Lin Chung-Hui, Lo Pei-Ying, Lam Man-Cham, Wu Huey-Dong
National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan.
Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan.
Front Vet Sci. 2020 Dec 18;7:616882. doi: 10.3389/fvets.2020.616882. eCollection 2020.
Chest ultrasonography has become an indispensable tool for pulmonary specialists in human medicine, but its current use in dogs and cats is primarily for emergency. The diagnostic performances of various ultrasonographic features other than comet-tail artifacts are of limited information in veterinary literatures. Therefore, the aims of this retrospective study were to investigate ultrasonographic findings in feline and canine respiratory patients with lung parenchymal and pleural space diseases, and to assess how ultrasonographic features correspond to specific diagnoses. Sixty-five non-emergency cases with radiographically identified lung parenchymal and pleural space abnormalities were included. Medical records and ultrasound video clips were reviewed, and additional follow-up information was subsequently collected. Common findings such as comet-tail artifacts (87.7% of cases), consolidation (84.6%), and thickened/irregular pleura (69.2%) were not distinguishable for a specific diagnosis. The presence of nodular/mass-like lesion (OR = 212, < 0.001) and consolidated lesion with heteroechogenicity (OR = 240, < 0.001) was significantly associated with and strongly predictive of neoplasia after age, body weight and other sonographic findings were adjusted. The finding of nodular/mass-like lesion has the best diagnostic performance (AUC = 0.93) for neoplasia, with sensitivity of 91.7% and specificity of 93.6%. For predicting a diagnosis of pneumonia, although several sonographic features were found to be statistically associated with pneumonia, only a negative finding of nodular/mass-like lesion showed good diagnostic performance (AUC = 0.83, sensitivity 95.7%, specificity 71%). These findings demonstrate the value of chest ultrasonography in predicting diagnosis in non-emergency cases. The application of thoracic ultrasound in small animal respiratory patients as part of non-invasive assessment warrants further investigation.
胸部超声检查已成为人类医学中肺部专家不可或缺的工具，但目前在犬猫中的应用主要是用于急诊。除彗尾伪像外，各种超声特征的诊断性能在兽医文献中的信息有限。因此，这项回顾性研究的目的是调查患有肺实质和胸膜腔疾病的猫科和犬科呼吸道疾病患者的超声检查结果，并评估超声特征与特定诊断的对应关系。纳入了65例经放射学检查确定有肺实质和胸膜腔异常的非急诊病例。回顾了病历和超声视频片段，并随后收集了额外的随访信息。彗尾伪像（87.7%的病例）、实变（84.6%）和增厚/不规则胸膜（69.2%）等常见表现无法区分特定诊断。在调整年龄、体重和其他超声检查结果后，结节状/肿块样病变（OR = 212，P < 0.001）和具有异质性的实变病变（OR = 240，P < 0.001）与肿瘤形成显著相关且具有强烈的预测性。结节状/肿块样病变的发现对肿瘤形成具有最佳诊断性能（AUC = 0.93），敏感性为91.7%，特异性为93.6%。对于预测肺炎的诊断，尽管发现一些超声特征与肺炎有统计学关联，但只有结节状/肿块样病变的阴性发现显示出良好的诊断性能（AUC = 0.83，敏感性95.7%，特异性71%）。这些发现证明了胸部超声在预测非急诊病例诊断中的价值。将胸部超声应用于小动物呼吸道疾病患者作为非侵入性评估的一部分值得进一步研究。
