Département des sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.
J Vet Intern Med. 2021 Jul;35(4):2058-2068. doi: 10.1111/jvim.16157. Epub 2021 May 16.
The best test between thoracic ultrasonography (TUS) and thoracic radiography (TR) or the best combination of tests (series or parallel) to detect active infectious bronchopneumonia (BP) in hospitalized dairy calves remains unknown.
HYPOTHESIS/OBJECTIVES: To estimate performances of TUS and TR to detect active BP in hospitalized dairy calves and to determine the best strategy for using these tests based on a panel diagnosis method (PDM). Performances of TUS and TR were hypothesized to be equivalent.
Fifty hospitalized dairy calves (≥7 days old; ≤100 kg; standing; pCO ≥ 53 mm Hg; any reason of presentation).
Each calf prospectively and sequentially underwent physical examination, thoracic auscultation, blood analyses, and TUS and TR. Three blinded experts determined whether active BP was present/absent based on PDM. Krippendorff's alpha measured interexpert agreement. The sensitivities (Se) and specificities (Sp) of TUS and TR alone and in series or parallel were compared (McNemar's test; P < .05).
Interexpert agreement was moderate at 0.58 (95%CI: 0.42; 0.73). The Se and Sp of TUS were 0.84 (95%CI: 0.60; 0.97) and 0.74 (95%CI: 0.57; 0.86), respectively. The Se and Sp of TR were 0.89 (95%CI: 0.67; 0.99) and 0.58 (95%CI: 0.39; 0.75), respectively. No significant difference was found in the Se and Sp of TUS and TR when analyzed alone, in series or in parallel.
Thoracic ultrasonography or TR alone equally detected active BP in hospitalized dairy calves. Series or parallel analysis provided no additional benefit. Its ease of use and widespread accessibility support using TUS as a first-line test to detect active BP in hospitalized dairy calves.
在住院奶牛犊牛中，哪种检测方法（超声检查或 X 射线检查）或哪种检测方法的组合（串联或并联）对活动性传染性支气管肺炎（BP）的检测效果最佳仍不清楚。
假设/目的：评估超声检查和 X 射线检查在住院奶牛犊牛中检测活动性 BP 的性能，并根据面板诊断方法（PDM）确定使用这些检测方法的最佳策略。假设超声检查和 X 射线检查的性能相当。
50 头住院奶牛犊牛（≥7 日龄；≤100kg；站立；pCO2≥53mmHg；任何就诊原因）。
每头犊牛前瞻性、顺序性地接受体格检查、胸部听诊、血液分析以及超声检查和 X 射线检查。3 名盲法专家根据 PDM 确定是否存在活动性 BP。Krippendorff's alpha 评估专家间的一致性。比较了单独使用超声检查和 X 射线检查以及串联或并联使用时的敏感性（Se）和特异性（Sp）（McNemar 检验；P＜0.05）。
专家间的一致性为中等水平，为 0.58（95%CI：0.42；0.73）。超声检查的 Se 和 Sp 分别为 0.84（95%CI：0.60；0.97）和 0.74（95%CI：0.57；0.86），X 射线检查的 Se 和 Sp 分别为 0.89（95%CI：0.67；0.99）和 0.58（95%CI：0.39；0.75）。单独、串联或并联分析时，超声检查和 X 射线检查的 Se 和 Sp 无显著差异。
在住院奶牛犊牛中，单独使用超声检查或 X 射线检查均可检测到活动性 BP。串联或并联分析没有提供额外的益处。由于其易于使用和广泛的可及性，支持将超声检查作为检测住院奶牛犊牛活动性 BP 的一线检测方法。
