EVDI2016 BOOK.indd - evdi 2016 wroclaw poland

Transcription

1
MAIN SPONSOR
GOLDEN SPONSOR
SILVER SPONSOR
RESIDENT SPONSORSHIP
2
BRONZE SPONSOR
BRONZE SPONSOR
HONORARY PATRONAGE
MEDIA PATRONAGE
3
TABLE OF CONTENT
ECVDI and EAVDI welocme letter
6
Local Organizing Committee welome letter
7
TUESDAY / 30.08.2016 detailed programme
8
WEDNESDAY / 31.08.2016 detailed programme
9
SESSION I
11
SESSION II
19
THURSDAY / 01.09.2016 detailed programme
27
SESSION III
31
SESSION IV
37
SESSION V
43
FRIDAY / 02.09.2016 detailed programme
76
SESSION VI
78
SESSION VII
84
SESSION VIII
90
SATURDAY / 03.09.2016 detailed programme
98
SESSION IX
100
SESSION X
107
SESSION XI
114
SESSION XII
121
SUNDAY / 04.09.2016 detailed programme
126
Please see the back inside cover for a map with all conference locations.
4
AtAISweprideourselvesonfocusingonpatientcareasournumberone
goal.Accomplishingthatobviouslyrequiresprovidingqualityradiographic
interpretation.Wewouldliketothinkourcollaborativeenvironmentthat
providesourstaffradiologistsinstantaccesstoother’sopinions,resultsin
thehighestreportaccuracyandrelevancetothepatient.Inadditionto
reportquality,inatelemedicineenvironment,anotherequallyimportant
requirementisprovidingourradiologistswithapredictableandconsistent
caseloadthatistailoredtotheircomfortlevel.Tomeetthatgoal,wehave
developed,andarecontinuingtoperfect,accuratepredictionalgorithmsto
anticipatecaseloadeachhourofthedaytakingintoaccountthehistorical
effectsofsuchthingsasholidays,andmajorsportingevents.Webelieve
wehavecreatedthebestworkenvironmentfortele-radiologists,andthat
itseparatesusfromthecompetition.
WehavecomeupwitharecruitingprogramfortheEVDImeetingthat
allowsindividualstoseehowtheymightlikedoingthis,withoutafull
commitment.Thisofferinvolvessettingascheduleoftheindividual’s
choosingfrom4to8hourseachweek.Duringthattimecaseswillbe
meteredatonecaseperhour.Ifatanytimeduringtheshifttheindividual
wouldliketodomorecases,thereisanextracasebutton(forextra
compensation),whichwilladdanothertotheirbench.Forindividuals
decidingtogivethisatry,thetrialcanremainineffectforupto90days.If
atanytimetheindividualdecidesteleradiologyisnotforthem,theymay
leaveatanytimewithoutpenalty.
Ifyouareinterested,pleasecontact
Dr.WilliamHornof
[email protected]
(530)220-2437
-or-
Dr.JohnMattoon
[email protected]
(509)592-7060
5
5
Dear Collegues,
What a pleasure to be in Wroclav, Poland, a town with a great history.
The local organization committee has worked very hard to make this
event, the EVDI Annual scientific meeting 2016, an unforgettable moment.
Looking through the program – be it the scientific, but also the social program
– we will be able to not only share state of the art knowledge and
great experience but also friendship. The latter is probably as important
as the professional exchange during these meetings. Something we have
experienced over all the years I’m actively participating.
Our college and our association has a great history of such meetings,
during which this spirit of being not only professional colleagues has been
transferred to the young and new members of this community. We are
sure, that also this meeting here in Wroclav provides the grounds for the
continuation of this opportunity to catch up with all our friends from all
over the world.
We hope you enjoy your stay here in Wroclaw
6
Pat Kircher
Carolina Monteiro
President ECVDI
President EAVDI
Dear Friends,
Here we meet again, to learn and to share the knowledge, to meet old friends
and to make new connections. This year, for the first time in the history of the
EVDI Congresses we meet in Wrocław, Poland. A historical city shaped by
many nations, cultures and religions that have encountered at this European
crossroad, once called the holy blossom of Europe, a beautiful gem among
cities, the European Capital of Culture, the city ruled by dwarfs!
During months of preparations we did our best to let you enjoy and learn its
atmosphere, its culture and its history. We would like to give you a warm
welcome at EVDI 2016 Meeting!
Sincerely yours
Local Organizing Committee
Jan Lorenc
Ewa Stańczyk
Wojciech Kinda
Justyna Ostrowska
Wojciech Atamaniuk
7
TUESDAY / 30.08.2016
13:00 - 15:30
13.00 - 14.00
Stefanie Veraa: DI of the equine head
14.00 - 15.00
Erik Wisner: What radiographs can tell us about cardiac disease
15.00 - 15.30
Ann Carstens: How can I survive the exam?
Hotel Monopol - Room A
14:00 - 18:30
ECVDI BOARD MEETING
15:30 - 16:00
RESIDENTS’ LUNCH BREAK
Hotel Monopol
16:00 - 17:30
RESIDENT COURSE
Hotel Monopol
16:00 - 17:00
17.00 - 17.30
8
Hotel Monopol - Room C
RESIDENT COURSE
Tod Drost: Abdominal radiographs, still useful?
Bill Hornof: Teleradiology: what does that mean for you?
