犬先天性肝外门体分流术(EHPSS)的形态尚未完全阐明。这次回顾展的目的,多机构研究是使用CT血管造影为犬先天性EHPSS创建基于解剖学的命名系统.然后评估这些分流形态,以确定与患者年龄的任何显著关联,性别,品种,体重,或主观门静脉灌注评分。分别从SVSTS和VIRIES列表中收集的数据包括患者DOB,性别,品种,体重,CT日期,并报告诊断。一位作者(C.W.)查看了所有CT扫描,并根据分流门脉血管的起源对分流进行了分类,插入的分流全身血管,以及有助于分流的任何实质性门脉血管。此外,根据肝内门静脉的口径,肝门灌注主观评分在1分(差/无)和5分(良好/正常)之间。共提交了来自13个不同机构的1182次CT扫描。由于排除标准,100(8.5%)被删除,留下1082个CT扫描。确定了45个不同的EHPSS解剖结构,其中5个分类占所有分流的85%(左胃膈[27%],左胃怪症[19%],左胃腔[15%],右胃静脉异常左胃腔[12%],和异常的左胃腔,右胃静脉和短胃静脉[11%])。在95%的所述分类中,分流起源涉及左胃静脉。在CT扫描时,五种最常见的分流类型之间的年龄存在显着差异(P<0.001),性别(P=.009),品种(P<.001),重量(P<.001),和主观门静脉灌注评分(P<0.001)。犬EHPSS的解剖分类系统可以提高理解,治疗比较,以及这些患者的预后预测。
Canine congenital extrahepatic portosystemic shunt (EHPSS) morphologies have not been fully elucidated. The goal of this retrospective, multi-institutional study was to use CT angiography to create an anatomical-based nomenclature system for canine congenital EHPSS. These shunt morphologies were then evaluated to identify any significant association with patient age, sex, breed, weight, or subjective portal perfusion score. Data collected respectively from the SVSTS and VIRIES list-serves included patient DOB, sex, breed, weight, CT date, and reported diagnosis. A single author (C.W.) viewed all CT scans and classified shunts based on the shunt portal vessel(s) of origin, the shunt systemic vessel(s) of insertion, and any substantial portal vessels contributing to the shunt. Additionally, hepatic portal perfusion was subjectively scored between one (poor/none) and five (good/normal) based on the caliber of the intrahepatic portal veins. A total of 1182 CT scans were submitted from 13 different institutions. Due to exclusion criteria, 100 (8.5%) were removed, leaving 1082 CT scans to be included. Forty-five different EHPSS anatomies were identified with five classifications accounting for 85% of all shunts (left gastric-phrenic [27%], left gastric-azygos [19%], left gastric-caval [15%], aberrant left gastric-caval with right gastric vein [12%], and aberrant left gastric-caval with right gastric vein and short gastric vein [11%]). Shunt origin involved the left gastric vein in 95% of the described classifications. Significant differences were identified among the five most common shunt types with respect to age at the time of the CT scan (P < .001), sex (P = .009), breed (P < .001), weight (P < .001), and subjective portal perfusion score (P < .001). An anatomical classification system for canine EHPSS may enable improved understanding, treatment comparisons, and outcome prediction for these patients.