Szatmári Viktor, Hofman Zelie M M, van Bijsterveldt Nynke J, Tellegen Anna R, Vilaplana Grosso Federico R
Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands.
Animals (Basel). 2023 Jul 2;13(13):2178. doi: 10.3390/ani13132178.
Left atrial enlargement indicates severe cardiac disease. Although the gold standard for determining left atrial size is echocardiography, many veterinary practices lack the necessary equipment and expertise. Therefore, thoracic radiography is often used to differentiate cardiogenic pulmonary edema from primary respiratory diseases and to facilitate distinguishing dogs with stage B1 and B2 mitral valve degeneration.
The goal was to test a new standardized method for identifying radiographic left atrial enlargement. On a lateral radiograph, a straight line was drawn from the dorsal border of the tracheal bifurcation to the crossing point of the dorsal border of the caudal vena cava and the most cranial crus of the diaphragm. If a part of the left atrium extended this line dorsally, it was considered enlarged. Echocardiographic left atrial to aortic ratio (LA:Ao) was used as a reference. Thirty-nine observers with various levels of experience evaluated 90 radiographs, first subjectively, then applying the new method.
The new method moderately correlated with LA:Ao (r = 0.56-0.66) in all groups. The diagnostic accuracy (72-74%) of the subjective assessment and the new method showed no difference.
Though the new method was not superior to subjective assessment, it may facilitate learning and subjective interpretation.
左心房增大提示严重的心脏疾病。虽然确定左心房大小的金标准是超声心动图，但许多兽医诊所缺乏必要的设备和专业知识。因此，胸部X线摄影常用于区分心源性肺水肿与原发性呼吸道疾病，并有助于鉴别处于B1和B2期二尖瓣退化的犬。
目的是测试一种识别X线摄影左心房增大的新标准化方法。在侧位X线片上，从气管分叉的背侧边界画一条直线至尾腔静脉背侧边界与膈最头侧脚的交叉点。如果左心房的一部分向该线背侧延伸，则认为左心房增大。以超声心动图测量的左心房与主动脉比值（LA:Ao）作为参考。39名经验水平各异的观察者对90张X线片进行评估，首先进行主观评估，然后应用新方法评估。
在所有组中，新方法与LA:Ao呈中度相关（r = 0.56 - 0.66）。主观评估和新方法的诊断准确性（72 - 74%）无差异。
虽然新方法并不优于主观评估，但它可能有助于学习和主观解释。
