{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T13:10:25Z","timestamp":1756818625206,"version":"3.44.0"},"reference-count":25,"publisher":"American Veterinary Medical Association (AVMA)","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec id=\"sc_a1\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To evaluate the agreement between radiographic and tracheobronchoscopic assessments of grade IV tracheal collapse (TC) in dogs and characterize the prevalence of the radiographic axial-rotation pattern.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a2\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective study included dogs diagnosed with grade IV TC via tracheobronchoscopy from 2021 through 2024. Inspiratory and expiratory right-lateral thoracic radiographs and tracheobronchoscopy images were reviewed. Collapse at 4 sites (midcervical, thoracic inlet, midthoracic, and carina) was categorized as mild (\u2264 50%) or severe (&gt; 50%). The most severe radiographic observation per site, the dominant radiographic finding, was compared with tracheobronchoscopic grade by weighted \u03ba statistics and percentages of agreement.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a3\">\n<jats:title>Results<\/jats:title>\n<jats:p>78 dogs had inspiratory radiographs, and 68 also had expiratory radiographs. Radiography identified severe collapse in 68 of 78 dogs (87.2%) at the thoracic inlet but less frequently at midcervical (38 of 78 [48.7%]), midthoracic (9 of 78 [11.5%]), and carinal sites (9 of 78 [11.5%]). Agreement was fair for the midthoracic trachea (weighted \u03ba = 0.24) and slight to poor elsewhere. The percentage of agreement for severe versus nonsevere collapse was 87.2% (68 of 78) at the thoracic inlet, followed by midthoracic (76.9% [60 of 78]), carina (66.7% [52 of 78]), and midcervical (47.4% [37 of 78]) sites. Mild or no radiographic collapse was observed in 11 of 78 cases (14.1%) despite grade IV collapse on tracheobronchoscopy. Radiographic pattern, known as TC with axial-rotation (Rad-AR) confined to the thoracic inlet was present in 17 of 78 cases (21.8%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a4\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Thoracic radiographs often underestimate the grade IV TC and cannot exclude disease when collapse is not visible.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sc_a5\">\n<jats:title>Clinical Relevance<\/jats:title>\n<jats:p>Radiography is a useful screening tool for localizing severe TC when collapse is evident, but tracheobronchoscopy remains essential for definitive staging and therapeutic planning.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.25.04.0150","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T09:00:12Z","timestamp":1749027612000},"source":"Crossref","is-referenced-by-count":0,"title":["Radiography underestimates the severity of tracheobronchoscopy-confirmed grade IV tracheal collapse in dogs"],"prefix":"10.2460","volume":"86","author":[{"given":"Masahiro","family":"Suematsu","sequence":"first","affiliation":[{"name":"AMC Suematsu Animal Hospital, Hita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline V.","family":"Fulkerson","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reo","family":"Nishi","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"6","key":"B1","series-title":"Vet Clin North Am Small Anim Pract","first-page":"1253","article-title":"Tracheal collapse: diagnosis and medical and surgical treatment","volume":"30","author":"Johnson L","year":"2000","unstructured":"Johnson L. 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