Hotel Monopol
18:00 - 18:30
RESIDENTS’ START DRINK
18:30 - 20:30
ECVDI BOARD DINNER
Hotel Monopol - Acquario restaurant
19:00 - 21:30
RESIDENTS’ DINNER
Dinette Bistro vis a vis Hotel Monopol
WEDNESDAY / 31.08.2016
08:30-12:00
RESIDENTS’ FILMREADING
08:30 - 09:30
3-4 groups for KCC
09:30 - 09:45
room change
09:45 - 10:45
3-4 groups for KCC
10:45 - 11:00
room change
11:00 - 12:00
3-4 groups for KCC
Hotel Monopol
Opera House - Conference Bureau
09:00 - 12:00
ECVDI BOARD MEETING
12:00 - 12:30
ECVDI BOARD’S AND RESIDENTS’ LUNCH
12:30 - 13:00
OFFICIAL OPENING OF THE EVDI 2016 CONFERENCE
Opera House - Main Stage
13:00 - 15:15
SESSION I, Chairperson: SUSANNE BOROFFKA
Hotel Monopol
13:00 - 13:45
Keynote Lecture
Marek Sasiadek: UPDATE ON IMAGING OF DEMYELINATING DISEASES IN HUMANS
13:45 - 13:57
H. Gaillot: CHARACTERIZATION OF SPLENOSYSTEMIC SHUNTS IN CATS:
A RETROSPECTIVE STUDY OF 49 CASES (2011-2015)
13:57 - 14:09
H. Hahn: ULTRASONOGRAPHIC, ENDOSCOPIC AND HISTOLOGIC APPEARANCES OF
THE CAECUM IN CATS PRESENTED WITH CLINICAL SIGNS OF CAECOCOLIC DISEASE
14:09 - 14:21
M. Bertal: ASSOCIATION BETWEEN ULTRASONOGRAPHIC APPEARANCE OF SPLENIC
PARENCHYMA AND CYTOLOGY IN THE CAT
14:21 - 14:33
M. Martinez: RELATIONSHIP BETWEEN ULTRASONOGRAPHIC AND HISTOPATHOLOGICAL
MEASUREMENTS OF THICKNESS OF INTESTINAL WALL LAYERS IN CAT CADAVERS
14:33 - 14:45
T. Schwarz: PREVALENCE OF RETROCAVAL URETERS IN DOGS AND CATS AND THEIR
ASSOCIATION WITH OBSTRUCTIVE URETEROLITHIASIS
14:45 - 14:57
W. M. du Plessis: STUDENT PERSPECTIVE OF CLASSROOM RESPONSE SYSTEMS USED
INDIVIDUALLY AND AFTER PEER DISCUSSION IN DIAGNOSTIC IMAGING
14:57 - 15:09
M. O. Cathasaigh: DURATION OF ACTION OF FEMORAL AND SCIATIC ULTRASOUND-GUIDED
NERVE BLOCKS USING BUPIVICAINE IN DOGS
9
WEDNESDAY / 31.08.2016
15:15 - 16:15
LUNCH
16:15 - 18:30
SESSION II, Chairperson: STEFANIE VERAA
16:15 - 17:00
Keynote Lecture
Susanne Boroffka: VETERINARY DIAGNOSTIC IMAGING EDUCATION: quo vadis?
17:00 - 17:12
M. Francois: ASSOCIATION BETWEEN VERTEBRAL HEART SCORE MEASUREMENT AND
OVERWEIGHT CONDITION IN DOGS
17:12 - 17:24
P. Pey: RADIOGRAPHIC AND HIGH RESOLUTION COMPUTED TOMOGRAPHIC APPEARANCES
OF BRONCHIOLAR PLUGGING IN CATS: THE “TREE-IN-BUD” PATTERN
17:24 - 17:36
H. G. Heng: RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC APPEARANCE OF ATYPICAL
TRACHEAL COLLAPSE IN FOUR DOGS
17:36-17:48
E.A. Hassan: TWO-DIMENSIONAL CARDIOTHORACIC RATIO FOR EVALUATION OF CARDIAC SIZE
IN CATS
17:48 - 18:00
E. Febo: ISINGLE AND MIXED FELINE LUNGWORM INFESTATION: CLINICAL, RADIOGRAPHIC AND
TOMOGRAPHIC FEATURES OF THIRTY-FOUR CASES
18:00 - 18:12
F. Thierry: CORRELATION BETWEEN COMPUTED TOMOGRAPHIC AND CLINICAL FINDINGS
IN IDIOPATHIC PULMONARY FIBROSIS IN WEST HIGHLAND WHITE TERRIERS
18:12 - 18:24
S. Bouyssou: CORRELATION BETWEEN RADIOGRAPHIC FEATURES AND UNDERLYING
CAUSE IN DOGS AND CATS WITH NONCARDIOGENIC PULMONARY EDEMA
18:30 - 20:00
FREETIME
20:00 - 00:00
WELCOME RECEPTION
10
Opera House - Foyer
Hotel Monopol - Roof Terrace
SESSION I
I
KEYNOTE LECTURE
UPDATE ON IMAGING OF DEMYELINATING DISEASES IN HUMANS
Marek J. Sąsiadek, Wrocław, Poland
Demyelinating diseases are important group of disorders affecting central nervous
system (CNS) in humans. The most common is multiple sclerosis (MS), the other
include e.g. acute disseminating encephalopathy (ADEM), progressive multifocal leukoencephalopathy (PML), neuromyelitis optica (Devic disease), Schilder’s disease,
central pontine myelinolysis (CPM), Marchiafava-Bignami disease. Some of these
diseases (e.g. ADEM, PML) may occur also in animals, besides animal models are
often used in research studies and to evaluate new therapeutic agents, especially in
MS.
