Peer-reviewed veterinary case report
Ultrasound accuracy for spotting small intestine lesions in cats
By Guttin, Talia et al.·Published in Journal of veterinary internal medicine·2019·Department of Small Animal Medicine and Surgery·View original on PubMed →
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Original publication title: Ability of ultrasonography to predict the presence and location of histologic lesions in the small intestine of cats.
- Species:
- cat
Plain-English summary
A group of 169 cats with suspected small intestinal (SI) issues underwent abdominal ultrasound and full-thickness biopsies to check for lesions. The ultrasound was able to predict the presence of mucosal lesions (the innermost layer of the intestine) with high accuracy, meaning that if the ultrasound showed problems, the biopsy was likely to confirm them. However, the ultrasound was less reliable for detecting issues in deeper layers of the intestine. This suggests that while ultrasound can be a helpful tool in deciding where to take biopsies, it may not always be necessary to take full-thickness samples if only deeper layers are suspected.
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Abstract
BACKGROUND: Diagnosis of infiltrative small intestinal (SI) disease in cats is challenging, and debate continues regarding optimal biopsy techniques. Ultrasonography may facilitate selection of biopsy type and location. HYPOTHESIS/OBJECTIVES: Assess ability of ultrasonography to predict histologic lesions by SI segment and tissue layer. ANIMALS: One-hundred sixty-nine cats that had abdominal ultrasonography and full-thickness SI biopsies performed. METHODS: Ultrasonographic images and full-thickness biopsy samples were retrospectively reviewed, and each SI wall layer evaluated for lesions according to published standards. RESULTS: Ultrasonographic SI lesions were present in 132 cats (63 duodenum; 115 jejunum; 71 ileum). Samples were obtained at laparotomy (60) or necropsy (109). Ultrasonographic abnormalities had high positive predictive value (PPV) for histologic lesions (duodenum, 82.0%; 95% confidence interval [CI], 68.6-91.4; jejunum, 91.0%; 95% CI, 81.5-96.6; ileum, 88.1%; 95% CI, 74.4-96.0), but poor negative predictive value (duodenum, 27.1%; 95% CI, 17.2-39.1; jejunum, 27.3%; 95% CI, 10.7-50.2; ileum, 40.4%; 95% CI, 26.4-55.7). The ability of ultrasonography to predict histologic lesions in this population, which had high disease prevalence (SI histologic lesions in 78.1% of cats) was high for mucosal lesions (PPV, 72.7%-100%) but low for submucosal or muscularis lesions (PPV, 18.9%-57.1%). CONCLUSIONS AND CLINICAL IMPORTANCE: In a population with high disease prevalence, most cats with SI mucosal ultrasonographic lesions will have mucosal histologic lesions. Small intestinal submucosal and muscularis ultrasonographic lesions are not predictive of histologic disease in those layers, suggesting that full-thickness biopsy may not be essential in these cats. Ultrasonography may help guide decisions about biopsy type in individual cats.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/30847975/