Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/98519
標題: 腎臟皮質回音各向異性於貓慢性腎病消失所代表之臨床意義
The absence of anisotropic effect on the renal cortical echogenicity in feline chronic kidney disease
作者: 周秉賢
Ping-Hsien Chou
關鍵字: 
慢性腎臟病
超音波
腎臟皮質回音性
cats
chronic kidney disease
ultrasound
renal cortical echogenicity
引用: 1. Adibi MD, Emami Naini MD, Salehi MD, et al. Renal cortical thickness in adults with normal renal function measured by ultrasonography. Iran J Radiol 5:163-166, 2008. 2. Adin CA, Herrgesell EJ, Nyland TG, et al. Antegrade pyelography for suspected ureteral obstruction in cats: 11 cases (1995-2001). J Am Vet Med Assoc 222:1576-1581, 2003. 3. Aresu L, Zanatta R, Pregel P, et al. Bilateral juvenile renal dysplasia in a Norwegian Forest Cat. J Feline Med Surg 11:236-239, 2009. 4. Atkins RC. The epidemiology of chronic kidney disease. Kidney Int 67:S14–S18, 2005. 5. Banzato T, Bonsembiante F, Aresu L, et al. Relationship of diagnostic accuracy of renal cortical echogenicity with renal histopathology in dogs and cats, a quantitative study. BMC Vet Res 13:24, 2017. 6. Bartges JW. Chronic kidney disease in dogs and cats. Vet Clin North Am Small Anim Pract 42:669-692, vi, 2012. 7. Bartlett PC, Van Buren JW, Bartlett AD, et al. Case-control study of risk factors associated with feline and canine chronic kidney disease. Vet Med Int 20102010. 8. Baxter KJ, Levy JK, Edinboro CH, et al. Renal disease in cats infected with feline immunodeficiency virus. J Vet Intern Med 26:238-243, 2012. 9. Beck C, Lavelle RB. Feline polycystic kidney disease in Persian and othercats: a prospective study using ultrasonography. Aust Vet J 79:181-184, 2001. 10. Boag AK, Neiger R, Slater L, et al. Changes in the glomerular filtration rate of 27 cats with hyperthyroidism after treatment with radioactive iodine. Vet Rec 161:711-715, 2017. 11. Bode-Böger SM, Scalera F, Kielstein JT, et al. Symmetrical dimethylarginine: a new combined parameter for renal function and extent of coronary artery disease. J Am Soc Nephrol 17:1128-1134, 2006. 12. Bonnett BN, Egenvall A. Age patterns of disease and death in insured Swedish dogs, cats and horses. J Comp Pathol 142 Suppl 1:S33-38, 2010. 13. Boyce JT, DiBartola SP, Chew DJ, et al. Familial Renal Amyloidosis in Abyssinian Cats. Send toVet Pathol 21:33-38, 1984. 14. Brown CA, Elliott J, Schmiedt CW, et al. Chronic Kidney Disease in Aged Cats: Clinical Features, Morphology, and Proposed Pathogeneses. Vet Pathol 53:309-326, 2016. 15. Brown SA, Crowell WA, Brown CA, et al. Pathophysiology and management of progressive renal disease. Vet J 154:93-109, 1997. 16. Brown SA, Finco DR, Crowell WA, et al. Single-nephron adaptations to partial renal ablation in the dog. Am J Physiol 258:F495–503, 1990. 17. Chakrabarti S, Syme HM, Brown CA, et al. Histomorphometry of feline chronic kidney disease and correlation with markers of renal dysfunction. Vet Pathol 50:147-155, 2013. 18. Chakrabarti S, Syme HM, Elliott J. Clinicopathological Variables Predicting Progression of Azotemiain Cats with Chronic Kidney Disease. J Vet Intern Med 26:275-281, 2012. 19. Chalhoub S, Langston C, Eatroff A. Anemia of renal disease: what it is, what to do and what's new. J Feline Med Surg 13:629-640, 2011. 20. Chen JZ, Deng AW, Xu JF. Electroenterogram manifestations and significance in hypokalemia. Di Yi Jun Yi Da Xue Xue Bao 25:7-9, 2005. 21. Chi T, Feldstein VA, Nguyen HT. Increased echogenicity as a predictor of poor renal function in children with grade 3 to 4 hydronephrosis. J Urol 175:1898-1901, 2006. 22. Churchill JA, Feeney DA, Fletcher TF, et al. Age and diet effects on relative renal echogenicity in geriatric bitches. Vet Radiol Ultrasound 40:642-647, 1990. 