Loading...
Publication
Imagiologia abdominal : ultrassonografia Vs. tomografia computorizada em pequenos animais : estudo retrospectivo
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.18 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Os sinais clínicos com origem abdominal em cães e gatos são dos estímulos
iatrotrópicos verificados de forma mais frequente na clínica de cães e gatos, sendo a
imagiologia um importante contributo na avaliação e na determinação do sistema originário
do quadro clínico. Este estudo retrospectivo procura compreender o contributo da ecografia e
da Tomografia Computorizada (TC) para o diagnóstico de doença abdominal, se possibilitam
a diferenciação entre doença neoplásica e doença inflamatória e se a informação fornecida
por ambas é coincidente. A amostra foi constituída por 29 animais: 24 cães e 5 gatos, que se
apresentaram ao HEV-FMV com sintomatologia que justificasse a realização de uma
ecografia abdominal e uma TC abdominal, entre Setembro 2017 e Abril 2018. Foram
recolhidas informações acerca do animal e anamnese, exame ecográfico e tomográfico,
citologia e/ou histopatologia das lesões encontradas para análise estatística. Em termos de
resultados, verificou-se uma prevalência de animais geriátricos, com 65.5% da amostra com
idade superior a 10 anos. Verificou-se também uma maior prevalência de diagnósticos de
doença neoplásica (72.3%) quando comparado com o diagnóstico de doença inflamatória ou
infecciosa (24.2%), e de outras etiologias (3%). Não se verificou relação estatisticamente
significativa entre as características do animal e a obtenção de um diagnóstico imagiológico
ecográfico nem tomográfico compatível com o diagnóstico definitivo. Também não se verificou
relação estatisticamente significativa entre os parâmetros do exame ecográfico e do exame
tomográfico avaliados com o tipo de diagnóstico definitivo. A concordância entre o diagnóstico
ecográfico e o diagnóstico definitivo foi quase perfeita (κ=0.89, PABAκ=0.93), apresentando
uma sensibilidade global para a detecção de patologia abdominal de 78.8%, e específica para
doença neoplásica de 87.5% e para doença inflamatória/infecciosa de 55.6%. Relativamente
à TC, a concordância entre o diagnóstico tomográfico e o diagnóstico definitivo é perfeita (κ=1,
PABAκ=1), apresentando uma sensibilidade global para a detecção de patologia abdominal
de 87.9%, e específica para doença neoplásica de 83.3% e para doença inflamatória de 100%.
Os exames forneceram diagnósticos diferenciais concordantes entre si e compatíveis com o
diagnóstico definitivo em 69.7% dos casos, com um aumento para 97% na utilização dos
exames de forma sequencial, indicando uma forte capacidade diagnóstica destas
modalidades quando utilizadas em conjunto.
Em suma, tanto a TC como a ecografia permitem a obtenção de um diagnóstico
imagiológico compatível com o definitivo em casos de patologia abdominal com elevada
fiabilidade, podendo ser utilizadas de forma independente para o diagnóstico de alterações
abdominais. No entanto, dada a complexidade da anatomia abdominal e as limitações
inerentes de cada modalidade, a sua utilização em conjunto aumenta a acuidade diagnóstica.
