Usefulness of Chest Ultrasonography in Predicting Diagnosis in Non-emergency Small Animal Patients With Lung Parenchymal and Pleural Disease

Abstract

Chest ultrasonography has become an indispensable tool for pulmonary specialists in human medicine, but its current use in dogs and cats is primarily for emergency. The diagnostic performances of various ultrasonographic features other than comet-tail artifacts are of limited information in veterinary literatures. Therefore, the aims of this retrospective study were to investigate ultrasonographic findings in feline and canine respiratory patients with lung parenchymal and pleural space diseases, and to assess how ultrasonographic features correspond to specific diagnoses. Sixty-five non-emergency cases with radiographically identified lung parenchymal and pleural space abnormalities were included. Medical records and ultrasound video clips were reviewed, and additional follow-up information was subsequently collected. Common findings such as comet-tail artifacts (87.7% of cases), consolidation (84.6%), and thickened/irregular pleura (69.2%) were not distinguishable for a specific diagnosis. The presence of nodular/mass-like lesion (OR = 212, p < 0.001) and consolidated lesion with heteroechogenicity (OR = 240, p < 0.001) was significantly associated with and strongly predictive of neoplasia after age, body weight and other sonographic findings were adjusted. The finding of nodular/mass-like lesion has the best diagnostic performance (AUC = 0.93) for neoplasia, with sensitivity of 91.7% and specificity of 93.6%. For predicting a diagnosis of pneumonia, although several sonographic features were found to be statistically associated with pneumonia, only a negative finding of nodular/mass-like lesion showed good diagnostic performance (AUC = 0.83, sensitivity 95.7%, specificity 71%). These findings demonstrate the value of chest ultrasonography in predicting diagnosis in non-emergency cases. The application of thoracic ultrasound in small animal respiratory patients as part of non-invasive assessment warrants further investigation.

Ultrasound examination for diagnosing pneumopathies in New World primates, focusing on pulmonary consolidation

“…In a study on dogs and cats, ndings of ultrasound alterations were associated with a diagnosis of pneumonia. These alterations consisted of thickened or irregular pleura (p = 0.034), consolidation (p = 0.032) and absence of nodular lesion or mass (p < 0.001) (Lin et al 2020).…”

“…Consolidations may be focal, partial or lobar (Lin et al 2020). According to the appearance and location, it is possible to differentiate pneumonia from atelectasis due to tissue resorption.…”

Two cases (a cat and a dog) illustrating computed tomographic features distinguishing an accessory lung lobe mass from a caudal mediastinal origin

“…Thoracic ultrasonography and ultrasound-guided FNAs/biopsy have been studied extensively in human patients with different kinds of respiratory pathology and were reported to be a valuable tool in small animals with noncardiac intrathoracic disease. 11,12,13,14 In the study by Lin et al, 15 it was reported that the presence of a "nodular or mass-like lesion" and a "consolidated lesion with heteroechogenicity" are significantly associated with pulmonary neoplasia, and although a definitive diagnosis cannot be based merely on the ultrasonographic appearance of a lesion, some characteristics could help predict the underlying aetiology. Similarly, in the present study, sonographic assessment of the thorax allowed further characterisation of the tumor that appeared as a ''mass-like lesion'' in both cases, and ultrasound-guided FNAs allowed a definitive diagnosis to be made in Case 1.…”

A Comparative Study of Chest CT With Lung Ultrasound After SARS-CoV-2 Infection in the Assessment of Pulmonary Lesions in Rhesus Monkeys (Macaca Mulatta)

“…Further research could include different NHP species to confirm the applicability of LUS among species. In addition, it could also include other animal species like dogs and cats in which LUS has proven to be a useful technique but also warrants further investigation to use as a stand-alone imaging modality (39,40). Moreover, to assess the full potential of LUS in NHPs, the effect of different levels of disease severity with respect to the diagnostic efficacy of LUS over CT needs to be evaluated probably in other lung disease models like tuberculosis or influenza (41,42).…”