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Comparison of contrast-enhanced multidetector computed tomography angiography and splenoportography for the evaluation of portosystemic-shunt occlusion after cellophane banding in dogs

Schaub, Sebastian ; Hartmann, Antje ; Schwarz, Tobias ; Kemper, Karsten ; Pueckler, Kerstin H. ; Schneider, Matthias A.

Originalveröffentlichung: (2016) BMC Veterinary Research 12:283 doi: 10.1186/s12917-016-0910-6
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URN: urn:nbn:de:hebis:26-opus-128747

Freie Schlagwörter (Englisch): Computed tomography , Splenoportography , Angiography , Extrahepatic portosystemic shunt
Sammlung: Open Access - Publikationsfonds
Universität Justus-Liebig-Universität GieĂźen
Institut: Department of Veterinary Clinical Sciences
Fachgebiet: Veterinärmedizin
DDC-Sachgruppe: Landwirtschaft
Dokumentart: Aufsatz
Sprache: Englisch
Erstellungsjahr: 2016
Publikationsdatum: 26.05.2017
Kurzfassung auf Englisch: Background: Many patients with a congenital extrahepatic portosystemic shunt (PSS) do not tolerate an immediate shunt closure. Therefore, slow progressive techniques were developed. To evaluate the success of shunt closure diagnostic imaging is essential to identify possible residual blood flow through the shunt vessel. There is a lack of information about the reliability of computed tomography angiography (CTA) for evaluating residual flow through a PSS after treatment. The purpose of this prospective study was to compare the results of CTA with splenoportography. Three months after cellophane banding CTA and splenoportography were performed in 20 dogs and reviewed by three independent examiners, respectively. In both imaging modalities the presences of a residual shunt was judged as present or absent and the extent of visibility of portal vasculature was recorded. Results: Based on the evaluation of the splenoportography residual flow through shunt was present in 6 dogs. The classification of residual shunt present or absent showed a substantial to perfect agreement (k=0.65–1.00) between the observers in splenoportography and a slight to moderate agreement (k=0.11–0.51) for CTA. Sensitivity and specificity varied between 0.50 and 1.00 and 0.57–0.85, respectively. Significant correlation between CTA and splenoportography for the classification of residual shunt was present only in one observer but not in the other two. Conclusion: More studies were classified as residual shunt positive with CTA compared to splenoportography. It remains unclear which methods do reflect reality better and thus which method is superior. The greater inter-rater agreement for splenoportography suggests a greater reliability of this technique.
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