ABSTRACT - ABDOMINAL IMAGING: ULTRASOUND VS COMPUTED TOMOGRAPHY IN COMPANION ANIMALS : RETROSPECTIVE STUDY - As abdominal clinical signs are one of the most common iatrotropic stimuli, abdominal imaging provides an important contribution to determining the origin of the presenting issue. This retrospective study aims to understand the contribution of ultrasound and Computed Tomography (CT) to the diagnosis of abdominal pathology, if they enable the differentiation between neoplastic and inflammatory/infectious disease, and if the information they provide is overlapping. The sample contained 29 animals: 24 dogs and 5 cats, that presented to the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine (HEV FMV) with symptoms that would justify an abdominal ultrasound exam, and an abdominal CT scan, between September 2017 and April 2018. Patient information and history were collected, along with reports from both the ultrasound and CT examinations, and cytology and/or pathology results, for statistical analysis purposes. In terms of results, the author verified a prevalence of geriatric animals, with 65.5% of the population 10 years of age or older. A prevalence of neoplastic disease was also verified (72.3%) when compared to inflammatory/infectious disease (24.2%) and other aetiologies (3%). No statistically significant relationship could be established between patient criteria and the ability to obtain an imaging diagnosis via ultrasound or CT compatible with the final diagnosis. Similarly, no statistically significant relationship could be established between the tomographic or ultrasound parameters analysed with the type of definitive diagnosis (p<0.05). The agreement between the ultrasound diagnosis and definitive diagnosis was defined as almost perfect (κ=0.89, PABAκ=0.93), with a global sensitivity of 78.8% for the detection of abdominal disease, specifically for the detection of neoplastic disease of 87.5% and for the detection of inflammatory/infectious disease of 55.6%. As for CT, the agreement between the CT diagnosis and the definitive diagnosis was perfect (κ=1, PABAκ=1), with a global sensitivity of 87.9% for the detection of abdominal disease, of 83.3% specifically for the detection of neoplastic disease and 100% for the detection of inflammatory/infectious disease. These exams supplied differential diagnoses that were in agreement with each other and the definitive diagnoses in 69.7% of cases, with an increase to 97% when used sequentially, indicating a strong diagnostic capacity of these modalities when used together. To summarize, both abdominal ultrasound and CT permit the reliable acquisition of a differential diagnosis compatible with the definitive diagnosis independently, however, due to the complexity of the abdominal anatomy and the inherent limitations of the exams, their combined use raises diagnostic accuracy.
ABSTRACT - ABDOMINAL IMAGING: ULTRASOUND VS COMPUTED TOMOGRAPHY IN COMPANION ANIMALS : RETROSPECTIVE STUDY - As abdominal clinical signs are one of the most common iatrotropic stimuli, abdominal imaging provides an important contribution to determining the origin of the presenting issue. This retrospective study aims to understand the contribution of ultrasound and Computed Tomography (CT) to the diagnosis of abdominal pathology, if they enable the differentiation between neoplastic and inflammatory/infectious disease, and if the information they provide is overlapping. The sample contained 29 animals: 24 dogs and 5 cats, that presented to the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine (HEV FMV) with symptoms that would justify an abdominal ultrasound exam, and an abdominal CT scan, between September 2017 and April 2018. Patient information and history were collected, along with reports from both the ultrasound and CT examinations, and cytology and/or pathology results, for statistical analysis purposes. In terms of results, the author verified a prevalence of geriatric animals, with 65.5% of the population 10 years of age or older. A prevalence of neoplastic disease was also verified (72.3%) when compared to inflammatory/infectious disease (24.2%) and other aetiologies (3%). No statistically significant relationship could be established between patient criteria and the ability to obtain an imaging diagnosis via ultrasound or CT compatible with the final diagnosis. Similarly, no statistically significant relationship could be established between the tomographic or ultrasound parameters analysed with the type of definitive diagnosis (p<0.05). The agreement between the ultrasound diagnosis and definitive diagnosis was defined as almost perfect (κ=0.89, PABAκ=0.93), with a global sensitivity of 78.8% for the detection of abdominal disease, specifically for the detection of neoplastic disease of 87.5% and for the detection of inflammatory/infectious disease of 55.6%. As for CT, the agreement between the CT diagnosis and the definitive diagnosis was perfect (κ=1, PABAκ=1), with a global sensitivity of 87.9% for the detection of abdominal disease, of 83.3% specifically for the detection of neoplastic disease and 100% for the detection of inflammatory/infectious disease. These exams supplied differential diagnoses that were in agreement with each other and the definitive diagnoses in 69.7% of cases, with an increase to 97% when used sequentially, indicating a strong diagnostic capacity of these modalities when used together. To summarize, both abdominal ultrasound and CT permit the reliable acquisition of a differential diagnosis compatible with the definitive diagnosis independently, however, due to the complexity of the abdominal anatomy and the inherent limitations of the exams, their combined use raises diagnostic accuracy.
Description
Dissertação de Mestrado Integrado em Medicina Veterinária
Keywords
Cão Gato Patologia abdominal Tomografia Computorizada Ecografia Dog Cat Abdominal disease Computed Tomography Ultrasound
Pedagogical Context
Citation
Estevens IA 2021. Imagiologia abdominal : ultrassonografia Vs. tomografia computorizada em pequenos animais : estudo retrospectivo [dissertação de mestrado] Lisboa: FMV-Universidade de Lisboa.
Publisher
Universidade de Lisboa, Faculdade de Medicina Veterinária