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1.
High-resolution computed tomography (CT) is the preferred noninvasive tool for diagnosing bronchiectasis in people. A criterion for evaluating dilation of the bronchus is the bronchial lumen to pulmonary artery diameter (bronchoarterial ratio [BA ratio]). A ratio of > 1.0 in humans or > 2.0 in dogs has been suggested as a threshold for identifying bronchiectasis. The purpose of this study was to establish the BA ratio in normal cats. Fourteen specific pathogen-free cats were selected for analysis of thoracic CT images. The BA ratios of the lobar bronchi of the left cranial (cranial and caudal parts), right cranial, right middle, left caudal, and right caudal lung lobes were measured. The mean of the mean BA ratio of all lung lobes was 0.71 +/- 0.05. Individual BA ratios ranged from 0.5 to 1.11. Comparing individual lobes for each cat, there was no significant difference (P = 0.145) in mean BA ratio between lung lobes. A mean BA ratio for these normal cats was 0.71 +/- 0.1, which suggests an upper cut-off normal value > 0.91 (mean +/- 2 standard deviations) between normal and abnormal cats.  相似文献   

2.
The bronchoarterial (BA) ratio measured with computed tomography is widely used in human medicine to diagnose bronchial dilation or collapse. Although use of the BA ratio in veterinary medicine has been recently studied, this has not been evaluated in brachycephalic dogs predisposed to bronchial diseases including bronchial collapse. The purpose of this study was to establish BA ratios for brachycephalic dogs and compare the values with those of non-brachycephalic dogs. Twenty-three brachycephalic dogs and 15 non-brachycephalic dogs without clinical pulmonary disease were evaluated. The BA ratio of the lobar bronchi in the left and right cranial as well as the right middle, left, and right caudal lung lobes was measured. No significant difference in mean BA ratio was observed between lung lobes or the individual animals (p = 0.148). The mean BA ratio was 1.08 ± 0.10 (99% CI = 0.98~1.18) for brachycephalic dogs and 1.51 ± 0.05 (99% CI = 1.46~1.56) for the non-brachycephalic group. There was a significant difference between the mean BA ratios of the brachycephalic and non-brachycephalic groups (p = 0.00). Defining the normal limit of the BA ratio for brachycephalic breeds may be helpful for diagnosing bronchial disease in brachycephalic dogs.  相似文献   

3.
Computed tomography is increasingly being used in veterinary medicine to evaluate animals with pulmonary signs such as coughing, tachypnea, and exercise intolerance, however, a quantitative measure of bronchial wall thickening has yet to be validated in veterinary medicine. Canine chronic bronchitis is a disease that is characterized histologically by thickening of the bronchial walls. Thoracic CT images of 16 dogs with chronic bronchitis and 72 dogs presenting for conditions unrelated to cough were evaluated. A ratio comparing the bronchial wall thickness to the adjacent pulmonary artery diameter was obtained in the right and left cranial and caudal lung lobes. There was no significant difference in dogs with chronic bronchitis or unaffected dogs between the left and right hemithorax, patient weight, patient age, image slice thickness, or CT machine used. Dogs with chronic bronchitis were found to have a significantly greater ratio than unaffected dogs (P < 0.001). The ratios in the cranial lung lobes were found to be significantly greater than the caudal lung lobes in both chronic bronchitis and unaffected dogs (P < 0.001). A receiver operating characteristic curve of the ratios in the cranial lung lobes had an area under the curve of 0.912, indicating high accuracy in predicting for bronchial wall thickening. A ratio of ≥0.6 in the cranial lung lobes was found to have a sensitivity of 77% and specificity of 100% in predicting for the presence of chronic bronchitis, and we propose using this cut‐off as supportive of bronchial wall thickening on CT.  相似文献   

4.
The purpose of this study was to describe the anatomy of the lungs of wild boars for comparison with those of domestic swine. It was found that the right lung of the wild boar is divided into four lobes: cranial, median, caudal and accessory, whereas the left lung is divided into two lobes: cranial and caudal. In 93.4% of the cases, right pulmonary artery separates into the ascendant, descendant, median, accessory and caudal branches. In 73.3% of the cases, left pulmonary artery separates most frequently to form three branches to the cranial lobe, whereas the median lobe is generally supplied by only one arterial branch. There is a single pattern of bronchial distribution: in the right lung a tracheal bronchus leads to the cranial lobe, where it separates into the cranial and caudal bronchi and there are also bronchi to the median, caudal and accessory lobes. In the left lung, the large bronchus separates to form two branches, one of which further separates to form two branches to the cranial lobe whereas the other forms a single branch to the caudal lobe.  相似文献   

