Fantaconi Nicoletta, Parry Andrew T, Labrador Jose, Pérez López Luis Alejandro, Agthe Petra
Department of Diagnostic Imaging, Anderson Moores Veterinary Specialists, Winchester SO21 2LL, UK.
Antech Imaging Services, Fountain Valley, CA 92708, USA.
Animals (Basel). 2025 Sep 13;15(18):2684. doi: 10.3390/ani15182684.
Confident diagnosis of nasal foreign bodies (FBs) with computed tomography (CT) is challenging. Plant material FBs may be inconspicuous depending on size and attenuation and may be obscured by secondary nasal changes such as accumulation of mucous. The authors anecdotally observed that the lung window (LW) might improve visualization of some nasal FBs. The aim of this retrospective, multicentre study was to assess the diagnostic utility and interobserver variability of the LW in the diagnosis of nasal FBs. We hypothesized that use of the LW improves detection rate of nasal FBs compared to the bone window (BW), and that interobserver agreement is strong. Computed tomography examinations of 47 dogs with an endoscopically confirmed nasal foreign body (FB) were included, and each study was reviewed independently by two board certified radiologists, resulting in a total of 94 assessments. Pre-contrast CT series were reviewed in the BW and LW. The reviewers were blinded to the final diagnosis and were asked to evaluate the CT studies for presence or absence of a convincing nasal FB. Reviewers confidently detected a nasal FB on 19/94 (20%) assessments in the BW and 20/94 (21%) in the LW, the majority of the FBs were elongated in shape (30%) and were visible in the rostral and mid-portion of the nasal cavity. The interobserver agreement was moderate in the BW ( < 0.53) and in the LW ( < 0.49). Our findings do not support our main hypothesis that the use of the LW significantly increases diagnostic accuracy for the identification of nasal FBs in dogs. However, as the LW enabled correct diagnosis in one assessment, it may occasionally be helpful if no FB is visualized on initial examination.
通过计算机断层扫描（CT）对鼻腔异物（FBs）进行准确诊断具有挑战性。植物性异物FBs可能因大小和衰减情况而不明显，并且可能被诸如黏液积聚等鼻腔继发性改变所掩盖。作者凭经验观察到，肺窗（LW）可能会改善某些鼻腔FBs的可视化效果。这项回顾性多中心研究的目的是评估LW在鼻腔FBs诊断中的诊断效用和观察者间的变异性。我们假设，与骨窗（BW）相比，使用LW可提高鼻腔FBs的检出率，并且观察者间的一致性较强。纳入了47只经内镜确诊鼻腔异物（FB）的犬的CT检查，每项研究由两名获得认证委员会认证的放射科医生独立进行复查，共计94次评估。在BW和LW中对平扫CT系列进行复查。复查人员对最终诊断不知情，并被要求评估CT研究中是否存在令人信服的鼻腔FB。复查人员在BW的94次评估中有19次（20%）、在LW的94次评估中有20次（21%）自信地检测到鼻腔FB，大多数FB呈细长形（30%），可见于鼻腔的前部和中部。观察者间在BW（<0.53）和LW（<0.49）中的一致性为中等。我们的研究结果不支持我们的主要假设，即使用LW可显著提高犬鼻腔FBs识别的诊断准确性。然而，由于LW在一次评估中实现了正确诊断，如果在初次检查时未发现FB，它偶尔可能会有所帮助。
