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利用临床病理学、超声检查和肝胆超声评分评估犬多灶性肝脏病变恶性肝脏疾病的预测因素

Predictive Factors of Canine Malignant Hepatic Diseases with Multifocal Hepatic Lesions Using Clinicopathology, Ultrasonography, and Hepatobiliary Ultrasound Scores.

作者信息

Phosri Aphinan, Chantawong Pinkarn, Thitaram Niyada, Pringproa Kidsadagon, Thongtharb Atigan

机构信息

Graduate Program in Veterinary Science, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand.

Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai 50100, Thailand.

出版信息

Animals (Basel). 2024 Oct 9;14(19):2910. doi: 10.3390/ani14192910.

Abstract

Multifocal hepatic lesions in dogs arise from various benign and malignant liver diseases. Diagnosing these lesions is challenging because clinical signs, hematological data, and serum biochemistry are not definitive indicators. Ultrasound is utilized as a diagnostic imaging tool to evaluate liver parenchyma and detect hepatic lesions. This study aims to investigate the predictive factors that differentiate between benign and malignant multifocal hepatic lesions by examining ultrasound characteristics, blood tests, and serum biochemistry. In total, 43 dogs with multifocal hepatic lesions were included in this study. All dogs were classified into benign hepatic diseases ( = 32) and malignant haptic diseases ( = 11). For all dogs, their liver characteristics, lesion characteristics, and hepatobiliary ultrasound score by ultrasound were evaluated and we collected individual clinicopathological data for analysis. The findings of the univariate analysis revealed significant differences in four hematological and blood chemical parameters (hematocrit, white blood cell count, aspartate transaminase (AST), and alkaline phosphatase (ALP)) and six ultrasonographic parameters (liver parenchymal echogenicity, lesion homogeneity, lesion echogenicity, maximum lesion dimension, average lesion dimension, and hepatobiliary ultrasound score). Using multivariate analysis, only two parameters, hepatobiliary ultrasound score and lesion homogeneity, showed significant differences (-value < 0.001 and -value = 0.011, respectively). Additionally, these parameters demonstrated high accuracy in predicting malignant multifocal liver lesions, with accuracy rates of 97.67% and 93.02%, respectively. Therefore, the hepatobiliary ultrasound score and lesion homogeneity are considered effective parameters for screening malignant multifocal liver lesions in dogs.

摘要

犬的多灶性肝病变源于各种良性和恶性肝脏疾病。诊断这些病变具有挑战性,因为临床症状、血液学数据和血清生化指标都不是决定性指标。超声被用作诊断成像工具来评估肝实质并检测肝脏病变。本研究旨在通过检查超声特征、血液检测和血清生化指标,调查区分良性和恶性多灶性肝病变的预测因素。本研究共纳入43只患有多灶性肝病变的犬。所有犬被分为良性肝脏疾病组(n = 32)和恶性肝脏疾病组(n = 11)。对所有犬,通过超声评估其肝脏特征、病变特征和肝胆超声评分,并收集个体临床病理数据进行分析。单因素分析结果显示,四个血液学和血液化学参数(血细胞比容、白细胞计数、天冬氨酸转氨酶(AST)和碱性磷酸酶(ALP))以及六个超声参数(肝实质回声、病变均匀性、病变回声、最大病变尺寸、平均病变尺寸和肝胆超声评分)存在显著差异。使用多因素分析,只有两个参数,即肝胆超声评分和病变均匀性,显示出显著差异(P值分别<0.001和P值 = 0.011)。此外,这些参数在预测恶性多灶性肝病变方面具有较高的准确性,准确率分别为97.67%和93.02%。因此,肝胆超声评分和病变均匀性被认为是筛查犬恶性多灶性肝病变的有效参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4312/11476315/467892ae5534/animals-14-02910-g001.jpg

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