5.
Bronchiectasis is an irreversible dilatation of the bronchi resulting from chronic airway inflammation. In people, computed tomography (CT) has been described as the noninvasive gold standard for diagnosing bronchiectasis. In dogs, normal CT bronchoarterial ratios have been described as <2.0. The purpose of this retrospective study was to describe quantitative and qualitative CT characteristics of bronchiectasis in a cohort of dogs with confirmed disease. Inclusion criteria for the study were thoracic radiography, thoracic CT, and a diagnosis of bronchiectasis based on bronchoscopy and/or histopathology. For each included dog, a single observer measured CT bronchoarterial ratios at 6 lobar locations. Qualitative thoracic radiography and CT characteristics were recorded by consensus opinion of two board‐certified veterinary radiologists. Twelve dogs met inclusion criteria. The mean bronchoarterial ratio from 28 bronchiectatic lung lobes was 2.71 ± 0.80 (range 1.4 to 4.33), and 23/28 measurements were >2.0. Averaged bronchoarterial ratios from bronchiectatic lung lobes were significantly larger (P < 0.01) than averaged ratios from nonbronchiectatic lung lobes. Qualitative CT characteristics of bronchiectasis included lack of peripheral airway tapering (12/12), lobar consolidation (11/12), bronchial wall thickening (7/12), and bronchial lumen occlusion (4/12). Radiographs detected lack of airway tapering in 7/12 dogs. In conclusion, the most common CT characteristics of bronchiectasis were dilatation, a lack of peripheral airway tapering, and lobar consolidation. Lack of peripheral airway tapering was not visible in thoracic radiographs for some dogs. For some affected dogs, bronchoarterial ratios were less than published normal values.  相似文献   

6.
Bronchomalacia and bronchial collapse are important causes of chronic coughing in dogs. The current reference standard diagnostic tests for these problems are flexible bronchoscopy and biopsy. Previous human studies have also supported inspiration/expiration computed tomography (CT) as a diagnostic test. The current prospective, pilot study aimed to determine whether inspiration/expiration CT is also a feasible test for quantifying bronchial collapsibility in dogs. Thoracic CT images were acquired using a 64‐row multidetector CT for 10 healthy Beagle dogs during maximal inspiration and expiration. For each scan, one observer measured transverse sectional areas of the mainstem and lobar bronchi, and the dorsal and ventral segmental bronchi of the left cranial lobar bronchus. Diameters for each bronchus were also measured in transverse, sagittal, and dorsal planes. Bronchial collapsibility (%) was calculated as the difference between inspiration/expiration transverse sectional areas divided by the inspiration transverse sectional areas. Mean bronchial collapsibility of all bronchi was 38.20 ± 15.17%. A collapsibility of over 50% was found in the dorsal (n = 7) and ventral (n = 4) segmental bronchi of the left cranial lobar bronchus, and the left caudal (n = 5) and right middle (n = 2) lobar bronchus. Bronchial collapsibility measurements were greater in the dorsal and ventral segmental bronchi of the left cranial lobar bronchus and the left caudal lobar bronchus (P < 0.001). Findings supported inspiration/expiration CT as a modality to noninvasively assess bronchial collapse in dogs and a bronchial collapsibility value greater than 50% for detecting pathologic bronchial collapse in clinically affected dogs.  相似文献   

7.
The imaging features of lung lobe torsion in 10 dogs (nine complete, one partial torsion) acquired with a helical single‐slice computed tomography (CT) unit are described. Attenuation values of normal, rotated, and adjacent collapsed lung lobes before and after intravenous contrast medium administration were compared. Affected lung lobes were: left cranial (5), right middle (3), right cranial (1), and left caudal (1). CT findings in nine dogs with complete lung lobe torsion included pleural effusion and an abruptly ending bronchus. In eight of these dogs, enlargement, consolidation, emphysema of the affected lung lobe, and mediastinal shift to the contralateral side were present. Rotated lung lobes did not enhance, whereas adjacent collapsed and aerated lung lobes did (P<0.05). Apnea induced with hyperventilation or breath‐hold is essential to reduce motion artefacts and obtain a diagnostic study.  相似文献   

