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Canine nasal aspergillosis
Advances
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tion between a cavitated process and a mass lesion. Author Conclusion CT is more sensitive than radiography for diagnosis of nasal aspergillosis in the dog. Inclusions Two figures, 1 table, 22 references.
Diagnostic Imaging Canine Nasal Aspergillosis Background The radiographic and computerized tomography (CT) features of nasal neoplasia, nasal aspergillosis, and nonspecific rhinitis have been described. However, there have been few comparisons published of radiography and CT on the same group of dogs. CT is superior to radiography in identifying unilateral nasal neoplasia versus bilateral involvement and to define tumor extension into adjacent structures before radiation therapy. Objectives To compare radiography and CT for diagnosis of nasal aspergillosis in the dog. Procedure Forty-eight dogs with chronic nasal disease were evaluated by radiography and CT studies. Twenty-five were diagnosed with nasal aspergillosis and results of radiography and CT were compared. Results Based on aspergillosis as the definite diagnosis, CT had a sensitivity of 88% and radiography of 72%. Considering definite and probable aspergillosis as equivalent, CT had a sensitivity of 92% and radiography of 84%. The sensitivity was higher in 20 dogs with lesions affecting the entire nasal cavity and frontal sinus on at least one side (a sensitivity of 100% for CT and 90 to 95% for radiography). In 5 dogs with lesions restricted to the nasal cavities, CT had a sensitivity of 60 to 80% and radiography of 0 to 40%. CT was superior to radiography for evaluation of the nasal cavities, surrounding bone, frontal sinuses, and differentia-
Editor Annotation The debate over whether radiography or CT is a better imaging modality for the diagnosis of nasal disease in dogs continues in the current study. The authors compare the use of plain film radiography and CT in canine nasal aspergillosis and find, once again, that in the 48 dogs evaluated, CT proved itself the more sensitive tool. Statistically, the sensitivity of correct diagnosis improved in both modalities when an entire side or cavity and its associated frontal sinus were affected. However, even in cases with minimal pathology, the changes associated with fungal rhinitis, i.e., mucosal hypertrophy, bony hyperostosis, cavity masses, and punctuate lysis, were best demonstrated with CT. In my experience, CT is always more sensitive for revealing the extent, characteristics, and destructive nature of any intranasal and intrasinus pathology. Survey radiography, if well-made, can show side (right vs. left vs. both), conchal and turbinate detail, obvious external bone lysis, and septal thinning or pitting, but a trained eye is often necessary to visualize some of these lesions. CT leaves nothing to the imagination. Pathology associated with rhinitis, sinusitis, fungal infection, and neoplasia is clearly demonstrated in all of its manifestations. Personally, I don’t rely on survey radiography to make a correct diagnosis of nasal or sinus disease. Perhaps we have been spoiled by the addition of newer and more technical imaging equipment, but with the current cost of CT (as low as it is), how can we afford not to take advantage of its superiority for diagnosing these diseases? (JDS) Saunders JH, van Bree H. Comparison of radiography and computed tomography for the diagnosis of canine nasal aspergillosis. Vet Rad Ultrasound 2003;44:414-419.
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tion between a cavitated process and a mass lesion. Author Conclusion CT is more sensitive than radiography for diagnosis of nasal aspergillosis in the dog. Inclusions Two figures, 1 table, 22 references.
Diagnostic Imaging Canine Nasal Aspergillosis Background The radiographic and computerized tomography (CT) features of nasal neoplasia, nasal aspergillosis, and nonspecific rhinitis have been described. However, there have been few comparisons published of radiography and CT on the same group of dogs. CT is superior to radiography in identifying unilateral nasal neoplasia versus bilateral involvement and to define tumor extension into adjacent structures before radiation therapy. Objectives To compare radiography and CT for diagnosis of nasal aspergillosis in the dog. Procedure Forty-eight dogs with chronic nasal disease were evaluated by radiography and CT studies. Twenty-five were diagnosed with nasal aspergillosis and results of radiography and CT were compared. Results Based on aspergillosis as the definite diagnosis, CT had a sensitivity of 88% and radiography of 72%. Considering definite and probable aspergillosis as equivalent, CT had a sensitivity of 92% and radiography of 84%. The sensitivity was higher in 20 dogs with lesions affecting the entire nasal cavity and frontal sinus on at least one side (a sensitivity of 100% for CT and 90 to 95% for radiography). In 5 dogs with lesions restricted to the nasal cavities, CT had a sensitivity of 60 to 80% and radiography of 0 to 40%. CT was superior to radiography for evaluation of the nasal cavities, surrounding bone, frontal sinuses, and differentia-
Editor Annotation The debate over whether radiography or CT is a better imaging modality for the diagnosis of nasal disease in dogs continues in the current study. The authors compare the use of plain film radiography and CT in canine nasal aspergillosis and find, once again, that in the 48 dogs evaluated, CT proved itself the more sensitive tool. Statistically, the sensitivity of correct diagnosis improved in both modalities when an entire side or cavity and its associated frontal sinus were affected. However, even in cases with minimal pathology, the changes associated with fungal rhinitis, i.e., mucosal hypertrophy, bony hyperostosis, cavity masses, and punctuate lysis, were best demonstrated with CT. In my experience, CT is always more sensitive for revealing the extent, characteristics, and destructive nature of any intranasal and intrasinus pathology. Survey radiography, if well-made, can show side (right vs. left vs. both), conchal and turbinate detail, obvious external bone lysis, and septal thinning or pitting, but a trained eye is often necessary to visualize some of these lesions. CT leaves nothing to the imagination. Pathology associated with rhinitis, sinusitis, fungal infection, and neoplasia is clearly demonstrated in all of its manifestations. Personally, I don’t rely on survey radiography to make a correct diagnosis of nasal or sinus disease. Perhaps we have been spoiled by the addition of newer and more technical imaging equipment, but with the current cost of CT (as low as it is), how can we afford not to take advantage of its superiority for diagnosing these diseases? (JDS) Saunders JH, van Bree H. Comparison of radiography and computed tomography for the diagnosis of canine nasal aspergillosis. Vet Rad Ultrasound 2003;44:414-419.