Department of Radiology, Louisiana State School of Veterinary Medicine, Baton Rouge, Louisiana, USA.
VetCT, Orlando, Florida, USA.
Vet Radiol Ultrasound. 2024 May;65(3):219-226. doi: 10.1111/vru.13344. Epub 2024 Feb 16.
Bronchomalacia, the weakening of bronchial cartilage, is a common cause of cough in dogs. The gold standard for diagnosis of bronchomalacia is bronchoscopy; however, fluoroscopy is often used as a preliminary diagnostic test due to its noninvasiveness. The normal amount of bronchial collapse in healthy dogs using fluoroscopy has not been previously established, with some authors citing <25%. The aims of this prospective and retrospective analytical observational study were to determine the normal amount of airway collapse in healthy animals, the amount of airway collapse in dogs with chronic cough and presumed bronchomalacia, and cut-off values of airway collapse during expiration and cough to distinguish between the two groups. Thoracic fluoroscopy was performed in right and left lateral recumbency during inspiration, expiration, and cough to evaluate the percentage collapse of the trachea and lobar bronchi in 45 healthy and 76 chronically coughing dogs. The bronchi of chronically coughing dogs exhibited a significantly greater amount of collapse during both expiration and cough compared with healthy dogs. Chronically coughing dogs exhibited up to 31.7 ± 26.6% collapse in expiration and 87.5 ± 23.7% collapse during cough, whereas healthy dogs exhibited 14.9 ± 6.1% collapse in expiration and 35.0 ± 13.7% collapse during cough. Based on ROC curves, the authors suggest using cut-off values of 30% during expiration and 60% during cough to distinguish between healthy dogs and those with presumed bronchomalacia. Findings suggest that though healthy dogs can exhibit a greater degree of airway collapse than previously thought, fluoroscopy can be used to distinguish between healthy and presumed bronchomalacic dogs.
支气管软化,即支气管软骨变弱,是犬咳嗽的常见原因。支气管镜检查是诊断支气管软化的金标准;然而,由于其非侵入性,透视检查通常被用作初步诊断测试。以前没有确定使用透视检查时健康犬支气管塌陷的正常量,一些作者引用的正常值为 <25%。本前瞻性和回顾性分析观察性研究的目的是确定健康动物的正常气道塌陷量、慢性咳嗽和疑似支气管软化犬的气道塌陷量,以及呼气和咳嗽时气道塌陷的截止值,以区分两组。在右侧和左侧卧姿下进行透视检查,以评估 45 只健康犬和 76 只慢性咳嗽犬的气管和叶支气管在吸气、呼气和咳嗽时的塌陷百分比。与健康犬相比,慢性咳嗽犬的支气管在呼气和咳嗽时表现出明显更大的塌陷量。慢性咳嗽犬在呼气时的塌陷率高达 31.7 ± 26.6%,咳嗽时的塌陷率高达 87.5 ± 23.7%,而健康犬在呼气时的塌陷率为 14.9 ± 6.1%,咳嗽时的塌陷率为 35.0 ± 13.7%。基于 ROC 曲线,作者建议使用呼气时 30%和咳嗽时 60%的截止值来区分健康犬和疑似支气管软化犬。研究结果表明,尽管健康犬可能表现出比以前认为更大程度的气道塌陷,但透视检查可用于区分健康犬和疑似支气管软化犬。