23. Cléroux A, Alexander K, Beauchamp G, et al. Evaluation for association between urolithiasis and chronic kidney disease. J Am Vet Med Assoc 250:770-774, 2017. 24. Debruyn K, Haers H, Combes A, et al. Ultrasonography of the feline kidney: Technique, anatomy and changes associated with disease. J Feline Med Surg 14:794-803, 2012. 25. Debruyn K, Paepe D, Daminet S, et al. Comparison of renal ultrasonographic measurements between healthy cats of three cat breeds: Ragdoll, British Shorthair and Sphynx. J Feline Med Surg 15:478-482, 2013. 26. Dong Y, Wang W, Cao J, et al. Quantitative evaluation of contrast-enhanced ultrasonography in the diagnosis of chronic ischemic renal disease in a dog model. PLoS One 8: e70337, 2013. 27. Dong Y, Wang WP, Cao J, et al. Early assessment of chronic kidney dysfunction using contrast-enhanced ultrasound: a pilot study. Br J Radiol 87:1-7, 2014. 28. Drost W, Henry G, Meinkoth J, et al. Quantification of hepatic and renal cortical echogenicity in clinically normal cats. Am J Vet Res 61:1016-1020, 2000. 29. Eddy AA. Overview of the cellular and molecular basis of kidney fibrosis. Kidney Int Suppl (2011) 4:2-8, 2014. 30. Egenvall A, Penell JC, Bonnett BN, et al. Morbidity of Swedish horses insured for veterinary care between 1997 and 2000: variations with age, sex, breed and location. Vet Rec 15:436-443, 2005. 31. Elliott J, Barber P. Feline chronic renal failure clinical findings in 80 cases diagnosed between 1992 and 1995. J Small Anim Pract 39:78–85, 1998. 32. Elliott J, Barber PJ, Syme HM, et al. Feline hypertension: clinical findings and response to antihypertensive treatment in 30 cases. J Small Anim Pract 42:122-129, 2001. 33. Ferenbach DA, Bonventre JV. Mechanisms of maladaptive repair after AKI leading to accelerated kidney ageing and CKD. Nat Rev Nephrol 11:264-276, 2015. 34. Finch NC, Syme HM, Elliott J. Risk Factors for Development of Chronic Kidney Disease in Cats. J Vet Intern Med 30:602-610, 2016. 35. Fraga E, Barreiro JD, Goicoa A, et al. Abdominal ultrasonographic findings in dogs naturally infected with babesiosis. Vet Radiol Ultrasound 52:323-329, 2011. 36. Freeman LM. Cachexia and sarcopenia: emerging syndromes of importance in dogs and cats. J Vet Intern Med 26:3-17, 2012. 37. Freeman LM, Lachaud MP, Matthews S, et al. Evaluation of Weight Loss Over Time in Cats with Chronic Kidney Disease. J Vet Intern Med 30:1661-1666, 2016. 38. Geddes RF, Finch NC, Syme HM, et al. The role of phosphorus in the pathophysiology of chronic kidney disease. J Vet Emerg Crit Care (San Antonio) 23:122-133, 2013. 39. Glick AD, Horn RG, Holscher M. Characterization of feline glomerulonephritis associated with viral-induced hematopoietic neoplasms. Am J Pathol 92:321-327, 1978. 40. Greene JP, Lefebvre SL, Wang M, et al. Risk factors associated with the development of CKD in cats evaluated at primary veterinary hospitals. J Am Vet Med Assoc 224:320-327, 2014. 41. Haers H, Daminet S, Smets PM, et al. Use of quantitative contrast-enhanced ultrasonography to detect diffuse renal changes in Beagles with iatrogenic hypercortisolism. Am J Vet Res 74:70-77, 2013. 42. Hall JA, Yerramilli M, Obare E, et al. Comparison of serum concentrations of symmetric dimethylarginine and creatinine as kidney function biomarkers in cats with chronic kidney disease. J Vet Intern Med 28:1676-1683, 2014. 43. Heng HG, Rohleder JJ, Pressler BM. Comparative sonographic appearance of nephroliths and associated acoustic shadowing artifacts in conventional vs. spatial compound imaging. Vet Radiol Ultrasound 53:217-220, 2012. 44. Hughes KL, Slater MR, Geller S, et al. Diet and lifestyle variables as risk factors for chronic renal failure in pet cats. Prev Vet Med 55:1-15, 2002. 