PDF(Pubmed)
Abstract：
Thoracic radiography and abdominal ultrasonography are part of standard diagnostic investigations in cases of canine immune-mediated polyarthritis (IMPA). However, the clinical importance of thoracic and abdominal imaging towards the management of canine IMPA currently remains unknown. The primary aim of this study was to describe the findings documented on thoracic radiography and abdominal ultrasonography in dogs diagnosed with IMPA, and to evaluate the diagnostic utility of thoracic radiography and abdominal ultrasonography in the initial approach and management of these cases. Seventy-seven dogs diagnosed with IMPA who underwent thoracic radiography and abdominal ultrasonography at a single referral hospital between 2008 and 2022 were included. The diagnostic imaging studies of these 77 dogs were reviewed by one blinded board-certified diagnostic imaging specialist for quality assurance. The medical records, including the diagnostic imaging reports of these dogs, were then reviewed by three blinded board-certified internal medicine specialists. Using a modified version of a previous question and scoring system, the three internal medicine specialists then generated an answer for the overall diagnostic utility and a diagnostic utility score for thoracic radiography and abdominal ultrasonography for each case. The abnormal findings identified in radiography and ultrasonography were described. In the cases where the findings were considered significant enough to immediately affect the case management, the results of the further investigations that were subsequently performed were also described. No abnormalities were detected in thoracic radiography for 30 cases, and none were detected in abdominal ultrasound for 6. The majority of the internists considered thoracic radiography to be not useful in the overall case management at the time of IMPA diagnosis in 70 cases, and considered abdominal ultrasonography to be not useful in the overall case management in 57 cases. The majority of the internists agreed on the utility of thoracic radiography in 95% of the cases, and in 61% of the cases for abdominal ultrasonography. The most common finding in the thoracic radiography was a mild bronchial pulmonary pattern, and the most common in the abdominal ultrasonography was mild lymphadenomegaly. Therefore, although thoracic radiography and abdominal ultrasonography identified numerous abnormal findings in this population of dogs, in the majority of the cases, the findings were deemed not useful towards the overall case management at the time of the initial diagnosis of IMPA. Thus, the use of thoracic radiography and abdominal ultrasonography should be taken into careful consideration when considering initial diagnostic investigations for canine IMPA.
摘要：
胸部X线摄影和腹部超声检查是犬免疫介导的多关节炎（IMPA）病例的标准诊断研究的一部分。然而,目前尚不清楚胸部和腹部成像对犬IMPA治疗的临床重要性.这项研究的主要目的是描述诊断为IMPA的狗的胸部X线照相和腹部超声检查记录的发现，并评估胸部X线摄影术和腹部超声检查在这些病例的初始方法和处理中的诊断实用性。包括77只诊断为IMPA的狗，他们在2008年至2022年之间在一家转诊医院接受了胸部X线检查和腹部超声检查。由一名盲板认证的诊断成像专家审查了这77只狗的诊断成像研究，以确保质量保证。医疗记录,包括这些狗的诊断影像报告，然后由三名盲板认证的内科专家进行审查。使用以前的问题和评分系统的修改版本，然后,3名内科专家对每个病例的总体诊断效用和胸部X线摄影术和腹部超声检查的诊断效用评分进行回答.描述了在射线照相和超声检查中发现的异常发现。在发现被认为足以立即影响案件管理的情况下，本文还描述了随后进行的进一步研究的结果.30例胸部X线检查未发现异常，6例腹部超声均未检出。在70例IMPA诊断时，大多数内科医生认为胸部X线照相术在整体病例管理中没有用，并认为腹部超声检查对57例病例的整体处理没有帮助。大多数内科医生同意95%的病例使用胸部X线摄影，61％的病例进行腹部超声检查。胸部X线摄影术中最常见的发现是轻度支气管肺模式，在腹部超声检查中最常见的是轻度淋巴结肿大。因此,尽管胸部X线摄影术和腹部超声检查在这只狗中发现了许多异常发现，在大多数情况下，在初次诊断IMPA时,这些发现被认为对整体病例管理没有帮助.因此，在考虑对犬IMPA进行初步诊断时,应仔细考虑胸部X线和腹部超声检查的使用.
