Tang Julia W Y, Saiz Anna, Vulpe Alina, Ribas Latre Ariadna, Furtado Rita, Seth Mayank, Valls Sanchez Ferran
DWR Veterinary Specialists, Station Farm, London Road, Six Mile Bottom, Cambridgeshire CB8 0UH, UK.
Hospital de Referencia Veterios, 28022 Madrid, Spain.
Animals (Basel). 2024 Feb 6;14(4):534. doi: 10.3390/ani14040534.
Thoracic radiography and abdominal ultrasonography are part of standard diagnostic investigations in cases of canine immune-mediated polyarthritis (IMPA). However, the clinical importance of thoracic and abdominal imaging towards the management of canine IMPA currently remains unknown. The primary aim of this study was to describe the findings documented on thoracic radiography and abdominal ultrasonography in dogs diagnosed with IMPA, and to evaluate the diagnostic utility of thoracic radiography and abdominal ultrasonography in the initial approach and management of these cases. Seventy-seven dogs diagnosed with IMPA who underwent thoracic radiography and abdominal ultrasonography at a single referral hospital between 2008 and 2022 were included. The diagnostic imaging studies of these 77 dogs were reviewed by one blinded board-certified diagnostic imaging specialist for quality assurance. The medical records, including the diagnostic imaging reports of these dogs, were then reviewed by three blinded board-certified internal medicine specialists. Using a modified version of a previous question and scoring system, the three internal medicine specialists then generated an answer for the overall diagnostic utility and a diagnostic utility score for thoracic radiography and abdominal ultrasonography for each case. The abnormal findings identified in radiography and ultrasonography were described. In the cases where the findings were considered significant enough to immediately affect the case management, the results of the further investigations that were subsequently performed were also described. No abnormalities were detected in thoracic radiography for 30 cases, and none were detected in abdominal ultrasound for 6. The majority of the internists considered thoracic radiography to be not useful in the overall case management at the time of IMPA diagnosis in 70 cases, and considered abdominal ultrasonography to be not useful in the overall case management in 57 cases. The majority of the internists agreed on the utility of thoracic radiography in 95% of the cases, and in 61% of the cases for abdominal ultrasonography. The most common finding in the thoracic radiography was a mild bronchial pulmonary pattern, and the most common in the abdominal ultrasonography was mild lymphadenomegaly. Therefore, although thoracic radiography and abdominal ultrasonography identified numerous abnormal findings in this population of dogs, in the majority of the cases, the findings were deemed not useful towards the overall case management at the time of the initial diagnosis of IMPA. Thus, the use of thoracic radiography and abdominal ultrasonography should be taken into careful consideration when considering initial diagnostic investigations for canine IMPA.
胸部X线摄影和腹部超声检查是犬免疫介导性多关节炎（IMPA）病例标准诊断检查的一部分。然而，胸部和腹部影像学检查对犬IMPA治疗的临床重要性目前尚不清楚。本研究的主要目的是描述诊断为IMPA的犬的胸部X线摄影和腹部超声检查结果，并评估胸部X线摄影和腹部超声检查在这些病例的初始诊断和治疗中的诊断效用。纳入了2008年至2022年期间在一家转诊医院接受胸部X线摄影和腹部超声检查的77只诊断为IMPA的犬。这77只犬的诊断性影像学研究由一名经过盲法认证的诊断影像学专家进行审查以确保质量。然后，包括这些犬的诊断性影像学报告在内的病历由三名经过盲法认证的内科专家进行审查。这三名内科专家使用先前问题和评分系统的修改版本，为每个病例的总体诊断效用以及胸部X线摄影和腹部超声检查的诊断效用评分给出答案。描述了在X线摄影和超声检查中发现的异常情况。在那些发现被认为严重到足以立即影响病例管理的情况下，还描述了随后进行的进一步检查的结果。30例胸部X线摄影未检测到异常，6例腹部超声未检测到异常。大多数内科医生认为，在70例IMPA诊断时，胸部X线摄影对总体病例管理无用，57例中腹部超声检查对总体病例管理无用。大多数内科医生在95%的病例中对胸部X线摄影的效用达成一致，在61%的病例中对腹部超声检查的效用达成一致。胸部X线摄影中最常见的发现是轻度支气管肺纹理，腹部超声检查中最常见的是轻度淋巴结肿大。因此，尽管胸部X线摄影和腹部超声检查在这群犬中发现了许多异常情况，但在大多数病例中，这些发现在IMPA初始诊断时被认为对总体病例管理无用。因此，在考虑犬IMPA的初始诊断检查时，应仔细考虑使用胸部X线摄影和腹部超声检查。
