Anteveli G, Andrade J P, de Andrade Alves B, Matiello J P, Lemos G S, Souza de Oliveira C, da Cruz D L, Romero Nicolino R, Facury Filho E J, Meneses R M, de Carvalho A U, Buczinski S, Moreira T F
Department of Veterinary Clinic and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Minas Gerais, 31270-901, Brazil.
Department of Preventive Veterinary Medicine, Veterinary School, Universidade Federal de Minas Gerais, Minas Gerais, 31270-901, Brazil.
J Dairy Sci. 2025 Jan;108(1):750-759. doi: 10.3168/jds.2024-25186. Epub 2024 Sep 28.
Bovine respiratory disease (BRD) poses significant challenges on beef and dairy farms, affecting mortality rates, animal welfare, and production efficiency. Although pulmonary ultrasonography is highly sensitive and specific for monitoring lung lesions and diagnosing BRD, its practical application could be optimized by focusing on the most commonly affected lung lobes. This study first evaluated the efficacy of focused lung ultrasonography for diagnosing BRD in calves, examining individual lung lobes and their associations versus the extensive lung scanning under various disease prevalence scenarios. Then, the relationship between individual and combined clinical respiratory signs versus lung consolidation was analyzed. In a combined analysis, 193 Holstein calves from a longitudinal study and 112 Angus calves from a cross-sectional study underwent a total of 1,265 complete bilateral thoracic ultrasonographic evaluations from 1 to 6 mo of age. Then, the agreement and sensitivity (Se) of specific lung lobe combinations compared with the findings from total lung ultrasonography was assessed. The classification and regression tree (CART) algorithm was used to suggest an optimal examination sequence, and logistic regression was applied to associate specific clinical signs with the presence of lung consolidation, adjusting for breed and calf age. Findings revealed that the most sensitive areas are the cranial (kappa value [κ] = 0.867; Se = 84.7%) and caudal portion of the right cranial lobe (κ = 0.433; Se = 40.3%), the caudal portion (κ = 0.235; Se = 20.6%) of the left cranial lobe, and the middle lobe (κ = 0.25; Se = 22%). The optimal lobe combinations for focused lung ultrasonography were identified as the right cranial lobe paired with either the left cranial lobe or the middle lobe. Focused techniques achieved Se greater than 94% and maintained good agreement. These focused techniques were relatively robust to various true lung consolidation scenarios. The CART analysis recommended initiating examinations with the right cranial lobe, proceeding to the left cranial lobe, and concluding with the middle lobe. Although spontaneous cough was linked to pneumonia presence, reliance on a single clinical sign is not advised due to low Se (26.8%) and high specificity (85.4%); it should merely prompt further ultrasound assessment. In conclusion, focused lung ultrasonography, especially utilizing the right cranial lobe in conjunction with the left cranial lobe or the middle lobe, emerged as an effective strategy for focused pulmonary ultrasonography, preserving the accuracy of the results.
牛呼吸道疾病（BRD）给肉牛场和奶牛场带来了重大挑战，影响死亡率、动物福利和生产效率。尽管肺部超声检查在监测肺部病变和诊断BRD方面具有高度敏感性和特异性，但通过关注最常受影响的肺叶，其实际应用可以得到优化。本研究首先评估了聚焦肺部超声检查在诊断犊牛BRD中的效果，在不同疾病流行情况下检查单个肺叶及其关联情况，并与广泛的肺部扫描进行对比。然后，分析了个体和综合临床呼吸道症状与肺实变之间的关系。在一项综合分析中，来自纵向研究的193头荷斯坦犊牛和来自横断面研究的112头安格斯犊牛在1至6月龄期间共接受了1265次完整的双侧胸部超声检查评估。随后，评估了特定肺叶组合与全肺超声检查结果相比的一致性和敏感性（Se）。使用分类与回归树（CART）算法来建议最佳检查顺序，并应用逻辑回归将特定临床症状与肺实变的存在相关联，同时对品种和犊牛年龄进行调整。研究结果显示，最敏感的区域是右颅叶的头侧部分（kappa值[κ]=0.867；Se=84.7%）和尾侧部分（κ=0.433；Se=40.3%）、左颅叶的尾侧部分（κ=0.235；Se=20.6%）以及中叶（κ=0.25；Se=22%）。聚焦肺部超声检查的最佳肺叶组合被确定为右颅叶与左颅叶或中叶配对。聚焦技术的Se大于94%，并保持了良好的一致性。这些聚焦技术在各种实际肺实变情况下相对稳健。CART分析建议先检查右颅叶，接着检查左颅叶，最后检查中叶。尽管自发性咳嗽与肺炎的存在有关，但由于Se较低（26.8%）和特异性较高（85.4%），不建议仅依赖单一临床症状；它仅应促使进一步的超声评估。总之，聚焦肺部超声检查，特别是将右颅叶与左颅叶或中叶结合使用，成为一种有效的聚焦肺部超声检查策略，可保持结果的准确性。
