Correlation of ultrasonographic findings with surgical, portographic, and necropsy findings in dogs and cats with portosystemic shunts: 63 cases (1987-1993)

David E. Holt From the Sections of Surgery (Holt) and Radiology (Saunders), Department of Clinical Studies, Veterinary Hospital, University of Pennsylvania, 3850 Spruce St, Philadelphia, PA 19104-6010; Veterinary Diagnostic Imaging Associates (Schelling), 1520 Crest Rd, Wynnewood, PA 19096; and Veterinary Surgical Center (Orsher), 4197 Bristol Rd, Oakford, PA 19047.

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Curtis G. Schelling From the Sections of Surgery (Holt) and Radiology (Saunders), Department of Clinical Studies, Veterinary Hospital, University of Pennsylvania, 3850 Spruce St, Philadelphia, PA 19104-6010; Veterinary Diagnostic Imaging Associates (Schelling), 1520 Crest Rd, Wynnewood, PA 19096; and Veterinary Surgical Center (Orsher), 4197 Bristol Rd, Oakford, PA 19047.

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H. Mark Saunders From the Sections of Surgery (Holt) and Radiology (Saunders), Department of Clinical Studies, Veterinary Hospital, University of Pennsylvania, 3850 Spruce St, Philadelphia, PA 19104-6010; Veterinary Diagnostic Imaging Associates (Schelling), 1520 Crest Rd, Wynnewood, PA 19096; and Veterinary Surgical Center (Orsher), 4197 Bristol Rd, Oakford, PA 19047.

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Robert J. Orsher From the Sections of Surgery (Holt) and Radiology (Saunders), Department of Clinical Studies, Veterinary Hospital, University of Pennsylvania, 3850 Spruce St, Philadelphia, PA 19104-6010; Veterinary Diagnostic Imaging Associates (Schelling), 1520 Crest Rd, Wynnewood, PA 19096; and Veterinary Surgical Center (Orsher), 4197 Bristol Rd, Oakford, PA 19047.

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Summary

Results of abdominal ultrasonography in 63 dogs and cats with suspected congenital portosystemic shunts (PSS) were compared with surgical, portographic, and necropsy findings. True-positive ultrasonographic results were found in 33 animals, and 2 animals had falsepositive results for detection of single extrahepatic PSS. In 4 animals, results were true negative and in 8 animals, were false-negative for detection of extrahepatic PSS. The false-negative rate decreased substantially with operator experience. The sensitivity of ultrasonography for detection of extrahepatic PSS in these animals was 80.5%, and the specificity was 66.7%. In 5 other animals, ultrasonographic examination was strongly suggestive of the existence of a shunt, but the vessel could not be definitively imaged. All 5 animals had single extrahepatic shunts. Eleven animals had true-positive results for detection of intrahepatic PSS. One animal had false-positive ultrasonographic results for intrahepatic PSS, but an extrahepatic shunt was diagnosed at surgery. The sensitivity of ultrasonography for detection of intrahepatic PSS was 100%.

Summary

Results of abdominal ultrasonography in 63 dogs and cats with suspected congenital portosystemic shunts (PSS) were compared with surgical, portographic, and necropsy findings. True-positive ultrasonographic results were found in 33 animals, and 2 animals had falsepositive results for detection of single extrahepatic PSS. In 4 animals, results were true negative and in 8 animals, were false-negative for detection of extrahepatic PSS. The false-negative rate decreased substantially with operator experience. The sensitivity of ultrasonography for detection of extrahepatic PSS in these animals was 80.5%, and the specificity was 66.7%. In 5 other animals, ultrasonographic examination was strongly suggestive of the existence of a shunt, but the vessel could not be definitively imaged. All 5 animals had single extrahepatic shunts. Eleven animals had true-positive results for detection of intrahepatic PSS. One animal had false-positive ultrasonographic results for intrahepatic PSS, but an extrahepatic shunt was diagnosed at surgery. The sensitivity of ultrasonography for detection of intrahepatic PSS was 100%.

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