Magnetic resonance imaging (MRI) of the brain is one of the most important diagnostic
methods in demyelinating diseases. MR protocol, apart from conventional sequences,
should include thin-slice (1mm) 3D acquisition (to enable volumetric measurements).
Administration of paramagnetic contrast medium is mandatory to detect the active
lesions. Spinal cord should be examined if there is any suspicion of its involvement
Recently many advanced MR techniques have been introduced to imaging of MS and
other demyelinating diseses. Diffusion weighted imaging (DWI) with measurements
of apparent diffusion coefficient (ADC) reveals usually increased diffusion of demyelinating foci, but often also of so-called normal appearing white matter (NAWM) and
normal appearing gray matter (NAGM). Diffusion tensor imaging (DWI) with
measurements of fractional anisotropy (FA) detects decreased FA values both in
demyelinating foci and NAWM. Magnetic resonance spectroscopy may reveal
metabolic changes in demyelinating foci, NAWM and NAGM. The other new technique
is double inversion recovery (DIR) sequence which could detect subtle demyelinating
foci in gray matter and at gray/white matter border. On the other hand susceptibility
weighted imging (SWI) is very useful in defferentiating demyelinating and vasular
dieseses, with haemorrhagic foci detected in the latter.
Differentiation of demyelinating diseases from the other pathological processes of
CNS (especially vascular and infoctious diseases) is often diffucult. MR supplemented
by additional techniques mentioned above, should be analyzed together with history,
neurological examination and laboratory tests.
The other important issue is follow-up of demyelinating diseases with MR. To diagnose
correctly progression, regression or stabilization of demyelinating process, it is very
important to examine the patient with exactly the same protocol as in the previous
studies.
To conclude MRI, especially when supplemented by advanced techniques, is a powerful tool in diagnosing, differentiating and monitoring the demyelinating diseases.
11
CHARACTERIZATION OF SPLENOSYSTEMIC SHUNTS IN CATS: A RETROSPECTIVE STUDY OF 49 CASES (2011-2015) H. Gaillot, S. Valentin, Y. Ruel. ADVETIA,
France, 75012. [email protected]
Introduction/Purpose
Single-vessel splenosystemic shunts (SSS) in adult cats were first reported in 2013,
in a series of 33 cases. This study did not allow to draw any conclusion as to the etiology of SSS. We hypothetized that (1) SSS would not be correlated to portal hypertension (PH), (2) SSS would have little to no detrimental metabolic impact, and (3) SSS
would be congenital portosystemic shunts (PSS) with an original anatomy. The purpose of this study was to describe the ultrasonographic (US) and computed tomography
angiographic (CTA) characteristics of SSS in cats and confront their anatomic features
to serum bile acid (SBA) levels and patients’ outcome.
Methods
Medical records, US and CTA images and US video clips of cats seen at our practice
between 2011 and 2015, with a diagnosis of SSS originating from the ventral radicle
of the splenic vein, were reviewed. Selected cases were followed-up with owners and
referring veterinarians by phone.
Results
SSS were identified in 49 client-owned cats, all spayed females, among the 2504 cats
that had undergone an abdominal ultrasound during the study period (prevalence
1.96%). 41/49 cats had comorbid diseases with unknown correlation to PH. SSS were
the sole anomalous vessels seen on US and CTA in all cats. SSS diameter was significantly smaller than that of usual left gastric feline congenital PSS diagnosed during
the study period (p-value 0.002). Among the 20 cats with hepatofugal gastrosplenic
flow, SBA were measured in 11 cats and were within reference range (RR). Mean portal vein to aorta ratio was 0.87 (SD 0.07). Portal vein flow velocity was within RR (1018 cm/s) in 41/44 cats. The 3/39 cats that had increased SBA were diagnosed with
various hepatopathies. 14 cats were still alive 12 months after diagnosis. In 23/26
deceased cats, the cause of death was attributed to the comorbid disease. In the last
3 cats, fatal seizures of undetermined origin were reported.
Discussion/Conclusion
In this study, the rarity of comorbid diseases known to induce PH, the normal portal
flow in most cats, the rarity of elevated SBA and the single-vessel SSS presentation
strongly suggest that PH is not commonly associated with SSS. Even though the etiology of SSS remains undetermined, our results trend in favor of the hypothesis of
congenital PSS. We have no explanation for the presence of 100% of spayed females
in the study group. The confrontation between SBA levels and gastrosplenic vein flow
direction indicates that the fraction of mesenteric blood that is potentially drained into
the systemic circulation via the SSS is not significant. When compared to previously
described left gastric feline congenital PSS, SSS originate from a site that is farther
from the portal vein trunk and smaller in diameter. Such anatomic features could prevent mesenteric blood from flowing through SSS, allowing SSS to be clinically well
tolerated and therefore incidentally discovered in aged cats.
12
ULTRASONOGRAPHIC, ENDOSCOPIC AND HISTOLOGIC APPEARANCES OF
THE CAECUM IN CATS PRESENTED WITH CLINICAL SIGNS OF CAECOCOLIC
DISEASE. H. Hahn1,2, P. Pey1,3, A. Baril1, J. Charpentier1, L. Desquilbet1,
S. Le Poder1, S. Château-Joubert1, E. Laloy1, V. Freiche1. 1 - Alfort National Veterinary
School, France, 94704. 2 - Frégis Hospital Veterinary Center, France, 94110.
