Vignoli Massimo, Tamburro Roberto, Felici Andrea, Del Signore Francesca, Dettori Annalisa, Di Tommaso Morena, Ghiraldelli Angela, Terragni Rossella, Simeoni Francesco, Falerno Ilaria, Miglio Arianna
Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, 06126 Perugia, Italy.
Animals (Basel). 2021 Mar 19;11(3):883. doi: 10.3390/ani11030883.
Diagnosis of thoracic lesions on the basis of history and physical examination is often challenging. Diagnostic imaging is therefore of paramount importance in this field. Radiology has traditionally been considered the diagnostic procedure of choice for these diseases. Nevertheless, it is often not possible to differentiate inflammatory/infectious lesions from neoplastic diseases. A correct cytological and histopathologic diagnosis is therefore needed for an accurate diagnosis and subsequent prognostic and therapeutic approach. In human medicine, Computed Tomography (CT) and CT-guided biopsy are used in the presence of lesions which are not adequately diagnosed with other procedures. In the present study, thoracic lesions from 52 dogs and 10 cats of different sex, breed and size underwent both CT-guided fine-needle aspiration (FNAB) and tissue-core biopsy (TCB). Clinical examination, hematobiochemical analysis and chest radiography were performed on all animals. In this study, 59 of 62 histopathological samples were diagnostic (95.2%). Cytology was diagnostic in 43 of 62 samples (69.4%). General sensitivity, accuracy and PPV for FNAB and TCB were 67.7%, 67.7% and 100% and 96.7%, 95.2% and 98.3%, respectively. Combining the two techniques, the overall mean accuracy for diagnosis was 98.4%. Nineteen of 62 cases showed complications (30.6%). Mild pneumothorax was seen in 16 cases, whereas mild hemorrhage occurred in three cases. No major complications were encountered. CT-guided FNAB cytology can be considered a useful and reliable technique, especially for small lesions or lesions located close to vital organs and therefore dangerous to biopsy in other way.
基于病史和体格检查来诊断胸部病变往往具有挑战性。因此,诊断性影像学检查在该领域至关重要。传统上,放射学一直被认为是这些疾病的首选诊断方法。然而,通常无法将炎性/感染性病变与肿瘤性疾病区分开来。因此,需要进行正确的细胞学和组织病理学诊断,以便做出准确的诊断以及后续的预后评估和治疗方案。在人类医学中,对于其他检查方法无法充分诊断的病变,会使用计算机断层扫描(CT)和CT引导下活检。在本研究中,对52只犬和10只猫的不同性别、品种和体型的胸部病变进行了CT引导下细针穿刺抽吸活检(FNAB)和组织芯活检(TCB)。对所有动物都进行了临床检查、血液生化分析和胸部X线摄影。在本研究中,62个组织病理学样本中有59个具有诊断价值(95.2%)。62个样本中有43个细胞学检查具有诊断价值(69.4%)。FNAB和TCB的总体敏感性、准确性和阳性预测值分别为67.7%、67.7%和100%以及96.7%、95.2%和98.3%。将这两种技术结合起来,诊断的总体平均准确率为98.4%。62例中有19例出现并发症(30.6%)。16例出现轻度气胸,3例出现轻度出血。未遇到重大并发症。CT引导下FNAB细胞学检查可被认为是一种有用且可靠的技术,特别是对于小病变或位于重要器官附近因而以其他方式活检危险的病变。