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猫创伤性脑损伤的CT表现及科雷特CT评分的预后价值

CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury.

作者信息

Mann Ohad, Peery Dana, Bader Segev Ronnie, Klainbart Sigal, Kelmer Efrat, Sobarzo Ariel, Shub Vered, Rapoport Kira, Shamir Merav H, Chai Orit

机构信息

Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel.

Department of Radiology, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel.

出版信息

J Feline Med Surg. 2022 Feb;24(2):91-97. doi: 10.1177/1098612X211005306. Epub 2021 Apr 13.

Abstract

OBJECTIVES

The aims of this study were to evaluate associations between abnormal head CT findings and outcome, and to examine the prognostic value of the Koret CT score (KCTS) in cats sustaining acute traumatic brain injury (TBI).

METHODS

The medical records of cats hospitalised with TBI that underwent head CT scans within 72 h of admission were retrospectively reviewed. CT scans were evaluated independently by a radiologist and a neurologist who were blinded to the outcome. A KCTS and modified Glasgow Coma Scale (MGCS) were assigned to each cat and the association between abnormal CT findings, KCTS, MGCS and outcome were analysed.

RESULTS

Fourteen cats were included in the study: nine (64.2%) survivors and five (35.7%) non-survivors. Of the nine cats that were discharged, one was a short-term survivor (10 days) and eight (57.1%) were long-term survivors (⩾6 months). Abnormal CT findings included lateral ventricle asymmetry/midline shift (42.8%), intracranial haemorrhage (35.7%), caudotentorial lesions (14.2%) and cranial vault fractures (14.2%), all of which were depressed. Intracranial haemorrhage was found to be significantly and negatively associated with short-term ( = 0.005) and long-term ( = 0.023) survival. KCTS was significantly associated with short-term survival ( = 0.002) and long-term survival ( = 0.004). A KCTS cut-off value of 2 yielded a 100% sensitivity and 100% specificity for short-term survival and 100% sensitivity and 80% specificity for long-term survival. A MGCS cut-off value of ⩾13 was associated with a 100% sensitivity and 100% specificity for short-term survival, and with a 100% sensitivity and 80% specificity for long-term survival.

CONCLUSIONS AND RELEVANCE

KCTS, performed up to 72 h from injury, can be used as an additional diagnostic tool for the prediction of survival in cats with TBI.

摘要

目的

本研究旨在评估头部CT异常表现与预后之间的关联,并检验Koret CT评分(KCTS)在急性创伤性脑损伤(TBI)猫中的预后价值。

方法

回顾性分析入院72小时内接受头部CT扫描的TBI住院猫的病历。CT扫描由一名对结果不知情的放射科医生和一名神经科医生独立评估。为每只猫分配KCTS和改良格拉斯哥昏迷量表(MGCS),并分析CT异常表现、KCTS、MGCS与预后之间的关联。

结果

本研究纳入14只猫:9只(64.2%)存活,5只(35.7%)未存活。在出院的9只猫中,1只为短期存活者(10天),8只(57.1%)为长期存活者(≥6个月)。CT异常表现包括侧脑室不对称/中线移位(42.8%)、颅内出血(35.7%)、小脑幕病变(14.2%)和颅顶骨折(14.2%),均为凹陷性骨折。发现颅内出血与短期(P = 0.005)和长期(P = 0.023)存活显著负相关。KCTS与短期存活(P = 0.002)和长期存活(P = 0.004)显著相关。KCTS临界值为2时,短期存活的敏感性和特异性均为100%,长期存活的敏感性为100%,特异性为80%。MGCS临界值≥13时,短期存活的敏感性和特异性均为100%,长期存活的敏感性为100%,特异性为80%。

结论及意义

受伤后72小时内进行的KCTS可作为预测TBI猫存活的额外诊断工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/088e/10812167/24981cdd2f41/10.1177_1098612X211005306-fig1.jpg

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