3 - ANTECH Imaging Services, USA, 92614. [email protected]
Introduction/purpose
In a previous study by the same authors, a comparison between ultrasonographic,
endoscopic and histologic caecal findings in asymptomatic cats was performed. A unique follicular layer on ultrasound was described and correlated histologically to lymphoid follicles in the caecal mucosa and submucosa. In asymptomatic cats, a subtle
non-clinically relevant inflammation could exist and was correlated with an increased
thickness of the follicular layer on ultrasound, in the proximal caecal part (>2.0 mm).
The aim of this study was to describe the ultrasonographic, endoscopic and histologic
characteristics of the caecum and ileocaecocolic junction in cats suffering from clinical
signs compatible with caecocolic disease.
Methods
Symptomatic cats submitted to the gastroenterology consultation with clinical signs
suggesting a caecocolic disease (diarrhoea, dyschezia, tenesmus, haematochezia
and/or constipation) were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local fat;
a colonoscopy with macroscopic assessment of the caecocolic mucosa was also performed. Ileocaecocolic tissue samples were collected for histology.
Results
Eighteen cats were included. Ultrasonographically, 11/18 cats had abnormalities adjacent to the ileocaecocolic junction (lymph node thickening, local steatitis) and 13/18
cats had abnormalities directly related to the junction (wall thickening, loss of wall
layering). Seventeen of 18 cats had at least one ultrasonographic abnormality. Loss of
caecal wall layering was found in 7/18 cats: the follicular layer was thus not measurable in all cats. On endoscopy, no cat had a normal caecum and hyperaemia, oedema,
discoloration and/or erosions were found in all. Cats were classified as mildly or severely inflammatory according to endoscopic results; no classification could be established statistically for ultrasonographic results. Histologically, a large proportion of cats
showed typhlitis (13/16), 1 had lymphoma, 2 were normal. All cats with typhlitis also
had colitis. Agreement between endoscopic and histologic results on the severity of
inflammation was statistically fair.
Discussion/Conclusions
Loss of caecal wall layering surprisingly did not appear as a reliable predictor of the
severity of inflammation or of malignancy; neither did local steatitis nor lymph node
size. Loss of caecal wall layering seems nonetheless an important feature of moderate to severe inflammation. Ultrasonography and endoscopy should not be used solely
to investigate the ileocaecocolic region in cats with clinical signs suggestive of caecocolic disease, but in combination. A normal caecum on ultrasonography should not
prevent the cat from having endoscopic biopsies.
13
ASSOCIATION BETWEEN ULTRASONOGRAPHIC APPEARANCE OF SPLENIC
PARENCHYMA AND CYTOLOGY IN THE CAT. Mileva Bertal1,2, Eric Norman
Carmel3, Alessia Diana4, Loic Desquilbet5, Swan Specchi6, Pascaline Pey1,7.
1 - Department of Medical Imaging, Ecole Nationale Vétérinaire d’Alfort, France,
94700, 2 - Pride Veterinary Centre, United Kingdom, DE24 8HX. 3 - Centre Vétérinaire Laval, Canada, H7T 2P7. 4 - Department of Veterinary Medical Science, University
of Bologna, 40064. 5 - Department of Biostatistics and Clinical Epidemiology, Ecole
Nationale Vétérinaire d’Alfort, France, 94700. 6 - Diagnostic Imaging Service of the
Istituto Veterinario di Novara, Italy, 28060. 7 - ANTECH Imaging Services, USA, 92614.
[email protected]
Introduction
The purpose of this study was to (1) identify criteria of malignancy in the ultrasonographic examination of the spleen in cats and (2) determine which factors influence
the ultrasonographic assessment of the feline splenic parenchyma.
Methods
Feline patients with ultrasonographic images of the spleen and cytological analysis of
the splenic parenchyma obtained by fine needle aspiration from March 2012 to September 2015 were retrospectively selected and enrolled in this multicentric study. The
presence of a splenic mass and of a diffusely moth-eaten parenchyma were specifically assessed. Calculation of the kappa coefficient and of the sensitivity and specificity
was used to analyse the results.
Results
One hundred and ninety-five cats met our inclusion criteria between the Veterinary
Teaching Hospital of the National Veterinary School of Alfort (France), the Centre
Vétérinaire Laval (Canada) and the Istituto Veterinario di Novara (Italy). Neoplastic
infiltration of the spleen was detected in 38 cats out of 170 (22.3%). There was a lack
of agreement between a moth-eaten ultrasonographic appearance of the spleen
and the presence of neoplasia on cytological analysis. The sensitivity of a moth-eaten
parenchyma for predicting neoplastic disease was 13.2%, and specificity was 84.8%.
The sensitivity of a splenic mass for predicting neoplastic disease was 21.0%, and
specificity was 94.7%. A marbled appearance of the splenic parenchyma was significantly more frequent among patients examined with a high frequency transducer
(11-18 MHz) than among those examined with a low frequency transducer (6.6-10
MHz) (27.6% versus 11.1%, respectively; p = 0.004). Similarly, although not significantly, presenting a moth-eaten parenchyma was more frequent in the high frequency
transducer group than in the low frequency group (17.1% versus 8.9%, respectively;
p = 0.09).