8.
In dogs, a mean broncho‐arterial ratio of 1.45 ± 0.21 has been previously defined as normal. These values were obtained in dogs under general inhalational anesthesia using a single breath‐hold technique. The purpose of the study was to determine whether ventilation technique and bronchial diameter have an effect on broncho‐arterial ratios. Four healthy Beagle dogs were scanned twice, each time with positive‐pressure inspiration and end expiration. For each ventilation technique, broncho‐arterial ratios were grouped into those obtained from small or large bronchi using the median diameter of the bronchi as the cutoff value. Mean broncho‐arterial ratios obtained using positive‐pressure inspiration (1.24 ± 0.23) were statistically greater than those obtained at end expiration (1.11 ± 0.20) P = 0.005. There was a strong positive correlation between bronchial diameter and broncho‐arterial ratios for both ventilation techniques (positive‐pressure inspiration rs = .786, P < 0.0005 and end expiration rs = .709, P < 0.0005). Mean broncho‐arterial ratio for the large bronchi obtained applying positive‐pressure inspiration was 1.39 cm ± 0.20 and during end expiration was 1.22 cm ± 0.20. Mean broncho‐arterial ratio for the small bronchi obtained during positive‐pressure inspiration was 1.08 cm ± 0.13 and during end expiration was 1.01 cm ± 0.13. There was a statistically significant difference between these groups (F = 248.60, P = 0.005). Findings indicated that reference values obtained using positive‐pressure inspiration or from the larger bronchi may not be applicable to dogs scanned during end expiration or to the smaller bronchi.  相似文献   

9.
Endoscopic evaluation of bronchial morphology in rabbits   总被引：1，自引：0，他引：1  
OBJECTIVE: To evaluate bronchial morphology endoscopically in rabbits and develop a valid nomenclature for the endobronchial branching pattern. ANIMALS: 10 mature New Zealand White rabbits. PROCEDURES: Flexible bronchoscopy was performed in rabbits anesthetized with isoflurane via nasal mask. Airways were systematically evaluated from the larynx to the terminal branches accessible with a 2.5-mm-outer diameter flexible endoscope. Airway branching patterns were identified and assessed for variation among subjects. RESULTS: Airways of all rabbits were readily examined with the 2.5-mm flexible endoscope. Laryngeal structure and function were normal in each rabbit, and airway branching patterns in all rabbits evaluated were identical. At the carina, branching into left and right principal bronchi was evident. The left principal bronchus divided immediately into the left cranial and left caudal lobar bronchi. The left cranial lobe bronchus further divided into dorsal and ventral segmental bronchi. The left caudal lobe bronchus gave rise to branches originating dorsally, ventrally, and medially before continuing caudally. The right principal bronchus divided into the right cranial, right middle, and accessory lobar bronchi and continued distally as the right caudal lobar bronchus. The right cranial lobe bronchus also divided into dorsal and ventral segmental bronchi, and the right caudal lobe bronchus had branches that originated dorsally, ventrally, and medially. CONCLUSIONS AND CLINICAL RELEVANCE: Definition of a standard nomenclature for airway branching in rabbits will allow precise localization of disease in clinical cases and accurate collection of airway samples in clinical and scientific evaluations.  相似文献   

10.
Tracheobronchomalacia has been diagnosed using radiography or bronchoscopy to confirm bronchial changes in luminal diameter during the respiratory cycle. However, studies in healthy humans suggest that some degree of bronchial collapse may be observed during the normal respiratory cycle. In this analytical study, the luminal diameter of the bronchus to each of the six pulmonary lobes and the mean percentage of expiratory collapse from end inspiratory, end expiratory, and two forced expiratory phases (10 and 15 ml/kg) were determined via computed tomography (CT) and radiography in 22 healthy Beagle dogs. The bronchial collapsibility was significantly greater during the forced expiration than the end expiration (P < 0.001); the same results were observed in dorsal and sagittal CT images and radiographs (P < 0.001). Median collapsibility values associated with 15 ml/kg forced expiratory collapse determined via cross‐sectional CT images were measured as 16.6–45.5% and differed according to the pulmonary lobe. Median collapsibilities on radiography with 15 ml/kg forced expiration were 57.8% and 62.1% in the right cranial lobe and right caudal lobe, respectively. In conclusion, bronchial diameter may change during the respiratory cycle, and some degree of reduction in bronchial diameter may be an incidental finding in healthy dogs. More rigorous criteria are needed with regards to bronchial collapsibility during normal respiration for the diagnosis of bronchomalacia in order to avoid false‐positive diagnoses.  相似文献   

