一种新型成像方法用于胡须龙疑似颈静脉血栓的死前诊断

Agnes Galej, J. Robertson, Y. Hsieh
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引用次数: 0

摘要

1例5岁男性中须龙(Pogona vitticeps),左前肢跛行3天,肌肉张力轻微,肱骨中部远端无痛感。计算机断层扫描(CT)显示左侧肩胛骨和左颈部附近的软组织增厚和减弱,没有异常的对比增强。疑似左颈外静脉在此区域内界限不清且细小,有充盈缺陷,符合静脉血栓的外观。颈部左侧的局部超声检查证实这个位置有血栓,就在颅静脉到颈静脉瓣膜处。患者接受支持性治疗,并开始使用氯吡格雷作为抗血栓治疗。这次访问后临床改善很小,患者在明显下降后5个月再次出现。随访时,超声心动图显示疑似心脏肿块。当时对肿块进行细针抽吸,怀疑是肉瘤,但样本无法诊断。先前确定的血栓不能在超声检查中发现。主人最终决定在家中寻求临终关怀,没有进行额外的成像或进一步的检查。这是爬行动物中首次使用诊断成像描述静脉血栓的报道。鉴于在临床实践中报道的大胡子龙动脉瘤和血栓的发生,本病例展示了诊断这些疾病的重要工具的使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Novel Imaging Modalities for Antemortem Diagnosis of a Suspected Jugular Thrombus in a Bearded Dragon (Pogona vitticeps)
A 5-year-old male central bearded dragon (Pogona vitticeps) presented with a three-day history of left forelimb lameness, minimal muscle tone, and absent pain sensation distal to the mid-humerus. Computed tomography (CT) revealed thickened and hypoattenuating soft tissues adjacent to the left scapulohumeral and left neck regions with no abnormal contrast enhancement. The suspected left external jugular vein in this region was ill-defined and small, with filling defects, consistent with the appearance of a venous thrombus. Focal ultrasound of the left side of the neck confirmed a thrombus in this location, just cranial to a jugular venous valve. The patient was treated with supportive care and started on clopidogrel as an antithrombotic treatment. Clinical improvement was minimal following this visit and the patient presented again five months later after declining significantly. On follow-up imaging at this visit, a suspected cardiac mass was seen on echocardiography. A fine-needle aspirate of the mass at that time was suspicious for a sarcoma, however the sample was non-diagnostic. The previously identified thrombus could not be detected on ultrasonography at this visit. The owner ultimately decided to pursue hospice care at home and no additional imaging or further workup was performed. This is the first report in reptiles describing a venous thrombus using diagnostic imaging. Given the reported occurrence of aneurysms and thrombi in bearded dragons in clinical practice, this case demonstrates the use of an important tool for diagnosis of these conditions.
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