Conclusions
Based on our findings, a moth-eaten ultrasonographic appearance of the spleen
in cats does not necessarily reflect lymphoma or another neoplastic process. The presence of a splenic mass is suggestive of malignancy in cats. Finally, the transducer
frequency must be taken into account when assessing the splenic parenchyma, as
a high frequency transducer seems to improve the detection of a marbled or moth-eaten parenchyma.
14
RELATIONSHIP BETWEEN ULTRASONOGRAPHIC AND HISTOPATHOLOGICAL
MEASUREMENTS OF THICKNESS OF INTESTINAL WALL LAYERS IN CAT
CADAVERS. M. Martinez, F.J. Pallares. M. Soler, A. Agut. Teaching Veterinary
Hospital University of Murcia, Spain, 30100. [email protected]
The normal ultrasonographic (US) thickness of the small intestine wall and its layers in
normal cats has been described. However, to the author’s knowledge an histological
(H) morphometric study of the thickness layers of the small intestine and its relation to
the US thickness of each intestinal wall layer in cats has not been reported. The aim
of this study was to establish the relation between US and H thickness of the small
intestinal layers and overall wall thickness in the duodenum (D), jejunum (J), ileum (I)
and ileocecal valve (IV) in normal cats.
Methods
Seventeen fresh adult feline cadavers were used. The cats were humanely euthanased for reasons unrelated to gastrointestinal tract disorders. Ultrasound images of the
D, J, I and IV were obtained in both longitudinal (L) and transverse (T) planes. Three
measurements of overall intestinal wall, mucosa, submucosa, muscularis and serosa
layers thickness were made in each segment. After US evaluation samples of D, J, I
and IV were taken at similar regions where the US images were obtained. The samples were fixed in formalin and stained with haematoxylin and eosin. Overall intestinal
wall thickness and thickness of the mucosa, submucosa and muscularis layers were
measured. Statistical analysis was carried out using R 3.2.2 software. Descriptive statistics were obtained and all the variables were tested for normality (Shapiro-Wilk test).
Mixed analysis of variance (ANOVA) and post-hoc Tukey’s tests were performed
to analyse the thickness of the different intestinal layers related to different parts of
intestine. Bland-Altman analysis was used to assess agreement between US measurements obtained in L and T planes and between the two methods (US and H).
The results were considered significant at p< 0.05.
Results
Agreement between the US measurements L and T planes was observed, showing
better agreement at the duodenal mucosa (mean: 0.01 with limits of agreement -0.170.19) compared to the mucosa of IV at the level of the fold (0.56 with limits of agreement 0.27-0.85). The thickness of the intestinal wall was highest in the IV at the level
of the folds followed by I, D and J. The mucosa was the thickest layer in the D with
a progressive decrease to distal parts of the intestine. The submucosa was the thickest layer in the IV at the level of folds. The muscularis was thicker in the ileum compared with other segments of intestine. A good agreement between US and H values
of the overall wall thickness in all the small intestine segments was demonstrated.
There was no agreement between the measurements of the submucosa and
muscularis at the D.
A good agreement between US and H measurements of the overall wall thickness in
all intestinal segments was found, whereas this finding was not observed at the submucosa and muscularis of the duodenum. This fact may be due to changes of the
tissue during histologic sample processing.
15
PREVALENCE OF RETROCAVAL URETERS IN DOGS AND CATS AND THEIR ASSOCIATION WITH OBSTRUCTIVE URETEROLITHIASIS. T. Schwarz1, T. Nordbo1,
D. Gunn-Moore1, J. Saunders2. 1 - Royal (Dick) School of Veterinary Studies, UK
EH25 9RG. 2 – Faculty of Veterinary Medicine, Ghent University, Belgium 9820.
[email protected]
Introduction
Retrocaval ureter (RU) is a congenital, predominantly right-sided, anomaly with an
abnormal dorsomedial ureter location in relation to the great vessels. The caudal RU
curves over the great vessel to reach the urinary bladder, creating a potential
obstructive locus. Computed tomography (CT) has been used to identify RU, but body
position and colonic distension can interfere with ureteral identification. Objectives
of this study were to determine patient related factors for ureter conspicuity and
RU prevalence in dogs and cats, its association with ureterolithiasis and obstruction.
Methods
A retrospective cross-sectional study of canine and feline abdominal CT examinations
was performed. Signalment data, urolithiasis status were collected and CT studies
were scored for ureteral conspicuity, pathology, colonic distension and abdominal
extension by two consenting reviewers. Fisher’s exact test, two-sample-t test and
relative risk calculation were performed for statistical analysis.
Results
CT studies of 135 dogs and 53 cats were included in the study. None of the dogs had
RU, 5.2% had urolithiasis. In 19 cats (35.8%) RU was found which was predominantly
right sided (16 right, 3 left). Predominantly renal and cystic urolithiasis was found
in 12 cats (22.6%), of which 4 also had RU with a relative risk of 1.2 for this combination but without statistical significance. Colonic distension and abdominal flexion
decreased ureteral conspicuity.
Discussion
CT is adequate to identify the canine and feline ureter but abdominal extension
and a colonic enema are recommended to optimise conspicuity. Feline RU is common
but does not significantly increase urolithic risk.
16
STUDENT PERSPECTIVE OF CLASSROOM RESPONSE SYSTEMS USED
INDIVIDUALLY AND AFTER PEER DISCUSSION IN DIAGNOSTIC IMAGING.