45. Insana MF, Hall TJ, Fishback JL. Identifying acoustic scattering sources in normal renal parenchyma from the anisotropy in acoustic properties. Ultrasound Med Biol 17:613-626, 1991. 46. Ivancić M, Mai W. Qualitative and quantitative comparison of renal vs. hepatic ultrasonographic intensity in healthy dogs. Vet Radiol Ultrasound 49:368-373, 2008. 47. Jamerson KA, Townsend RR. The attributable burden of hypertension: focus on CKD. Adv Chronic Kidney Dis 18:6-10, 2011. 48. Jepson RE. Current understanding of the pathogenesis of progressive chronic kidney disease in cats. Vet Clin North Am Small Anim Pract 46:1015-1048, 2016. 49. Jepson RE. Feline systemic hypertension: Classification and pathogenesis. J Feline Med Surg 13:25-34, 2011. 50. Jepson RE, Brodbelt D, Vallance C, et al. Evaluation of predictors of the development of azotemia in cats. J Vet Intern Med 23:806-813, 2009. 51. Jepson RE, Syme HM, Elliott J. Plasma Renin Activity and Aldosterone Concentrations in Hypertensive Cats with and without Azotemia and in Response to Treatment with Amlodipine Besylate. J Vet Intern Med 28:144-153, 2014. 52. Jepson RE, Syme HM, Vallance C, et al. Plasma asymmetric dimethylarginine, symmetric dimethylarginine, l-arginine, and nitrite/nitrate concentrations in cats with chronic kidney disease and hypertension. J Vet Intern Med 22:317-324, 2008. 53. Ji H, Zheng W, Menini S, et al. Female protection in progressive renal disease is associated with estradiol attenuation of superoxide production. Gend Med 4:56-71, 2007. 54. Keppie N, Nelson N, Rosenstein D. Imaging diagnosis: Mineralization of the aorta, celiac and cranial mesenteric arteries in a cat with chronic renal failure. Vet Radiol Ultrasound 47:69-71, 2006. 55. King JN, Tasker S, Gunn-Moore DA, et al. Prognostic Factors in Cats with Chronic Kidney Disease. J Vet Intern Med 21:906-916, 2007. 56. Kramann R, Dirocco DP, Maarouf OH, et al. Matrix Producing Cells in Chronic Kidney Disease: Origin, Regulation, and Activation. Curr Pathobiol Rep 1:301-311, 2013. 57. Kraus RA, Gaisie G, Young LW. Increased renal parenchymal echogenicity: causes in pediatric patients. Radiographics 10:1009-1018, 1990. 58. Kyles AE, Hardie EM, Wooden BG, et al. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984-2002). J Am Vet Med Assoc 226:937-944, 2005. 59. Lamb CR, Dirrig H, Cortellini S. Comparison of ultrasonographic findings in cats with and without azotaemia. J Feline Med Surg:1-7, 2017. 60. Lawler DF, Evans RH, Chase K, et al. The aging feline kidney: a model mortality antagonist? Send to J Feline Med Surg 8:363-371, 2006. 61. Loy CT, Irwig L. Accuracy of diagnostic tests read with and without clinical information: a systematic review. JAMA 292:1602-1609, 2004. 62. Mack M, Yanagita M. Origin of myofibroblasts and cellular events triggering fibrosis. Kidney Int 87:297-307, 2015. 63. Manley JA, O'Neill WC. How echogenic is echogenic? Quantitative acoustics of the renal cortex. Am J Kidney Dis 37:706-711, 2001. 64. Marino CL, Lascelles BD, Vaden SL, et al. Prevalence and classification of chronic kidney disease in cats randomly selected from four age groups and in cats recruited for degenerative joint disease studies. J Feline Med Surg 16:465-472, 2014. 65. Mayer-Roenne B, Goldstein RE, Erb HN. Urinary tract infections in cats with hyperthyroidism, diabetes mellitus and chronic kidney disease. J Feline Med Surg 9:124-132, 2007. 66. McLeland SM, Cianciolo RE, Duncan CG, et al. A comparison of biochemical and histopathologic staging in cats with chronic kidney disease. Vet Pathol 52:524-534, 2015. 67. Medapalli RK, He JC, Klotman PE. HIV-associated nephropathy: pathogenesis. Curr Opin Nephrol Hypertens 20:306-311, 2011. 68. Mesnage R, Arno M, Costanzo M, et al. Transcriptome profile analysis reflects rat liver and kidney damage following chronic ultra-low dose Roundup exposure. Environ Health 14:70, 2015. 