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Vodnarek et al: Reliability of fluoroscopic examination of nasopharyngeal dorsoventral dimension change in pugs and French bulldogs
Veterinary Surgery 1, 2024

🔍 Key Findings

  • Study population: 36 brachycephalic dogs (20 French bulldogs, 16 pugs).
  • Objective: Compare intra- and interobserver reliability for fluoroscopic measurement of nasopharyngeal collapse using two methods:
    • Functional method
    • Anatomically adjusted method
  • Key measurements: Minimum (LMin), maximum (LMax) dorsoventral height, and dynamic change ratio (ΔL).
  • Outcomes:
    • Intraobserver agreement for ΔL was higher with the functional method (ICC 0.751 vs. 0.576).
    • Observer 1 (radiologist) showed excellent repeatability (>0.9 ICC).
    • Agreement for grading collapse was only moderate (κ ~0.49–0.53), worse than ΔL-based agreement.
    • ΔL ≥ 0.5 to <1 = partial collapse; ΔL = 1 = complete collapse.

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← Articles

Vodnarek et al: Reliability of fluoroscopic examination of nasopharyngeal dorsoventral dimension change in pugs and French bulldogs
Veterinary Surgery 1, 2024

🔍 Key Findings

  • Study population: 36 brachycephalic dogs (20 French bulldogs, 16 pugs).
  • Objective: Compare intra- and interobserver reliability for fluoroscopic measurement of nasopharyngeal collapse using two methods:
    • Functional method
    • Anatomically adjusted method
  • Key measurements: Minimum (LMin), maximum (LMax) dorsoventral height, and dynamic change ratio (ΔL).
  • Outcomes:
    • Intraobserver agreement for ΔL was higher with the functional method (ICC 0.751 vs. 0.576).
    • Observer 1 (radiologist) showed excellent repeatability (>0.9 ICC).
    • Agreement for grading collapse was only moderate (κ ~0.49–0.53), worse than ΔL-based agreement.
    • ΔL ≥ 0.5 to <1 = partial collapse; ΔL = 1 = complete collapse.

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Multiple Choice Questions on this study

In Vodnarek 2024 et al., on nasopharyngeal fluoroscopy, which method showed the **highest intraobserver agreement** for ΔL?

A. Anatomically adjusted method
B. Visual grading method
C. CT measurement method
D. Functional method
E. None; all were equal

Answer: Functional method

Explanation: The functional method yielded the highest intraobserver ICC (0.751) for ΔL.
In Vodnarek 2024 et al., on intraobserver performance, which observer achieved **excellent reliability** for both methods?

A. Surgery intern (Observer 3)
B. Imaging resident (Observer 4)
C. Radiologist (Observer 1)
D. Surgeon (Observer 2)
E. None achieved excellent reliability

Answer: Radiologist (Observer 1)

Explanation: Observer 1, a diplomate of ECVDI, had ICC > 0.9 for ΔL in both methods.
In Vodnarek 2024 et al., on nasopharyngeal fluoroscopy, what was the **main limitation** of grading using ΔL thresholds?

A. Too slow to use clinically
B. It requires anesthesia
C. It increases interobserver agreement
D. It introduces arbitrary cutoffs
E. Requires contrast medium

Answer: It introduces arbitrary cutoffs

Explanation: Using cutoffs to categorize continuous data increases variability and may misclassify similar clinical states.
In Vodnarek 2024 et al., on method comparison, which statement is true regarding the **anatomically adjusted method**?

A. It showed superior intraobserver agreement for ΔL
B. It eliminated variability in grading
C. It used the epiglottis as a landmark
D. It required contrast to visualize
E. It was significantly faster than the functional method

Answer: It used the epiglottis as a landmark

Explanation: The anatomically adjusted method measured LMin/LMax at the rostral tip of the epiglottis.
In Vodnarek 2024 et al., on nasopharyngeal collapse grading, what ΔL value range defined **partial collapse**?

A. ΔL < 0.25
B. ΔL < 0.5
C. ΔL ≥ 0.5 and < 1
D. ΔL = 1
E. ΔL ≥ 0.25 and < 0.75

Answer: ΔL ≥ 0.5 and < 1

Explanation: Partial collapse was defined as a dynamic change ratio (ΔL) between 0.5 and less than 1.

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