Sensitivity, positive predictive value, and interobserver variability of computed tomography in the diagnosis of bullae associated with spontaneous pneumothorax in dogs: 19 cases (2003–2012)

Reetz, Jennifer A.; Cáceres, Ana V.; Suran, Jantra N.; Oura, Trisha J.; Zwingenberger, Allison L.; Maï, Wilfried

doi:10.2460/javma.243.2.244

Cited by 40 publications

(65 citation statements)

References 20 publications

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“…In all but one dog, this site appeared as a soft tissue attenuating lung infiltration with an adjacent extensive pleural thickening. This is also the first time that a 100% correct lateralization and a 95.5% correct identification of the perforated lobe has been published for spontaneous pneumothorax in dogs, contradicting previous findings in dogs with perforated blebs and bullae . However, this discrepancy probably resulted from the pulmonary or pleural inflammation induced by the grass awn that makes the perforation site more obvious than in ruptured blebs or bullae …”

Section: Discussioncontrasting

confidence: 73%

“…Moreover, radiography cannot identify the underlying cause for pneumothorax nor involvement of the cranial sublumbar musculature . A few studies report CT in cases of spontaneous pneumothorax, and mainly involve ruptured blebs and bullae . Their authors report CT has poor sensitivity and positive predictive value for their diagnosis but should be considered to rule out other etiologies for pneumothorax.…”

Section: Introductionmentioning

confidence: 99%

“…Their authors report CT has poor sensitivity and positive predictive value for their diagnosis but should be considered to rule out other etiologies for pneumothorax. Also, little detail is given as to whether or not the site of pulmonary leak can be identified . One published study reports a case where a grass awn was found at the location of a defect of the visceral pleura of a consolidated lung lobe that was confirmed to be a perforation site during surgery …”

Section: Introductionmentioning

confidence: 99%

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CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases

Tréhiou

Gibert

Sériot

et al. 2019

Vet Radiology Ultrasound

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Spontaneous pneumothorax induced by grass awns accounts for 5% of spontaneous pneumothorax and 22.5% of thoracic grass awn cases. Previous studies report limited interest of CT for spontaneous pneumothorax. Aims of this retrospective case series were to describe CT features of this condition and determine if CT features can efficiently localize the perforation site. Dogs that had a spontaneous pneumothorax, CT examination, thoracic surgery, and confirmed lung perforation due to a grass awn were included. Computed tomography studies were reviewed and compared to the surgical findings. In 19 of 22 (86.4%) dogs, the pneumothorax or its recurrence were ipsilateral to the perforation site. The perforation site was identified in 21 of 22 (95.5%) dogs and involved the caudal lobes in 20 of 22 (90.9%) cases. The lateralization and the involved lung lobe corresponded to surgical findings in 21 of 22(95.5%) dogs. The perforation site was characterized as a soft tissue attenuating focus lying against an extensive pleural thickening in 21 of 22(95.5%) dogs. An adjacent defect in the visceral pleura was seen in 13 of 22(59.1%) dogs. A grass awn was seen in 11 of 22(50%) dogs. The pneumothorax distribution and grass awn position consistently indicated the perforation side in this sample of dogs. The comparison with surgical findings suggests CT might be helpful for future presurgical planning of this etiology for pneumothorax.

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Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases

Tréhiou

Gibert

Sériot

et al. 2019

Vet Radiology Ultrasound

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“…Clinical management is based on diagnosis of underlying cause by means of diagnostic imaging, pleural fluid cytology, and microbial culture and sensitivity testing . Preoperative computed tomography (CT) is commonly performed in addition to thoracic radiography to evaluate intrathoracic disease in dogs in which pyothorax or pneumothorax has been diagnosed, with mixed reported utility in the literature . Minimally invasive methods of tracheobronchial foreign body retrieval in dogs and cats include fluoroscopy and endoscopy .…”

Section: Introductionmentioning

confidence: 99%

Utility of bronchoscopy combined with surgery in the treatment and outcomes of dogs with intrathoracic disease secondary to plant awn migration

et al. 2019

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Objective To evaluate the diagnostic and therapeutic utility of bronchoscopy in dogs undergoing computed tomography (CT) and surgery for intrathoracic disease (pyothorax and pneumothorax) secondary to migrating plant awns (MPA) and to report outcomes in dogs that did and did not undergo bronchoscopy in addition to CT and surgery. Study design Retrospective case series. Animals Thirty‐seven client‐owned dogs. Methods Medical records from 2008 to 2017 were reviewed for dogs with documented MPA in the thoracic cavity treated with CT and surgery with or without bronchoscopy. Information regarding diagnostics, treatments, complications, and outcomes relating to hospitalization was evaluated. Results At least one abnormal lung lobe was identified by CT in all dogs. Bronchial abnormalities were identified with bronchoscopy in 21 of 22 dogs (95.4%) with available reports. Agreement between CT and bronchoscopy findings ranged from 50% to 81.8%, depending on lung lobe. Thirty‐six dogs had one or more lung lobes surgically removed. Thirty‐seven MPA were retrieved via bronchoscopy in 10 of 27 (37%) dogs, and 39 MPA were retrieved at surgery in 26 of 37 (70.3%) dogs. Actinomyces spp. were cultured from surgical samples in 7 of 33 (21.2%) dogs. Thirty‐five of 37 (94.6%) dogs survived to discharge. Conclusion Migrating plant awns were successfully retrieved via bronchoscopy. Agreement between CT findings and bronchoscopy was inconsistent, so there may be roles for both modalities. Short‐ and long‐term survival was excellent in this cohort. Clinical significance Bronchoscopy may allow for diagnostic and therapeutic advantages compared with CT in dogs with endobronchial MPA. Actinomyces spp appear to be variably present in surgically acquired bacterial cultures in dogs with MPA.

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“…1 In the case described in the present report, the severity and extent of the pulmonary bullae were not appreciated radiographically. 2 In the dog of the present report, CT proved to be more specific than radiography for detecting pulmonary bullae and greatly assisted with the surgical approach and planning; however, CT did not identify the true extent of the bullae, which was discovered during surgery. 1 Computed tomography is not a perfect diagnostic tool because bullae size and rupture may affect visibility and diagnosis, possibly leading to clinical inaccuracies.…”

Section: Commentsmentioning

confidence: 56%

What Is Your Diagnosis?

Spencer¹,

Schroeder²,

Samii³

et al. 2015

javma

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HistoryA 10-month-old sexually intact male Shetland Sheepdog was evaluated by its primary veterinarian for a 1-day history of decreased appetite and mild lethargy. On physical examination, the dog was noted to have increased respiratory rate and effort with decreased lung sounds on the left side. The dog was not receiving heartworm preventative. The veterinarian performed survey radiography, made a diagnosis of pneumothorax, and performed bilateral thoracocentesis. The dog was referred to a surgical center for advanced imaging and continued care.On evaluation at the referral center the following day, the owner stated that the dog seemed clinically improved, with a normal appetite and energy level. On physical examination, the dog was bright, alert, and responsive, with no abnormal findings. Additional thoracic radiographs were obtained (Figure 1).Determine whether additional imaging studies are required, or make your diagnosis from Figure 1-then turn the page →

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Sensitivity, positive predictive value, and interobserver variability of computed tomography in the diagnosis of bullae associated with spontaneous pneumothorax in dogs: 19 cases (2003–2012)

Cited by 40 publications

References 20 publications

CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases

CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases

Utility of bronchoscopy combined with surgery in the treatment and outcomes of dogs with intrathoracic disease secondary to plant awn migration

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