69. Mitani S, Yabuki A, Taniguchi K, et al. Association between the Intrarenal Renin-Angiotensin System and Renal Injury in Chronic Kidney Disease of Dogs and Cats. Journal of Veterinary Medical Science:127-133, 2013. 70. Munson L, Terio KA, Worley M, et al. Extrinsic factors significantly affect patterns of disease in free-ranging and captive cheetah (Acinonyx jubatus) populations. J Wildl Dis 41:542-548, 2005. 71. Murphy SW, Barrett BJ, Parfrey PS. Contrast nephropathy. J Am Soc Nephrol 11:177-182, 2000. 72. Novellas R, Ruiz de Gopegui R, Espada Y. Assessment of renal vascular resistance and blood pressure in dogs and cats with renal disease. Vet Rec 166:618-623, 2010. 73. O'Neill D, Elliott J, Church D, et al. Chronic kidney disease in dogs in UK veterinary practices prevalence, risk factors, and survival. J Vet Intern Med 4:814-821, 2013. 74. Paepe D, Daminet S. Feline CKD: Diagnosis, staging and screening - what is recommended? J Feline Med Surg 15:Suppl 1:15-27, 2013. 75. Paepe D, Daminet S. Feline CKD: Diagnosis, staging and screening - what is recommended? J Feline Med Surg 15 Suppl 1:15-27, 2013. 76. Paepe D, Saunders JH, Bavegems V, et al. Screening of ragdoll cats for kidney disease: a retrospective evaluation. J Small Anim Pract 53:572-577, 2012. 77. Park IC, Lee HS, Kim JT, et al. Ultrasonographic evaluation of renal dimension and resistive index in clinically healthy Korean domestic short-hair cats. J Vet Sci 9:415-419, 2008. 78. Penninck D, d'Anjou MA. Atlas of Small Animal Ultrasonography. 2 ed. Hoboken: Blackwell Pub, 2015. 79. Perico N, Remuzzi G, Benigni A. Aging and the kidney. Curr Opin Nephrol Hypertens 20:312-317, 2011. 80. Peterson ME, Castellano CA, Rishniw M. Evaluation of Body Weight, Body Condition, and Muscle Condition in Cats with Hyperthyroidism. J Vet Intern Med 30:1780-1789, 2016. 81. Peterson ME, Varela FV, Rishniw M, et al. Evaluation of Serum Symmetric Dimethylarginine Concentration as a Marker for Masked Chronic Kidney Disease in Cats With Hyperthyroidism. J Vet Intern Med 32:295-304, 2018. 82. Piyarungsri K, Pusoonthornthum R. Risk and protective factors for cats with naturally occurring chronic kidney disease. J Feline Med Surg 19:358-363, 2017. 83. Poli A, Tozon N, Guidi G, et al. Renal alterations in feline immunodeficiency virus (FIV)-infected cats: a natural model of lentivirus-induced renal disease changes. Viruses 4:1372-1389, 2012. 84. Polzin DJ. Evidence-based step-wise approach to managing chronic kidney disease in dogs and cats. J Vet Em and Crit Care 23:205-215, 2013. 85. Prunotto M, Ghiggeri G, Bruschi M, et al. Renal fibrosis and proteomics: current knowledge and still key open questions for proteomic investigation. J Proteomics 74:1855-1870, 2011. 86. Quimby JM. Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease. Vet Clin North Am Small Anim Pract 46:1163-1181, 2016. 87. Quimby JM, Dowers K, Herndon AK, et al. Renal pelvic and ureteral ultrasonographic characteristics of cats with chronic kidney disease in comparison with normal cats, and cats with pyelonephritis or ureteral obstruction. J Feline Med Surg 8:784-790, 2017. 88. Randolph JE, Scarlett J, Stokol T, et al. Clinical efficacy and safety of recombinant canine erythropoietin in dogs with anemia of chronic renal failure and dogs with recombinant human erythropoietin-induced red cell aplasia. J Vet Intern Med 18:81-91, 2004. 89. Reynolds BS, Chetboul V, Nguyen P, et al. Effects of dietary salt intake on renal function: a 2-year study in healthy aged cats. J Vet Intern Med 27:507-515, 2013. 90. Reynolds BS, Lefebvre HP. Feline CKD: Pathophysiology and risk factors--what do we know? J Feline Med Surg 15 Suppl 1:3-14, 2013. 