A novel method for evaluating thoracic radiographs in dogs with pulmonary stenosis.

VMPS-DV type 1 >1.06 and VMPS-LATE >3.60 support pulmonary stenosis diagnosis but cannot assess severity.

This retrospective cohort study evaluated a novel vertebrae-based radiographic measurement method for assessing the main pulmonary artery (MPA) in dogs with pulmonary stenosis (PS). The study enrolled 29 dogs with PS, 30 normal dogs, and 30 dogs with myxomatous mitral valve disease (MMVD). Three measurement indices were developed: VMPS-DV type 1, VMPS-DV type 2 (dorsoventral projections), and VMPS-LATE (right lateral projection). VMPS-DV type 1 and VMPS-LATE were significantly elevated in PS dogs compared to normal dogs (P<0.001), though no significant difference was found between PS and MMVD groups. These findings persisted after excluding French bulldogs, a breed with known anatomical variations. ROC analysis identified optimal diagnostic cutoffs: VMPS-DV type 1 >1.06 and VMPS-LATE >3.60 for distinguishing PS from normal dogs. Importantly, no significant correlation was found between any VMPS index and maximal instantaneous pressure gradient measured via continuous wave Doppler, indicating these radiographic measurements cannot be used to assess PS severity. Key limitations include small sample size limiting statistical power, lack of echocardiographic MPA size comparisons, and inability to differentiate PS from MMVD radiographically. The method offers a practical screening tool when echocardiography is unavailable, but cannot replace echocardiography for definitive diagnosis or severity grading. These vertebral scaling indices may support PS diagnosis in dogs presenting with compatible clinical signs.

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