断层扫描(TCT)相比,确定肺挫伤(PC)的存在和定量的肺部超声(LUS)的准确性。

设计

2017 年 2 月至 2018 年 6 月进行的前瞻性队列研究。

地点

私人急诊和转诊中心。

动物

32 只因机动车事故受伤的狗连续入组。3 只狗被排除在统计分析之外。所有狗均存活至出院。

干预措施

在受伤后 24 小时内,狗进行了 LUS、TXR 和 TCT 检查。使用 VetBLUE 方案,根据 B 线和 C 线的存在和数量对 LUS PC 进行评分,表明血管外肺水。胸部 X 光片和 TCT 与 VetBLUE 方案类似的地形模式对 PC 进行评分。将肺超声和 TXR 与“金标准”TCT 进行比较,以确定 PC 的存在和定量。

测量和主要结果

在 TCT 上,29 只狗中有 21 只(72.4%)为阳性,29 只狗中有 8 只(27.6%)为阴性。当 LUS 与 TCT 进行比较时,21 只狗中有 19 只为 PC 阳性(90.5%的敏感性),8 只狗中有 7 只为 PC 阴性(87.5%的特异性)。LUS PC 评分与 TCT PC 评分密切相关(R=0.8,P<0.001)。当将 TXR 与 TCT 进行比较时,21 只狗中有 14 只为 PC 阳性(66.7%的敏感性),8 只狗中有 7 只为 PC 阴性(87.5%的特异性)。TXR PC 评分与 TCT PC 评分密切相关(R=0.74,P<0.001)。

结论

在这群因机动车事故受伤的狗中,与“金标准”TCT 相比,LUS 对 PC 的诊断具有高敏感性。LUS 可在创伤后提供可靠的 PC 诊断。通过 LUS 检测到的 PC 患者比通过 TXR 检测到的更多,需要进一步研究以确定这种敏感性增加是否具有统计学意义。

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