91. Rivers BJ, Walter PA, Polzin DJ, et al. Duplex doppler estimation of intrarenal pourcelot resistive index in dogs and cats with renal disease. J Vet Intern Med 11 250-260, 1997. 92. Rodriguez J, Blais MC, Lapointe C, et al. Serologic and urinary PCR survey of leptospirosis in healthy cats and in cats with kidney disease. J Vet Intern Med 28:284-292, 2014. 93. Ross SJ, Osborne CA, Kirk CA, et al. Clinical evaluation of dietary modification for treatment of spontaneous chronic kidney disease in cats. J Am Vet Med Assoc 229:949-957, 2006. 94. Rubin JM, Carson PL, Meyer CR. Anisotropic ultrasonic backscatter from the renal cortex. Ultrasound Med Biol 14:507-511, 1988. 95. Ruth JD, Heng HG, Miller MA, et al. Effect of anisotropy and spatial compound imaging on renal cortical echogenicity in dogs. Vet Radiol Ultrasound 54:659-665, 2013. 96. Schmiedt CW, Brainard BM, Hinson W, et al. Unilateral Renal Ischemia as a Model of Acute Kidney Injury and Renal Fibrosis in Cats. Vet Pathol 53:87-101, 2016. 97. Schweiger H, Ohlerth S, Gerber B. Contrast-enhanced ultrasound of both kidneys in healthy, non-anaesthetized cats. Acta Vet Scand 57:80, 2015. 98. Shiroma JT, Gabriel JK, Carter RL, et al. 1999 Effect of reproductive status on feline renal size. Vet Radiol Ultrasound 40:242-245, 1999. 99. Shoji K, Tanaka T, Nangaku M. Role of hypoxia in progressive chronic kidney disease and implications for therapy. Curr Opin Nephrol Hypertens 23:161-168, 2014. 100. Shropshire SB, Veir JK, Morris AK, et al. Evaluation of the Leptospira species microscopic agglutination test in experimentally vaccinated cats and Leptospira species seropositivity in aged azotemic client-owned cats. J Feline Med Surg 18:768-772, 2016. 101. Stock E, Paepe D, Daminet S, et al. Contrast-Enhanced Ultrasound Examination for the Assessment of Renal Perfusion in Cats with Chronic Kidney Disease. J Vet Intern Med 32:260-266, 2018. 102. Sun DF, Fujigaki Y, Fujimoto T, et al. Possible involvement of myofibroblasts in cellular recovery of uranyl acetate-induced acute renal failure in rats. Am J Pathol 157:1321-1335, 2000. 103. Syme HM, Markwell PJ, Pfeiffer D, et al. Survival of cats with naturally occurring chronic renal failure is related to severity of proteinuria. J Vet Intern Med 20:528-535, 2006. 104. Vaske HH, Schermerhorn T, Grauer GF. Effects of feline hyperthyroidism on kidney function: a review. J Feline Med Surg 18:55-59, 2016. 105. Vipattawat K, Kitiyakara C, Phakdeekitcharoen B, et al. Vascular calcification in long-term kidney transplantation. Send to Nephrology (Carlton) 19:251-256, 2014. 106. Webster N. ultrasonography of the urogenital tract in dogs and cats. In Pract 31:210-217, 2009. 107. White JD, Norris JM, Baral RM, et al. Naturally occurring chronic renal disease in Australian cats a prospective study of 184 cases. Aust Vet J 84:188-194, 2006. 108. White JD, Norris JM, Bosward KL, et al. Persistent haematuria and proteinuria due to glomerular disease in related Abyssinian cats. J Feline Med Surg 15:459-465, 2013. 109. Widmer WR, Biller DS, Adams LG. Ultrasonography of the urinary tract in small animals. J Am Vet Med Assoc 225:46-54, 2004. 110. Woo PC, Lau SK, Wong BH, et al. Feline morbillivirus, a previously undescribed paramyxovirus associated with tubulointerstitial nephritis in domestic cats. Proc Natl Acad Sci U S A 109:5435-5440, 2012. 111. Yabuki A, Endo Y, Sakamoto H, et al. Quantitative assessment of renal cortical echogenicity in clinically normal cats. Anat Histol Embryol 37:383-386, 2008. 112. Zotti A, Banzato T, Gelain ME, et al. Correlation of renal histopathology with renal echogenicity in dogs and cats: an ex-vivo quantitative study. BMC Vet Res 11:99, 2015.
