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Accuracy of radiographic diagnosis of pneumoperitoneum secondary to gastrointestinal perforation in dogs and cats
Author(s) -
Marwood Rachel,
Fleming Kathryn,
Masson Aurore Veronique,
Gilmour Hannah,
Schiborra Frederike,
Maddox Thomas W.
Publication year - 2022
Publication title -
veterinary record
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 99
eISSN - 2042-7670
pISSN - 0042-4900
DOI - 10.1002/vetr.2081
Subject(s) - pneumoperitoneum , medicine , perforation , radiography , peritonitis , gastrointestinal perforation , radiology , cats , significant difference , retrospective cohort study , diagnostic accuracy , surgery , laparoscopy , punching , materials science , metallurgy
Background Radiography is commonly included in the diagnostic investigation of animals with suspected gastrointestinal perforation and resultant pneumoperitoneum. This study aimed to (1) identify the accuracy of radiographic diagnosis of pneumoperitoneum and (2) determine if observer experience affected accuracy. Methods This was a retrospective case‐controlled study evaluating abdominal radiographs of dogs and cats with surgical confirmation of gastrointestinal perforation or peritonitis without pneumoperitoneum. Radiographs were reviewed by a radiologist, an imaging resident, a general practitioner and a veterinary student. Results Radiographs from 60 dogs and eight cats were evaluated; 34 animals had confirmed perforation. Accuracy was fair to excellent for all observers: student 61.8%, general practitioner 70.6%, resident 85.3% and radiologist 83.8%. There was no significant difference in sensitivity between observers (all 70.6%–85.3%); however, there was a significant difference in specificity between both the resident (91.2%) and radiologist (91.2%) compared to the student (52.9%) ( p < 0.001) and the general practitioner (55.9%) ( p = 0.002). Overall, there was slight to substantial agreement between observers ( κ = 0.28–0.73), with the highest being between the radiologist and resident. Conclusion Abdominal radiography, when interpreted by veterinarians with differing experience, has variable accuracy for diagnosis of pneumoperitoneum for animals in this study. Further studies are needed to determine if these results are applicable for other populations of animals with pneumoperitoneum.