W. M. du Plessis1, G. E. Gilbert2,3. 1 - Ross University School of Veterinary Medicine,
Small Animal Clinical Sciences, St. Kitts & Nevis, 2 - DeVry Medical International’s
Institute for Research & Clinical Strategy, USA, 08830, 3 - Ross University School of
Medicine, Commonwealth of Dominica. [email protected]
Literature suggests many benefits of using classroom response systems (CRS) - some
of them objectively quantified, others subjectively perceived. Benefits commonly mentioned include higher attendance, better preparation for class, increased enthusiasm,
attentiveness, participation and confidence in learning. There are numerous ways
to employ CRS to influence classroom achievement, one being answer design such
as answering individually or after peer discussion. This study investigated student
perspectives regarding individual CRS usage, followed by peer discussion in a 5th
semester Diagnostic Imaging class. To the best of the authors’ knowledge no information exists on this specific topic.
Methods
This study was approved by the Ross University School of Veterinary Medicine
(RUSVM) Institutional Review Board. Two clicker questions were presented during
Diagnostic Imaging lectures given to 5th semester students. Students first answered
questions individually, followed by answering it after peer discussion. Instructor
feedback (correct answer with explanation and histogram of student responses) was
given after answering the question the second time only. Use of CRS was voluntary
and no participation points were awarded and feedback was obtained by means of
a short online questionnaire.
Results
The majority of students rated themselves as feeling confident about their diagnostic
imaging knowledge and fully agreed that usage of CRS questions were beneficial
during lecture (≥75% versus ≤10% strongly disagreed). The majority of students
(> 50%) indicated “individually, followed by peer” as their preferred format overall,
but also concerning specific aspects, such as confidence, justification, active learning,
attentiveness, preparation for quizzes and exams, best feedback to lecturer, problem
solving and increasing the level of understanding, with the latter achieving the highest
percentage. Students either agreed or strongly agreed (>68%) that they answered
the questions as if a grade was linked with it.
One concern of using CRS in lectures is the time factor, hence particularly asking the
same question twice had to be weighed up carefully. This questionnaire strongly
supports that “individually, followed by peer” was regarded beneficial by the majority of
the students. Often CRS questions are linked with attendance grades to improve
attendance, however attendance and answering the clicker questions was absolutely
voluntarily in this study and good despite all lectures being recorded.
17
DURATION OF ACTION OF FEMORAL AND SCIATIC ULTRASOUND-GUIDED
NERVE BLOCKS USING BUPIVICAINE IN DOGS. M. Ó Cathasaigh1, M. Read2,
G.P.S. Kwong2. 1 - Queen’s Veterinary School Hospital, University of Cambridge
Veterinary School, Cambridge, UK. CB3 0ES. 2 - University of Calgary, Faculty of
Veterinary Medicine, Calgary, Canada. T2N 1N4. [email protected]
While nerve blocks have been used for many years, administration of different local
anaesthetic agents and the use of more advanced techniques particularly ultrasound
guidance are now being explored. Recently, several authors have described the
anatomic considerations for using ultrasound to assist in performing femoral and
sciatic nerve blocks using lidocaine. The purpose of this prospective study was to
document the duration of sensory and motor blockade following ultrasound-guided
femoral and sciatic nerve blocks using bupivacaine in dogs.
Methods and materials
Six Beagles were anesthetized twice, with three-months between anaesthetics.
The study was approved by the Animal Care Committee of the University of Calgary.
At the first anaesthetic, dogs were randomly assigned to receive either an ultrasound-guided femoral nerve block (pre-iliac iliopsoas approach) or an ultrasound-guided
sciatic nerve block (caudal approach) using 0.15 mL/kg of bupivacaine. The alternative nerve block was performed at the second anaesthetic. After 60-minutes of anaesthesia each dog was recovered. Video-recordings of the dogs were made every
two hours from the time of extubation for 24 hours and the videos were randomized
and the degree of motor and sensory blockade were evaluated using a three-point
scoring system (0 = no effect, 1 = mild effect, 2 = complete blockade) by two blinded,
board certified small animal surgeons. Agreement between the assessors was
calculated using Cohen’s kappa and Wilcoxon signed rank tests were performed
to test the differences in duration of motor and sensory block between the two
nerve block techniques.
Results
Agreement between observers were κ = 0.39 (sensory) and 0.87 (motor). The median
(IQR) times to full recovery from motor blockade were 11.0 hours (Range: 8.5 – 13.5)
for the femoral and 11.0 hours (Range: 10.0 - 13.5) for the sciatic, and for sensory
blockade 14.0 hours (Range: 14.0 – 15.5) for the femoral and 10.0 hours (Range: 10.0
– 14.5) for the sciatic. There were no differences in the median times to recovery
for the two techniques for motor (P = 0.57) or sensory (P = 0.09).
Results demonstrate that both blocks are reliable and effective for anaesthetising
their respective dependent structures on the pelvic limb of dogs. Blocks lasted at least
8.5 hours, with a median duration of action for blocking motor and sensory function
from 10.0 hours to 14.0 hours. These results suggest that ultrasound-guided peripheral nerve blocks are suitable for providing anaesthesia of the pelvic limb of dogs and
that the duration of action is comparable to the reported duration of effect of epidural
anaesthesia.
18
SESSION II
II
KEYNOTE LECTURE
VETERINARY DIAGNOSTIC IMAGING EDUCATION: quo vadis?
