猫慢性鼻窦炎的CT-临床分离现象与局灶性阻塞：一项初步研究

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中文摘要

背景： 猫慢性鼻窦炎（CRS）常见且难以管理，计算机断层扫描（CT）表现与临床严重程度之间的关系仍不明确。方法：这项探索性回顾性初步研究纳入了10只具有至少4周慢性上呼吸道症状、并在单一转诊医院接受鼻腔和鼻旁窦CT检查的猫。新开发的、未经验证的半定量评分分别对CT严重程度（0-12）和临床严重程度（0-12）进行分级，并综合CT、临床和细胞学表现以及（在可获得时）微生物学表现，将猫分为四种暂定的临床影像学模式。结果：CT评分为2至10分（中位数8.0），临床评分为4至11分（中位数6.5），二者之间没有一致的单调关联（Spearman rs = 0.250，95% bootstrap置信区间（CI）-0.558至0.885，p = 0.486）。暂定模式为活动性/渗出性（n = 2）、结构性/重塑型（n = 4）、阻塞性（n = 3）和免疫/黏膜型（n = 1）。局灶性阻塞既定义了阻塞性模式，也定义了概念上的手术候选类别，因此二者的重叠是设计使然；值得注意的是，CT评分最高的猫并不一定存在局灶性阻塞。没有猫接受手术。结论：这些产生假设的发现需要在更大规模的前瞻性研究中采用经过验证的评分加以验证。

英文摘要

Feline chronic rhinosinusitis (CRS) is common and difficult to manage, and the relationship between computed tomography (CT) findings and clinical severity remains unclear. This exploratory retrospective pilot study included 10 cats with chronic upper respiratory signs for at least 4 weeks that underwent CT of the nasal cavity and paranasal sinuses at a single referral hospital. Newly developed, unvalidated semiquantitative scores graded CT severity (0-12) and clinical severity (0-12), and cats were grouped into four provisional clinicoradiologic patterns using integrated CT, clinical, and cytologic findings and, where available, microbiologic findings. CT scores ranged from 2 to 10 (median 8.0) and clinical scores from 4 to 11 (median 6.5), without a consistent monotonic association (Spearman rs = 0.250, 95% bootstrap confidence interval (CI) -0.558 to 0.885, p = 0.486). The provisional patterns were active/exudative (n = 2), structural/remodeling (n = 4), obstructive (n = 3), and immune/mucosal (n = 1). Focal obstruction defined both the obstructive pattern and the conceptual surgical candidacy categories, so their overlap is by design; of interest is that cats with the highest CT scores did not necessarily have focal obstruction. No cat underwent surgery. These hypothesis-generating findings require validation in larger prospective studies with validated scores.