11.
This study was performed to radiographically examine the prevalence of aspiration sites and to evaluate their atomical correlation with the bronchial pattens. Ten healthy beagle dogs were repeatedly radiographed, at weekly intervals, in the left and right lateral, ventrodorsal (VD) and dorsoventral (DV) positions. Three mililiters of iohexol distilled with same volume of saline was infused into the tracheal inlet. Which lung lobe was aspirated was decided upon by the presence of a significant alveolar pattern due to the contrast medium. Alveolar patterns were identified at the left (100%) and right cranial lung lobes (77%) with the dogs in dependant lateral recumbency, at the right caudal lung lobe (71%) with the dogs in VD recumbency and at the right middle lung lobe (59%) with the dogs in DV recumbency, respectively. The anatomical correlation was evaluated by performing computed tomography. The right principal bronchus (165.8 ± 1.6°) was more straightly bifurcated than was the left principal bronchus (142.7 ± 1.8°, p < 0.01). In VD position, the right side lung had a greater opertunity to become aspirated. The ventrally positioned right middle lobar bronchial origin was more easily to be aspirated the other laterally positioned ones. We think that these anatomical characteristics can be one of the causes for aspiration pneumonia to occur more frequently in the right side lung.  相似文献   

12.
Canine primary lung tumors typically appear radiographically as a well‐circumscribed solitary mass in the periphery of a caudal lung lobe. Consolidated and diffuse forms of primary lung tumors have also been described. Nineteen dogs with computed tomographic (CT) images of the thorax and a histological diagnosis of primary lung tumor (17 primary carcinomas and two primary sarcomas) were evaluated retrospectively to characterize the CT findings. All primary lung tumors were bronchocentric in origin with internal air bronchograms. The bronchi were typically narrowed, displaced, and often obstructed by the tumor. Eighteen of 19 (95%) of the tumors were solitary and there was one pneumonic/alveolar form. Most solitary tumors were well circumscribed (17/18), located in the central to periphery of the lung (14/18), and in a cranial or caudal lobe (16/19). Most primary lung tumors (11/17) had mild to moderate heterogeneous contrast enhancement. Five of 19 dogs (26%) had evidence of pulmonary metastasis. Internal mineralization (3/19) and tracheobronchial lymphadenopathy (4/19) were also identified. On CT examination, solitary, well circumscribed, bronchocentric masses with internal air bronchograms are consistent with a primary pulmonary tumor in dogs.  相似文献   

13.
Thoracic conformation, age, amount of body fat, and stage of respiration and cardiac contraction affect the cardiac silhouette. Deep-chested dogs have an upright, narrow cardiac silhouette about 2 1/2 intercostal spaces wide, while barrel-chested dogs have a round, wide silhouette about 3 1/2 intercostal spaces wide. On LAT films the vessels to a lung lobe should be of equal size and 0.25-1.2 times the diameter of the upper third of the 4th rib at the 4th intercostal space. On DV projections, vessels to the caudal lung lobe should be no larger than the diameter of the 9th rib. Signs of right ventricular enlargement include loss of the cranial waist, increased width of the cardiac silhouette, increased sternal contact of the heart, and an elevated cardiac apex. Signs of left ventricular enlargement include an elevated carina, loss of the caudal waist, and a more perpendicular caudal cardiac border. Signs of left atrial enlargement include separation of mainstem bronchi, compression of the bronchus to the left caudal lung lobe, and an increased distance from the carina to the dorsal border of the caudal vena cava. Enlargement of the aorta and main pulmonary artery segment on a LAT view appears as a soft tissue density obscuring the cranial waist. Pulmonary vascular fields are usually hypervascular in patent ductus arteriosus and interventricular septal defects, normal in uncomplicated aortic or pulmonic stenosis, and hypovascular in tetralogy of Fallot.  相似文献   

