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

Schaub S; Hartmann A; Schwarz T; Kemper K; Pueckler KH; Schneider MA

doi:10.1186/s12917-016-0910-6

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Journal article

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

Schaub S Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany. Sebast.schaub@gmail.com.
Hartmann A Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland.
Schwarz T Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, EH25 9RG, UK.
Kemper K Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany.
Pueckler KH Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany.
Schneider MA Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany.

2016-12-13

Published in:

BMC veterinary research. - 2016

Extrahepatic portosystemic shunt

Computed Tomography Angiography

English 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 (κ = 0.65-1.00) between the observers in splenoportography and a slight to moderate agreement (κ = 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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