Aplicabilidade da ultrassonografia em modo b e elastografia transtorácica no diagnóstico de doenças pulmonares em cães
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Data
2023-02-24
Autores
Lima, Bruna Bressianini
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
- As doenças pulmonares em cães possuem alta relevância na rotina de pequenos animais, sendo que os sinais clínicos em sua maioria são inespecíficos e a grande variedade etiológica das afecções pulmonares possibilitam uma série de diagnósticos diferenciais. Na busca de um diagnóstico conclusivo recorre-se aos procedimentos invasivos, uma vez que os achados de técnicas não invasivas como exames radiográficos e ultrassonografia convencional possuem baixa especificidade na diferenciação das doenças pulmonares. Neste contexto, o presente estudo objetivou determinar a aplicabilidade da ARFI (acoustic radiation force impulse) na avaliação de lesões pulmonares em cães e correlacionar os dados obtidos pela técnica com os parâmetros radiográficos, da ultrassonografia modo-B e achados de citologia e histopatologia dos tecidos anormais, sugerindo um protocolo de exame e valores de corte em pacientes caninos com doenças pulmonares. Foi realizado estudo clínico prospectivo caso-controle e avaliadas e comparadas as características de áreas pulmonares com atelectasia ou massas utilizando a radiografia como exame de triagem para localização das lesões e a ultrassonografia em modo B avaliando a ecogenicidade, ecotextura, contornos, margeamento, presença de linhas B, áreas císticas, pontos ecogênicos centrais e o número de massas (únicas ou múltiplas). Posteriormente, foram avaliadas as características elastográficas (qualitativas e quantitativas). As avaliações ultrassonográficas realizadas ao modo-B não se mostraram significativas estatisticamente nos parâmetros estudados, assim como a elastografia ARFI qualitativa e quantitativa;não obtendo assim valor diagnóstico para estes parâmetros avaliados. A elastografia ARFI é um método recente que pode fornecer dados importantes a respeito da rigidez dos tecidos em humanos, de forma a permitir a utilização futura desta técnica na avaliação de cães com afecções pulmonares, sendo que estudos mais extensos sobre essa questão e uma amostragem maior de pacientes são necessários devido à escassez de pesquisas sobre esta técnica de imagem em pequenos animais.
Pulmonary diseases in dogs have high relevance in the routine of small animals, and the clinical signs are mostly nonspecific and the wide etiological variety of pulmonary diseases allow a series of differential diagnoses. In the search for a conclusive diagnosis, invasive procedures are used, since the findings of noninvasive techniques such as radiographic examinations and conventional ultrasound have low specificity in differentiating lung diseases. In this context, the present study aimed to determine the applicability of ARFI (acoustic radiation force impulse) in the evaluation of lung lesions in dogs and to correlate the data obtained by the technique with radiographic parameters, B-mode ultrasonography and cytology and histopathology findings of the tissues. abnormalities, suggesting an examination protocol and cut-off values in canine patients with pulmonary diseases. A prospective case-control clinical study was carried out and the characteristics of lung areas with atelectasis or masses were evaluated and compared using radiography as a screening test and for locating the lesions and B-mode ultrasonography evaluating the echogenicity, echotexture, contours, margins, presence of B lines, cystic areas, central echogenic points and the number of masses (single or multiple). Subsequently, the elastographic characteristics (qualitative and quantitative) were evaluated. The Bmode ultrasonographic evaluations were not statistically significant in the parameters studied, as well as the qualitative and quantitative ARFI elastography;, thus not obtaining diagnostic value for these evaluated parameters. ARFI elastography is a recent method that can provide important data regarding the stiffness of tissues in humans, in order to allow the future use of this technique in the evaluation of dogs with pulmonary diseases, and more extensive studies on this issue and a larger sample of patients are needed due to the paucity of research on this imaging technique in small animals.
Pulmonary diseases in dogs have high relevance in the routine of small animals, and the clinical signs are mostly nonspecific and the wide etiological variety of pulmonary diseases allow a series of differential diagnoses. In the search for a conclusive diagnosis, invasive procedures are used, since the findings of noninvasive techniques such as radiographic examinations and conventional ultrasound have low specificity in differentiating lung diseases. In this context, the present study aimed to determine the applicability of ARFI (acoustic radiation force impulse) in the evaluation of lung lesions in dogs and to correlate the data obtained by the technique with radiographic parameters, B-mode ultrasonography and cytology and histopathology findings of the tissues. abnormalities, suggesting an examination protocol and cut-off values in canine patients with pulmonary diseases. A prospective case-control clinical study was carried out and the characteristics of lung areas with atelectasis or masses were evaluated and compared using radiography as a screening test and for locating the lesions and B-mode ultrasonography evaluating the echogenicity, echotexture, contours, margins, presence of B lines, cystic areas, central echogenic points and the number of masses (single or multiple). Subsequently, the elastographic characteristics (qualitative and quantitative) were evaluated. The Bmode ultrasonographic evaluations were not statistically significant in the parameters studied, as well as the qualitative and quantitative ARFI elastography;, thus not obtaining diagnostic value for these evaluated parameters. ARFI elastography is a recent method that can provide important data regarding the stiffness of tissues in humans, in order to allow the future use of this technique in the evaluation of dogs with pulmonary diseases, and more extensive studies on this issue and a larger sample of patients are needed due to the paucity of research on this imaging technique in small animals.
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Palavras-chave
Cisalhamento, Pulmão, Malignidade, Histopatologia veterinária