title: Comparison of contrast-enhanced multidetector computed tomography angiography and splenoportography for the evaluation of portosystemic-shunt occlusion after cellophane banding in dogs.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany. Sebast.schaub@gmail.com.
authors.forename: Sebastian
authors.identifier: http://orcid.org/0000-0002-4527-2953
authors.initials: S
authors.lastname: Schaub
authors.affiliation: Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012, Bern, Switzerland.
authors.forename: Antje
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, Midlothian, EH25 9RG, UK.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schwarz
authors.affiliation: Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Kemper
authors.affiliation: Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany.
authors.forename: Kerstin H
authors.initials: KH
authors.lastname: Pueckler
authors.affiliation: Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University Giessen, 35392, Giessen, Germany.
authors.forename: Matthias A
authors.initials: MA
authors.lastname: Schneider
mesh_terms: D000818:Animals; D002476:Cellophane; D000072226:Computed Tomography Angiography / Q000662:veterinary*; D004283:Dog Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D004285:Dogs; D005260:Female; D008297:Male; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011172:Portography / Q000662:veterinary*; D011446:Prospective Studies; D054079:Vascular Malformations / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*
chemical_list: D002476:Cellophane
keywords: Angiography; Computed tomography; Extrahepatic portosystemic shunt; Splenoportography