Susanne Boroffka
After studying Veterinary Medicine at the Free University of Berlin, Dr. Boroffka worked
as a technician at the Department of Veterinary Radiology under supervision of
Prof. Klaus Hartung. In the period she worked also on her German thesis that she
defended successfully in 1995. In 1992 Dr. Boroffka started her „Residency Diagnostic
Imaging“ at the Department of Diagnostic Imaging at the University Utrecht, the Netherlands. Since 1998 she is Diplomate ECVDI (European College of Veterinary Diagnostic Imaging) and worked for many years as an „Assistant Professor“ in Utrecht.
In 2007 she defended her PhD successfully on “Diagnostic Imaging of the Canine Eye
and Orbit”. Her special interest is diagnostic imaging of the eye and orbit, but also
radiology and CT of the thorax and US of the GI-tract, especially in emergency and
critical patients.
Since January 2016 she founded her own business: Boroffka Diagnostic Imaging,
working in veterinary specialist centers.
19
ASSOCIATION BETWEEN VERTEBRAL HEART SCORE MEASUREMENT AND
OVERWEIGHT CONDITION IN DOGS. M. François1, AC. Merveille1, K. Mc Entee1-2,
G. Bolen1. 1 - Department of Small Animals and Equidae Clinics, FARAH, Faculty of
Veterinary Medicine, University of Liège, Belgium. 2 - Laboratory of Physiology and
Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Belgium.
Introduction
Vertebral heart score (VHS) is used to assess heart size on thoracic radiographs.
A study on eight dog breeds has reported a significant effect of the body condition
score (BCS) on VHS of Lhasa Apso. Association between VHS and overweight condition in dogs of different breeds is still unknown. The aim of this study is to determine
if VHS is influenced by overweight condition in dogs. The hypothesis is that VHS is
influenced by BCS and T4 ratio.
Methods
Recruitment criteria for this retrospective study were the presence of a minimum of
2 thoracic radiographic views and a diagnosis of “normal echocardiographic examination” in medical records from 2013 to 2016. Body weight, BCS and breed were extracted. VHS was calculated and classified as normal or enlarged according to the dog’s
breed. Overweight condition was also calculated with the previously described T4 ratio
(ratio of subcutaneous fat thickness (8th rib) on a ventrodorsal or dorsoventral radiograph to the length of T4 on a right lateral radiograph). Dogs from breeds with a normal
maximal VHS < 11 (group 1) and from breeds with a normal maximal VHS > 11 (group
2) were separated. Statistical analyses were performed using XLStat® software.
A Spearman test was performed to assess correlation between BCS and T4 ratio.
A linear model (ANCOVA) was used to evaluate the influence of BCS and of T4 ratio
on VHS in each group.
Results
Fifty-one dogs were included in the study. Body weight ranged from 3.7 to 44.8 kg and
was not recorded in 2 dogs. These dogs were not excluded because of the BCS was
recorded for these dogs. BCS ranged from 3 to 9. Thirteen dogs had a VHS value
superior to the normal range and all of them had BCS ≥ 4. A weak positive correlation
was found between BCS and T4 ratio (P ≤ 0.001, R2=0.4). There was a positive
relationship between BCS and VHS (ANCOVA, P ≤ 0.003) for each group and
between T4 ratio and VHS for each group (ANCOVA, P ≤ 0.001).
This study confirms that the T4 ratio is correlated to BCS evaluated clinically. This ratio
could be used to assess overweight condition on thoracic radiographs. VHS is influenced by BCS and the T4 ratio; therefore, VHS should be use with caution in overweighed dogs.
20
RADIOGRAPHIC AND HIGH RESOLUTION COMPUTED TOMOGRAPHIC
APPEARANCES OF BRONCHIOLAR PLUGGING IN CATS: THE «TREE-IN-BUD»
PATTERN. H.Hahn1,2, S.Specchi3,7, I.Masseau4, C.Reinero5, G.Benchekroun1,
J.Rechy6, G.Seiler6, P.Pey1,3. 1 - Alfort National Veterinary School, France, 94704.
2 - Frégis Hospital Veterinary Center, France, 94110. 3 - ANTECH Imaging Services,
USA, 92614. 4 - Faculté de Médecine Vétérinaire, Université de Montréal, Canada,
J2S 2M2. 5 - College of Veterinary Medicine, University of Missouri, USA, MO 65211.
6 - North Carolina State University, USA, NC 27606. 7 - Veterinary Institute of Novara,
Italy, 28060. [email protected]
Introduction/purpose: Bronchiolar plugging is well described in human medicine as
a centrilobular bronchiolar dilation and filling by mucus, pus or fluid, which produces
on computed tomography (CT) a characteristic pattern of a « tree-in-bud » (TIB). The
aim of this study was to characterize the radiographic and CT appearance of bronchiolar plugging in cats and to describe the clinical presentation and underlying diseases
associated with this lesion.
Methods: Cats with thoracic CT reports consistent with bronchiolar plugging and with
thoracic radiographs performed within the same month were included in this multicenter study. Data retrieved from the medical records included history, clinical signs and,
when available, results of respiratory diagnostics including but not limited to bronchoscopy, cytology, culture and histology. Images were retrospectively and consensually
reviewed by two radiologists and screened for several criteria. Clinical data and
imaging features were used by internists and radiologists to reach a multidisciplinary
consensus for the final clinical diagnosis for each cat.
