Yarbrough T B, Langer D L, Snyder J R, Gardner I A, O'Brien T R
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616.
J Am Vet Med Assoc. 1994 Aug 15;205(4):592-5.
Medical records of 245 horses that had been evaluated by use of abdominal radiography between January 1990 and December 1992 were reviewed. One hundred forty-one horses subsequently had a postmortem examination or surgical exploration performed for definitive lesion diagnosis. The signalment, diagnosis, site, and number of enteroliths were obtained from the medical records. Radiographs were evaluated individually by 3 reviewers for the presence of enteroliths, preferred diagnostic view, evidence of large colon tympany, and film quality. Of the 141 cases reviewed, 66.7% (94/141) had confirmed enterolithiasis. Enteroliths were identified in the right dorsal colon of 59 horses, in the transverse colon of 28, in the small colon of 24, and in the ventral colon of 1 (enteroliths were detected in multiple sites in 12 horses). For the 3 reviewers, mean sensitivity was 76.9% and specificity was 94.4%. Mean positive-predictive value was 96.4%, and negative-predictive value was 67.5%. Cases involving only large colon enteroliths were correctly diagnosed 83.2% of the time, compared with 41.6% of the time for cases involving small colon enteroliths. Enteroliths were evident in 54.8% of the horses with radiographic signs of large colon distention. Fifteen horses had enteroliths in the small colon, 4 in the transverse colon, and 4 in the dorsal colon. Radiographic quality was evaluated and scored as adequate (0), underexposed (-1), overexposed (1), or incomplete. Mean score was -0.5, and there were 21 (14.9%) incomplete studies.(ABSTRACT TRUNCATED AT 250 WORDS)
回顾了1990年1月至1992年12月期间接受腹部X光检查的245匹马的病历。随后对141匹马进行了尸体剖检或手术探查,以明确病变诊断。从病历中获取了马匹的特征、诊断、肠结石的部位和数量。由3名阅片者分别评估X光片,检查是否存在肠结石、最佳诊断视角、大结肠鼓胀的证据以及胶片质量。在141例被回顾的病例中,66.7%(94/141)确诊为肠结石症。在59匹马的右背侧结肠、28匹马的横结肠、24匹马的小结肠和1匹马的腹侧结肠中发现了肠结石(12匹马在多个部位检测到肠结石)。对于3名阅片者,平均敏感度为76.9%,特异度为94.4%。平均阳性预测值为96.4%,阴性预测值为67.5%。仅涉及大结肠肠结石的病例诊断正确率为83.2%,而涉及小结肠肠结石的病例诊断正确率为41.6%。在有大结肠扩张X光征象的马匹中,54.8%可见肠结石。15匹马的小结肠有肠结石,4匹马的横结肠有肠结石,4匹马的背侧结肠有肠结石。对X光片质量进行评估并评分,分为合适(0)、曝光不足(-1)、曝光过度(1)或不完整。平均评分为-0.5,有21项(14.9%)检查不完整。(摘要截取自250词)