14.
Selected structures seen on right and left lateral thoracic radiographs of 12 dogs were evaluated for differences in position, size, and shape. The size and position of the cardiac silhouette were different when thoracic radiographs made in left and right lateral recumbency were compared. These changes were, however, considered insignificant. The position of the right cranial lobe bronchus relative to the left varied in right lateral recumbency and left lateral recumbency. The right cranial lung lobe was better aerated when dogs were positioned in left lateral recumbency.
Lesions seen in the caudal portion of the left cranial lung lobe or the right middle lobe were masked when the affected lobe was dependent, and enhanced when the affected lung lobe was non-dependent. It is believed that this difference occurred due to compression of the dependent lung with greater aeration of the non-dependent lung.  相似文献   

15.
Primary pulmonary neoplasia is relatively uncommon in cats and generally has a poor prognosis. In this multicenter, retrospective study of 57 cats with pulmonary neoplasia, the most frequent presenting signs were anorexia/inappetence (39%) and cough (37%). The pulmonary tumors were considered to be incidental findings in 9% cats. In computed tomographic (CT) images, primary pulmonary tumors appeared as a pulmonary mass in 55 (96%) cats and as a disseminated pulmonary lesion without a defined mass in two (4%) cats. Most pulmonary tumors were in the caudal lobes, with 28 (49%) in the right caudal lobe and 17 (30%) in the left caudal lobe. CT features associated with pulmonary tumors included mass in contact with visceral pleura (96%), irregular margins (83%), well‐defined borders (79%), bronchial compression (74%), gas‐containing cavities (63%), foci of mineral attenuation (56%), and bronchial invasion (19%). The mean (range) maximal dimension of the pulmonary masses was 3.5 cm (1.1–11.5 cm). Additional foci of pulmonary disease compatible with metastasis were observed in 53% cats. Pleural fluid was evident in 30% cats and pulmonary thrombosis in 12% cats. The histologic diagnoses were 47 (82%) adenocarcinomas, six (11%) tumors of bronchial origin, three (5%) adenosquamous cell carcinomas, and one (2%) squamous cell carcinoma. In this series, adenocarcinoma was the predominant tumor type, but shared many features with less common tumor types. No associations were identified between tumor type and CT features. Prevalence of suspected intrapulmonary metastasis was higher than in previous radiographic studies of cats with lung tumors.  相似文献   

16.
A 10‐year‐old female spayed Dachshund was referred with progressive coughing for 1 month. The dog was tentatively diagnosed with right middle lung torsion based on pleural effusion, vesicular emphysema, abruptly ending bronchus in consolidated right middle lung, and no contrast enhancement of the affected lobe on radiography and computed tomography (CT). There was no evidence of torsion upon thoracotomy, and histological examination confirmed lobar pneumonia. The CT images were reevaluated using minimum intensity projection and revealed normal bronchial courses. The minimum intensity projection technique can be to assist in evaluation of the bronchial tree for dogs with suspected lung lobe torsion and other pulmonary diseases.  相似文献   

17.
The purpose of this study was to determine the frequency of hypoxemia and pulmonary mineralization using 99mTc-methylene diphosphonate (99mTc-MDP) in dogs with pituitary-dependent hyperadrenocorticism (PDH). Twenty-one dogs with PDH were pro-spectively evaluated using thoracic radiography, arterial blood gas analysis, and bone phase and pulmonary perfusion scintigraphy (using 99mTc-macro-aggregated albumin [99mTc-MAA]). The radiographs and bone and perfusion studies were evaluated subjectively. An averaged quantitative count density ratio was calculated between the thorax and cranial thoraco-lumbar vertebrae from lateral thoracic 99mTc-MDP images. Thoracic: vertebral ratios were calculated using 99mTc-MDP studies from 21 control dogs. The thoracic: vertebral ratios were compared between the 2 groups (PDH and control). The mean age (±SD) of the 21 PDH dogs was 10.2 (±3) years, whereas the mean age of the control group was 9.8 (±3) years. Seven of the 21 dogs with PDH were hypoxemic (denned as an arterial partial pressure of oxygen [PaO2] <80 mm Hg) with an average PaO2 (±SD) of 62 (±15) mm Hg. Of the 7 hypoxemic dogs, 2 were found to have pulmonary mineralization based on bone scintigraphic images. Pulmonary perfusion abnormalities were not identified using 99mTc-MAA in any of the 21 PDH dogs. Six PDH dogs had an abnormal interstitial pulmonary pattern and 5 of these dogs were hypoxemic. The average quantitative thoracic: vertebral ratio was not significantly different between the PDH and control dogs (0.5 ± 0.4 versus 0.4 ± 0.1, P = .16). Causes of hypoxemia other than pulmonary thromboembolism should be considered in dogs with PDH. Pulmonary mineralization may contribute to hypoxemia in dogs with PDH.  相似文献   

