RESUMO
Arterial thromboembolism is a life-threatening condition in cats most commonly secondary to cardiac disease. Echocardiography is the reference standard to evaluate for presence of a thrombus. In humans, computed tomographic (CT) angiography is becoming widely used to detect left atrial thrombi precluding the use of sedation. The purpose of this prospective, controlled, methods comparison pilot study was threefold: (1) describe new CT angiography protocol used in awake cats with cardiac disease and congestive heart failure; (2) determine accuracy of continuous and dynamic acquisition CT angiography to identify and characterize cardiac thrombi from spontaneous echocardiographic contrast using transthoracic echocardiography as our reference standard; (3) identify known negative prognostic factors and comorbidities of the thorax that CT angiography may provide that complement or supersede echocardiographic examination. Fourteen cats with heart disease were recruited; 7 with thrombi and 7 with spontaneous echocardiographic contrast. Echocardiography and awake CT angiography were performed using a microdose of contrast. Six of 7 thrombi were identified on CT angiography as filling defects by at least one reviewer within the left auricle (n = 6) and right heart (n = 1). Highest sensitivity (71.4%) was in continuous phase and highest specificity (85.7%) was in dynamic studies with fair to moderate interobserver agreement (0.38 and 0.44). CT angiography identified prognostic cardiac information (left atrial enlargement, congestive heart failure, arterial thromboembolism) and comorbidities (suspected idiopathic pulmonary fibrosis, asthma). This study indicates CT angiography can readily identify cardiac thrombi, important prognostic information and comorbidities, and can be safely performed in cats with cardiac disease and congestive heart failure.
Assuntos
Doenças do Gato/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/veterinária , Cardiopatias/veterinária , Animais , Gatos , Comorbidade , Angiografia por Tomografia Computadorizada/métodos , Cardiopatias/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/veterinária , Projetos Piloto , Prognóstico , Estudos Prospectivos , Sensibilidade e Especificidade , Tórax/diagnóstico por imagemRESUMO
A firm mass was noted in the right inguinal subcutaneous region of an 11-year-old intact male Labrador retriever dog presented for right pelvic limb weakness. Pelvic radiographs showed 2 large ovoid structures with circumferential thin eggshell-like mineralization in the right external inguinal region. The structures were confirmed sonographically, and on magnetic resonance imaging as a large folded herniated mineralized paraprostatic cyst through a defect in the right inguinal wall. To the author's knowledge, this is the first published report of an inguinal herniated mineralized paraprostatic cyst.
Herniation inguinale d'un kyste paraprostatique minéralisé chez un chien. Une masse ferme a été observée dans la région sous-cutanée chez un Labrador retriever mâle intact âgé de 11 ans qui était présenté pour une faiblesse du membre pelvien droit et des radiographies pelviennes ont montré deux grosses structures ovoïdes avec une mince minéralisation circonférencielle semblable à une coquille d'oeuf dans la région inguinale droite. Les structures ont été confirmées par échographie et à l'imagerie par résonance magnétique comme un gros kyste paraprostatique replié minéralisé et hernié via un défaut de la paroi inguinale droite. À la connaissance de l'auteur, il s'agit du premier rapport publié d'un kyste paraprostatique minéralisé hernié inguinal.(Traduit par Isabelle Vallières).