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比较影像学技术检测移行性异物。术前和术中超声检查对诊断和手术切除的相关性。

Comparison of imaging techniques to detect migrating foreign bodies. Relevance of preoperative and intraoperative ultrasonography for diagnosis and surgical removal.

机构信息

Small Animal Surgery Unit, Department of Clinical Sciences, VetAgroSup, Campus vétérinaire de Lyon, Marcy l'Etoile, France.

Diagnostic Imaging Unit, Department of Clinical Sciences, VetAgroSup, Campus vétérinaire de Lyon, Marcy l'Etoile, France.

出版信息

Vet Surg. 2021 May;50(4):833-842. doi: 10.1111/vsu.13607. Epub 2021 Mar 22.

Abstract

OBJECTIVE

To report the relative sensitivity of different diagnostic imaging (DI) techniques to detect migrating foreign bodies (FB) in subcutaneous and underlying soft tissue structures of dogs and evaluate the value of intraoperative ultrasonography (intraop-US).

STUDY DESIGN

Retrospective study.

SAMPLE POPULATION

Forty-one dogs.

METHODS

Medical records (2007-2019) of dogs that underwent surgery for a chronic abscess or draining tract were included when preoperative US (preop-US), computed tomography (preop-CT), or preop-MRI, and at least 6 months of follow-up information were available. Collected data included the DI techniques used, DI findings, and surgical findings. The relative sensitivity of each preoperative DI (preop-DI) technique was calculated. Dogs were divided into two groups, dogs that underwent only a preop-DI examination (group A) and dogs that underwent an additional intraop-US (group B). The success rates for FB surgical removal were compared between groups.

RESULTS

The relative sensitivity of preop-US and preop-CT/MRI was 88% (95% CI, 70%-95.8%) and 57.1% (95% CI, 32.6%-78.6%), respectively. The success rate for FB removal was higher in group B (89.5%) than in group A (59.1%; P = .038). Clinical resolution occurred in 90.2% of dogs for a median duration of follow-up of 4.2 years (6 months to 9.3 years).

CONCLUSION

Preoperative US seems more suitable than preop-CT/MRI for detection of migrating FB in subcutaneous and underlying soft tissue structures. The use of intraop-US increases the success rate for FB surgical removal.

CLINICAL SIGNIFICANCE

Intraoperative US should be used in combination with preop-US to increase the likelihood of migrating FB surgical removal in dogs.

摘要

目的

报告不同诊断影像学(DI)技术检测狗皮下和深部软组织结构中移行异物(FB)的相对敏感性,并评估术中超声(intraop-US)的价值。

研究设计

回顾性研究。

样本人群

41 只狗。

方法

纳入 2007 年至 2019 年期间因慢性脓肿或引流道而行手术的狗的病历,当有术前超声(preop-US)、计算机断层扫描(preop-CT)或术前磁共振成像(preop-MRI),且有至少 6 个月的随访信息时,将其纳入研究。收集的数据包括使用的 DI 技术、DI 结果和手术结果。计算每种术前 DI(preop-DI)技术的相对敏感性。狗分为两组,仅行术前 DI 检查的狗(A 组)和行额外术中超声检查的狗(B 组)。比较两组 FB 手术切除的成功率。

结果

preop-US 和 preop-CT/MRI 的相对敏感性分别为 88%(95%可信区间,70%-95.8%)和 57.1%(95%可信区间,32.6%-78.6%)。B 组 FB 切除成功率(89.5%)高于 A 组(59.1%;P=.038)。中位随访时间为 4.2 年(6 个月至 9.3 年),90.2%的狗临床症状缓解。

结论

术前 US 似乎比 preop-CT/MRI 更适合检测皮下和深部软组织结构中的移行 FB。术中 US 的使用增加了 FB 手术切除的成功率。

临床意义

术中 US 应与 preop-US 联合使用,以提高狗移行 FB 手术切除的可能性。

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