PDF(Pubmed)
Abstract：
BACKGROUND: Cerebrovascular accidents (CVAs) in dogs are diagnosed using magnetic resonance imaging (MRI). This modality is sometimes unavailable, and CVAs can resemble other lesions on MRI. D-dimer concentration and thromboelastography (TEG) are utilized in human medicine in addition to diagnostic imaging to support diagnosis of CVAs, but their use in veterinary patients has not been assessed.
OBJECTIVE: Assess utility of blood D-dimer concentration and TEG in supporting the imaging diagnosis of CVAs in dogs.
METHODS: Sixty-eight client-owned dogs with neurologic signs that had brain MRI and D-dimer concentration or TEG performed.
METHODS: Multicenter, retrospective study. The incidence of abnormal D-dimer concentration or TEG was compared between patients with MRI evidence of CVA and a control population. Analysis methods included Fisher\'s exact test or Chi-squared test for association and comparison of independent proportions.
RESULTS: Neither D-dimer concentration nor TEG was significantly associated with a CVA (P = .38 and .2, respectively). D-dimer testing was performed in a low-risk population and showed low sensitivity (30.8%; 95% confidence interval [CI], 10%-61%) and high specificity (86.4%; 95% CI, 64%-96%) for CVA diagnosis. Thromboelastography was performed in a high-risk population and showed moderate sensitivity (64.3%; 95% CI, 44%-81%) and specificity (66.7%; 95% CI, 24%-94%) for CVA diagnosis. Abnormal D-dimer concentration or TEG were not helpful in differentiating hemorrhagic from ischemic stroke (P = .43 and .41, respectively).
CONCLUSIONS: Although blood D-dimer concentration or TEG alone are not diagnostic of CVAs in dogs, a positive D-dimer result supports additional testing for CVA.
OBJECTIVE: Assess utility of blood D-dimer concentration and TEG in supporting the imaging diagnosis of CVAs in dogs.
METHODS: Sixty-eight client-owned dogs with neurologic signs that had brain MRI and D-dimer concentration or TEG performed.
METHODS: Multicenter, retrospective study. The incidence of abnormal D-dimer concentration or TEG was compared between patients with MRI evidence of CVA and a control population. Analysis methods included Fisher\'s exact test or Chi-squared test for association and comparison of independent proportions.
RESULTS: Neither D-dimer concentration nor TEG was significantly associated with a CVA (P = .38 and .2, respectively). D-dimer testing was performed in a low-risk population and showed low sensitivity (30.8%; 95% confidence interval [CI], 10%-61%) and high specificity (86.4%; 95% CI, 64%-96%) for CVA diagnosis. Thromboelastography was performed in a high-risk population and showed moderate sensitivity (64.3%; 95% CI, 44%-81%) and specificity (66.7%; 95% CI, 24%-94%) for CVA diagnosis. Abnormal D-dimer concentration or TEG were not helpful in differentiating hemorrhagic from ischemic stroke (P = .43 and .41, respectively).
CONCLUSIONS: Although blood D-dimer concentration or TEG alone are not diagnostic of CVAs in dogs, a positive D-dimer result supports additional testing for CVA.
摘要：
背景：使用磁共振成像（MRI）诊断狗的脑血管意外（CVA）。这种模式有时是不可用的，和CVAs可以类似于MRI上的其他病变。D-二聚体浓度和血栓弹力图（TEG）在人类医学中使用，除了诊断成像外，还可以支持CVA的诊断。但它们在兽医患者中的使用尚未得到评估。
目的：评估血液D-二聚体浓度和TEG在支持犬CVA影像学诊断中的实用性。
方法：68只具有神经系统症状的患者犬进行了脑部MRI和D-二聚体浓度或TEG检查。
方法：多中心，回顾性研究。在有CVAMRI证据的患者和对照组之间比较D-二聚体浓度或TEG异常的发生率。分析方法包括Fisher精确检验或卡方检验，用于关联和独立比例的比较。
结果：D-二聚体浓度和TEG与CVA均无显著相关性（分别为P=.38和.2）。D-二聚体检测在低风险人群中进行，并显示低敏感性（30.8％;95％置信区间[CI]，10％-61％）和CVA诊断的高特异性（86.4％；95％CI，64％-96％）。在高危人群中进行了血栓弹力图，并显示出CVA诊断的中等敏感性（64.3％；95％CI，44％-81％）和特异性（66.7％；95％CI，24％-94％）。异常的D-二聚体浓度或TEG对区分出血性卒中和缺血性卒中没有帮助（分别为P=0.43和0.41）。
结论：尽管血液D-二聚体浓度或TEG单独不能诊断犬的CVA，D-二聚体阳性结果支持CVA的其他检测.
目的：评估血液D-二聚体浓度和TEG在支持犬CVA影像学诊断中的实用性。
方法：68只具有神经系统症状的患者犬进行了脑部MRI和D-二聚体浓度或TEG检查。
方法：多中心，回顾性研究。在有CVAMRI证据的患者和对照组之间比较D-二聚体浓度或TEG异常的发生率。分析方法包括Fisher精确检验或卡方检验，用于关联和独立比例的比较。
结果：D-二聚体浓度和TEG与CVA均无显著相关性（分别为P=.38和.2）。D-二聚体检测在低风险人群中进行，并显示低敏感性（30.8％;95％置信区间[CI]，10％-61％）和CVA诊断的高特异性（86.4％；95％CI，64％-96％）。在高危人群中进行了血栓弹力图，并显示出CVA诊断的中等敏感性（64.3％；95％CI，44％-81％）和特异性（66.7％；95％CI，24％-94％）。异常的D-二聚体浓度或TEG对区分出血性卒中和缺血性卒中没有帮助（分别为P=0.43和0.41）。
结论：尽管血液D-二聚体浓度或TEG单独不能诊断犬的CVA，D-二聚体阳性结果支持CVA的其他检测.
