Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.
Vet Med Sci. 2024 Jul;10(4):e1510. doi: 10.1002/vms3.1510.
Radiographic assessment of the intrathoracic caudal vena cava (CVC) is commonly used to evaluate hemodynamic status in veterinary patients without and with pulmonary, pericardial, or right-sided cardiac diseases. Many of these patients are now commonly evaluated with computed tomography (CT) in both emergency and referral settings. Traditional radiographic ratios in dogs, particularly the CVC height/aorta height (CVC/Ao) ratio, are often extrapolated to CT in order to determine if the CVC is normal in size.
The first goal of this retrospective study was to create an objective measurement method to evaluate the size of the CVC via CT. The second goal was to report normal CVC ratio values in both sagittal and transverse CT images.
The traditional lateral radiographic CVC ratios were extrapolated to similar ratios obtained from sagittal CT images in stable, sedated adult canine patients without known cardiac or pulmonary disease. Additionally, new methods of canine CVC ratios using transverse CT images were defined using vessel height and area. Mean, standard deviation, and 95% confidence intervals (CIs) of the CVC ratios in transverse and sagittal CT images were calculated to determine normal reference ranges.
Ratio agreement from observers of different skill levels was moderate to excellent. Sagittal CT CVC/Ao mean was 1.07 ± 0.17 with a CI of 0.71.42. The mean and CI of transverse CT CVC/Ao height and area were 1.14 ± 0.27 and 0.781.44 and 1.36 ± 0.59 and 0.641.94, respectively.
Application of normal sagittal and transverse CT ratio values in canine patients with and without hypotension, pulmonary, pericardial, or right-sided cardiac diseases is necessary to determine the clinical usefulness of these ratios.
在没有肺部、心包或右侧心脏疾病以及患有这些疾病的兽医患者中,通常使用胸内尾腔静脉(CVC)的放射学评估来评估血液动力学状态。现在,许多这些患者在急诊和转诊环境中通常都接受计算机断层扫描(CT)检查。狗的传统放射比值,特别是 CVC 高度/主动脉高度(CVC/Ao)比值,通常被推断到 CT 中,以确定 CVC 的大小是否正常。
本回顾性研究的第一个目标是创建一种客观的测量方法,通过 CT 评估 CVC 的大小。第二个目标是报告矢状和横断 CT 图像中正常的 CVC 比值。
将稳定、镇静的成年犬患者的传统侧位放射 CVC 比值推断到类似的矢状 CT 图像中获得的比值,这些患者没有已知的心脏或肺部疾病。此外,还定义了使用横断 CT 图像的犬 CVC 比值的新方法,使用血管高度和面积。计算横断和矢状 CT 图像中 CVC 比值的平均值、标准差和 95%置信区间(CI),以确定正常参考范围。
不同技能水平的观察者之间的比值一致性为中等至优秀。矢状 CT CVC/Ao 的平均值为 1.07 ± 0.17,置信区间为 0.71-1.42。横断 CT CVC/Ao 高度和面积的平均值和 CI 分别为 1.14 ± 0.27 和 0.78-1.44,以及 1.36 ± 0.59 和 0.64-1.94。
在患有和不患有低血压、肺部、心包或右侧心脏疾病的犬患者中应用正常的矢状和横断 CT 比值对于确定这些比值的临床用途是必要的。