摘要: 貓之慢性腎病被定義為腎臟功能不可逆的喪失,通常為一種長期且慢性的病程。然而,即使符合慢性腎病的標準,未必所有的病患都會在臨床初期就表現出現氮血症的症狀。(Jepson, 2016)因此在懷疑患有慢性腎病的動物,常會建議進行腹腔超音波檢查以獲取更多臨床資訊。在正常犬貓的腎臟中可見的各向異性,是一種和角度相關的局部腎臟皮質回音性上升的現象(約位於腎臟皮質三點鐘與九點鐘位置),應當留意不要與真正的高回音性病變混淆。(Ruth et al., 2013)由於腎臟疾病最常見的特徵之一就是腎臟皮質回音性的上升,因此我們假設由各向異性所導致的局部皮質高回音性,將會因此被腎病引起的整體回音性上升所掩蓋掉。本研究期望評估腎臟皮質回音各向異性於貓慢性腎病消失所代表之臨床意義。回溯2012年一月至2017年十二月之間國立中興大學獸醫教學醫院的病歷資料,選入35個病情穩定的貓慢性腎病病例,並且招募18隻臨床上健康的貓。費雪精確檢定和趨勢檢定分別顯示出腎臟皮質回音各向異性的消失和貓隻慢性腎病之間具有顯著相關(p<0.001),以及在慢性腎病各分級之間有顯著趨勢關係(p<0.0001)。多重邏輯式回歸分析中,腎臟皮質回音各向異性的消失表示出和年齡的顯著正相關(p=0.0172, odds ratio=1.427)以及體重之間顯著的負相關(p=0.0173, odds ratio=0.231)。在本研究以此方式去診斷貓之慢性腎病,能夠表現出82.9%的敏感度和83.3%的特異度。此外,無論是在單一觀測者內,或是有經驗的影像科醫師和初學的影像科研究生的觀測者間都保有良好的一致性,表示出主觀評估的穩定性以及這是一個簡易可行,而且比較不受經驗不足影響的影像診斷方法。總結來說,腎臟皮質回音各向異性消失的比例會隨著貓之慢性腎病的嚴重程度在統計上有依次增加的相關,我們認為這將有助於診斷貓之慢性腎病。
Chronic kidney disease (CKD) in cats is a prolonged process marked by irreversible loss of kidney function, but not all of the conditions fulfilling the criteria of CKD will result in azotemia initially. (Jepson, 2016) Abdominal ultrasound is therefore suggested in animals with suspected renal diseases. In normal canine and feline kidneys, anisotropic effect, focal angle-dependent regions of increased renal cortical echogenicity (at about 3 o' clock and 9 o' clock positions), could be detected and should not be mistaken for true hyperechoic lesion. (Ruth et al., 2013) Because one of the most common signs of kidney disease is increased cortical echogenicity, we hypothesized that the focal regions of hyperechogenicity caused by anisotropic effect in the renal cortex would be accordingly disguised. The purpose of this study is to evaluate the absence of anisotropic effect on renal cortical echogenicity in cats with CKD. A retrospective research from January 2012 to December 2017 was performed in the veterinary medical teaching hospital of National Chung Hsing University to enroll 35 cats with stable progress of CKD, and to recruit 18 clinically health cats. Significant association between the absence of anisotropic effect on the renal cortical echogenicity and CKD stages was revealed using the Fisher exact test (p<0.001), and the Cochran-Armitage trend test also showed the significant ordering of CKD stages (p<0.0001). According to the multiple logistic regression, the model showed significantly positive correlation in age (p=0.0172, odds ratio=1.427) and negative correlation in body weight (p=0.0173, odds ratio=0.231). The diagnostic method demonstrate 82.9% sensitivity and 83.3% specificity to differentiate the cats with CKD from the population of our study. Both intra-observer and inter-observer agreement between an experienced radiologist and a graduate student demonstrated substantial agreement, indicating consistency of the subjective evaluation and an easy and feasible method less likely influenced due to the insufficiency in experience. In conclusion, the absence of anisotropic effect on renal cortical echogenicity was statistically associated with the CKD progress and considered helpful to evaluate feline CKD.
URI: http://hdl.handle.net/11455/98519
文章公開時間: 2021-08-08
Appears in Collections:獸醫學系所

文件中的檔案:

取得全文請前往華藝線上圖書館

Show full item record
 
TAIR Related Article
 
Citations:


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.