臺灣博碩士論文加值系統

犬原發性鼻腔和副鼻竇腫瘤約占所有犬隻腫瘤的1%–2%。在鼻腔的惡性腫瘤中，有60%-75%是上皮癌，其中大部分是腺癌。由於犬鼻腔結構和重疊的骨頭結構很複雜，放射學影像不一定能提供詳細資訊，以判斷鼻腔疾病的可能病因。電腦斷層常用於辨別犬鼻腔腫瘤的擴展範圍和腫瘤的分期。使用電腦斷層對於腫瘤定位、淋巴結的涉及、相鄰受侵犯組織的鑑別和遠端的轉移，至關重要。據我們所知，目前僅有一個病例報告提及犬鼻腔的傳染性花柳性腫瘤的電腦斷層影像。本回顧性研究的目的，是描述一群犬隻被確診為鼻腔腫瘤的電腦斷層影像特徵，並確定是否有特殊的影像發現，以促進協助犬鼻腔傳染性花柳性腫瘤的診斷。我們假設傳染性花柳性腫瘤，可能具有和其他鼻腔腫瘤不同的電腦斷層影像特徵。本研究總共蒐集了19隻狗：6隻為鼻腔傳染性花柳性腫瘤，9隻為鼻腔上皮癌，1隻為鼻腔肉瘤，2隻為鼻腔黑色素瘤以及1隻為鼻腔肥大細胞瘤。我們評估了傳染性花柳性腫瘤和其餘類型腫瘤的定量、定性以及描述性的電腦斷層影像特徵。在傳染性花柳性腫瘤組中，平均衰減值在造影前系列為49.56 HU (± 8.40)，在造影後系列為89.89 HU (± 22.19)。在控制組中，平均衰減值在造影前系列為55.15 HU (± 15.12)，在造影後系列為120.54 HU (± 22.46)。在傳染性花柳性腫瘤和其餘類型的腫瘤之間的平均增強的HU值中，有統計學的顯著差異 (p值= 0.014)，但在骨頭侵犯的嚴重程度和腫瘤類型之間，沒有發現顯著差異 (p值= 0.184)。在鼻腔上皮癌中可注意到條紋狀增強影徵，但鼻腔傳染性花柳性腫瘤沒有顯示這種跡象。綜上所述，鼻腔傳染性花柳性腫瘤的平均增強的HU值低於其餘類型的腫瘤的HU值，而條紋狀增強影徵可能是區分上皮癌和傳染性花柳性腫瘤的特殊結構。

Primary canine nasal and paranasal tumors comprise approximately 1%–2% of all canine neoplasia. Among the malignant nasal neoplasia, 60%–75% are carcinomas, and adenocarcinoma is over-represented. Because of the complexity of the canine nose structure and overlying bony structures, radiography does not always provide detailed information to determine the possible cause of nasal disease. Computed tomography (CT) is commonly used to recognize nasal neoplasia extension and tumor staging in dogs. The use of CT is essential for localization of tumors, involvement of lymph nodes, identification of adjacent affected tissues and distant metastasis. To the best of our knowledge, only one case report mentioned CT imaging of canine nasal transmissible venereal tumor (TVT). The purpose of this retrospective study is to describe CT features of confirmed nasal neoplasia in a group of dogs, and to determine whether there are specific findings to facilitate TVT diagnosis. We hypothesized that TVT may have different CT features from other nasal tumors. A total of 19 dogs were included: 6 with TVT, 9 with carcinoma, 1 with sarcoma, 2 with melanoma and 1 with mast cell tumor. We evaluated the quantitative and qualitative CT imaging features of TVT and other types of tumors. In the TVT group, mean Hounsfield Units (HU) was 49.56 HU (± 8.40) in the pre-contrast series and 89.89 HU (± 22.19) in the post-contrast series. In the non-TVT group, mean HU was 55.15 HU (± 15.12) in the pre-contrast series and 120.54 HU (± 22.46) in the post-contrast series. Statistically significance was found in mean post-contrast HU between TVT and carcinoma (p value = 0.014), but no significant relationship was found between the severity of bone invasion and tumor types (p value = 0.184). Stripe-enhancement pattern was noticed in the carcinoma, whereas TVT did not show this sign. In conclusion, the mean enhanced HU value in nasal TVT is lower than that in other types of tumors, and stripe-enhancement pattern may be a specific structure to distinguish carcinoma from TVT.

中文摘要……………………………………………………………………………….i
Abstract ……………………………...…………………………………….………….ii
Contents ………………………………………………………………………………iv
Table Contents …………………………….…………………………………………vii
Figure Contents ……………………………………………………………………. viii
Chapter 1 Introduction ………………….…………………………………………….1
Chapter 2 Literature Review ………………………………………………………….3
2.1. Transmissible Venereal Tumor ………..…………………………….………3
2.1.1. Pathophysiology ………………….………………………………….3
2.1.2. Etiology ……………………………………………………………...4
2.1.3. Clinical signs ………………………………………………………...5
2.1.4. Diagnosis …………………………………………………………….6
2.1.5. Treatment…. ………………………………………………...……….6
2.1.5.1. Excisional Surgery ………………………………….….……6
2.1.5.2. Radiation Therapy ……………………………………………7
2.1.5.3. Immunotherapy ………………………………………………7
2.1.5.4. Chemotherapy ………….……………………………….……8
2.1.6. Prognosis ……………………………………………………….……9
2.2. Canine Nasal Carcinoma …………...……………………………….………9
2.2.1. Etiology and Risk Factors……………………...…………………….9
2.2.2. Signalments and Clinical Signs ………….…………………………10
2.2.3. Tumor Diagnosis and Staging ……………………………………11
2.2.4. Treatment and Prognosis …………………………………….……13
Chapter 3 Materials and Methods ……………………………………………...……15
3.1. Study Design and Inclusion Criteria ………………………………15
3.2. Computed Tomography Examination …..…………………………………15
3.3. Image Analyses ……………………………………………………………16
3.3.1. Quantitative CT Features…………………………………....…16
3.3.2. Qualitative CT Features ………………………………………….…17
3.3.3. Descriptive CT Features ……………………………………………17
3.4. Statistical Analyses …………………………………………………...……18
Chapter 4 Results ……………………………………………………………………20
4.1. Dogs in the Study ……………………………………………….…………20
4.1.1. TVT Group …………………………………………………………20
4.1.2. Carcinoma Group ……………….……………………….…………20
4.2. Computed Tomographic Finding ………………………………….….……21
4.2.1. Quantitative CT Features ………………………………….………21
4.2.2. Qualitative CT Features ……………………………………….……21
4.2.3. Descriptive CT Features ……………………………………………23
4.3. Prognosis ……………………………….…………………………….……24
Chapter 5 Discussion …………………………………………………………...……40
5.1. The Signalment of Dogs with TVT……………….………………….……40
5.2. Clinical Signs of Nasal TVT and and Other types of Tumors………...…41
5.3. Computed Tomographic Features …………………………………….……42
5.4. Etiology and Risk Factors of Nasal TVT ………………………45
5.5. Medical Treatment and Prognosis …………………………………………46
5.6. The Limitation ……………………………..………………………………48
5.7. Conclusion …………………………………………………………………48
Reference …………………………………………………………………………….49
Appendix .……………………………………………………………………………58

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