18.
OBJECTIVE: To evaluate use of computed tomography (CT) of the lungs, compared with conventional radiography, for detection of blebs and bullae associated with spontaneous pneumothorax in dogs. DESIGN: Retrospective case series. ANIMALS: 12 dogs with spontaneous pneumothorax. PROCEDURE: Medical records were reviewed, and information was collected that included signalment, body weight, initial owner complaint, laboratory findings, radiographic findings, CT findings, medical and surgical treatment, histologic findings, complications, duration of hospitalization, and final outcome. RESULTS: Radiographs were excellent for identifying pneumothorax (sensitivity, 100%) but poor for identifying the underlying cause (bullae or blebs); these were identified in radiographs of only 2 of 12 dogs. Computed tomography allowed identification of bullae or blebs in 9 of 12 dogs. Ten of the 12 dogs were treated via surgery, and 17 affected lung lobes were identified. Four of the 17 affected lobes were identified via radiography. Thirteen of the 17 affected lobes were identified via CT; however, 1 lobe was incorrectly identified as the right caudal lobe instead of the right cranial lobe. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that CT is better than radiography for identifying the underlying causes of spontaneous pneumothorax.  相似文献   

19.
This study was done to investigate the validity of published canine thyroid/salivary (TS) rations of approximately i in normal dogs and to detemine thyroid uptak of 99mTc-pertechnetate (pertechnetate) measured as percent uptake of injected dose. These parameters were evaluated in 13 Beagle dogs over a 4 hour period. Mean ± standard deviation (SD) and median T/S ratios of 1.2 ± 0.3 and 1.1 were essentially the same at twenty minutes and 1 hour. T/S Values ranged from 0.9 to 2.2 at 20minutes and from 0.8 to 2.4 at 1 hour. T/S ratio values progressively declined over the subsequent time intervals with mean ± SD and median values of 0.6 ± 0.2 and 0.6, respectively, measured at 4 hour. The mean with a rang of 0.28% to 0.90%. The mean ± SD time interval from injection of pertechanetate to maximum uptake within the thyroid gland was 160 ± 55 minutes with a range 31–240 minutes. The data derived from this study of normal dogs may be useful in the evaluation of dogs with thyroidal diseases including hypthyroidism  相似文献   

20.
Canine pulmonary eosinophilic granulomatosis is a rare inflammatory pulmonary disease characterized by formation of eosinophilic granulomas that tend to obliterate the normal pulmonary architecture. The purpose of this retrospective study was to describe the CT characteristics of confirmed idiopathic pulmonary eosinophilic granulomatosis in a group of dogs. Five dogs met inclusion criteria. All patients were young adult dogs of variable breeds. No dog had concurrent occult heartworm disease. Computed tomographic characteristics most commonly included pulmonary masses and nodules of variable size, and lesions were most commonly located in the caudal lung lobes. Four dogs had large pulmonary masses with or without additional nodules and one dog had nodular lesions disseminated throughout the entire lung parenchyma. All large eosinophilic granulomas were smoothly margined, heterogeneous pulmonary masses displaying heterogeneous contrast enhancement. A honeycomb‐like enhancement pattern was observed in all but one mass and consisted of multiple hyperattenuating rims delineating central hypoattenuating areas, suggestive of bronchiectatic lung with peripheral enhancing airway walls and fluid‐filled, necrotic bronchial lumen. One dog had evidence of tracheobronchial lymphadenopathy. Findings indicated that canine eosinophilic pulmonary granulomatosis should be included as a differential diagnosis for dogs with CT characteristics of multiple pulmonary masses and/or nodules in caudal lung lobes, and a honeycomb‐like enhancement pattern in masses after intravenous administration of iodinated contrast medium.  相似文献   

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