Results: Thirty-six cats were included. The number of plugs by cat varied from 1 to an
innumerable count. On CT TIB pattern was seen in > 1 lobe (86%); on radiographs
plugs were underestimated in number (47%) or missed (16%). Percentages calculation was performed on the number of cats and not plugs. When assessing presence or
absence of TIB lesions in each lung region, right cranial and right caudal lung lobes
most commonly had TIB lesions (75 and 64%, respectively) and ventral (92%)
distribution was more common than dorsal (67%) and middle (58%) distribution (cats
could show more than one regional distribution). All lesions were along the bronchial
tree and in the lumen of bronchioles, with 39% also involving a segmental bronchus
and 14% a lobar bronchus. Bronchiolar plugs generally had well defined contours
(86%) with individual plugs from each cat having a tubular and/or nodular shape (86%
and 44%, respectively). The density of the bronchiolar plugs ranged from 43 to 277 HU
and corresponded to soft tissue opacity on radiographs (93%) and rarely to mineral
opacities (6%). Broncholiths were noticed in 10/36 cats. Nearly all cats (32/36) presenting with TIB pattern were clinically suspected to have primary bronchial disease
with 24 of unknown type, 6 with asthma and 2 with chronic bronchitis. The final diagnosis was thought to explain the TIB pattern in all but one cat.
Discussion/Conclusions: Bronchiolar plugging was observed in cats with bronchial
disease most commonly affecting several pulmonary lobes. On radiographs the number of plugs and affected lobes were often underestimated. While plugs could take a
nodular shape, their lobar distribution that systematically followed the bronchial tree
and never presented with a random distribution would likely discriminate them from
other types of pulmonary nodules, as nodular fibrosis, granulomas or metastases.
21
RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC APPEARANCE OF ATYPICAL TRACHEAL COLLAPSE IN FOUR DOGS. H.G. Heng, C.K. Lim, B. Gutierrez-Crespo, L.F. Guptill. Department of Veterinary Clinical Sciences, Purdue University,
USA, IN 47907.
Introduction: The diagnosis of tracheal collapse is based on visualization of a distinctly narrowed dorsoventral tracheal diameter and is commonly made using radiography and fluoroscopy. However, conventional radiography is only diagnostic in dogs with
severe tracheal collapse approximately 60% of the time. Computed tomography (CT)
is an alternative imaging modality that could be helpful to demonstrate the degree of
collapse and the morphology of the trachea. In the present study, we evaluate the appearance of atypical forms of tracheal collapse in four dogs using radiography and CT.
Objective: To document atypical forms of tracheal collapse with CT and correlate with
radiography.
Methods: A retrospective study was conducted on known cases of atypical tracheal
collapse which had both radiography and CT studies (from Jan 2014- Feb 2016). The
signalment, including age, breed, sex, clinical signs, treatment and outcome were noted. The thoracic radiographs and CT were reviewed. The location of the lesion, margins of the trachea, luminal opacity and lung parenchyma were evaluated. The radiographic ratio of maximum dorsoventral TD to thoracic inlet diameter (TID) on the
lateral radiographs for each case was calculated based on left lateral thoracic radiographs. For CT evaluation, the location of the abnormality was noted. The shape of the
trachea and its luminal patency were evaluated. Any change in rotational axis of the
trachea was noted.
Results: A total of 4 small breed dogs were included, ranging from 7-14 year old. Dogs
1 and 2 were presented with suspected acute respiratory distress due to tracheal foreign body. Dog 3 and 4 had a history of chronic honking cough when excited, but dog
3 had no clinical signs at the time of presentation. All dogs had increased TD at the
level of caudal cervical and/or cranial thorax. Intraluminal soft tissue opacity appears
to be present within all the tracheas. Dog 3 had left sided cardiomegaly with enlarged
pulmonary veins. The TD/TID ratios ranged from 0.35 to 0.44. CT revealed complete
central DV collapse of the trachea at the caudal cervical/ cranial thorax in Dogs 1, 2
and 4, and near complete collapse in Dog 3. Dogs 1, 2 and 4 had clockwise rotation of
the trachea at the caudal cervical region, and rotated back in an anti-clockwise manner caudally. Dog 3 had anti-clockwise rotation in the cranial aspect followed by clockwise rotation at the caudal aspect. The maximum degree of rotation ranged from 25°
to 50°. In transverse CT images, there was dorsal (n shape) and ventral (u shape)
protrusions of the midline of the tracheal wall in Dogs 1, and 2 and 4 respectively. With
central tracheal collapse, gas is still present at both lateral aspect.
Discussion/Conclusion: This study showed that the atypical form of tracheal collapse will lead to radiographic increased TD with luminal soft tissue opacity and is due to
axial rotation of the trachea. This condition should not be misdiagnosed as intraluminal
tracheal foreign body.
22
TWO-DIMENSIONAL CARDIOTHORACIC RATIO FOR EVALUATION OF CARDIAC
SIZE IN CATS. E. A. Hassan, F. A. Torad. Department of Surgery, Anesthesiology
and Radiology, Faculty of Veterinary Medicine, Cairo University, Egypt, 12211.
[email protected]
Thoracic radiography is the most common diagnostic tool used for evaluating cats with
suspected cardiac disease. Evaluation of cardiac size and silhouette is an important
indicator of pathologic cardiac changes. Tracking of cardiac silhouette and calculation
of cardiothoracic ratio is a novel diagnostic tool that has been used for evaluation of
cardiac size in German shepherd dogs1. The purpose of the present study was to
evaluate cardiac size in cats using two-dimensional cardiothoracic ratio calculation.
Methods
Clinical, radiographic and echocardiographic data of fifty cats with normal (n=25)
as well as enlarged heart (n=25) were used in the study. Echocardiographic examination was used as a gold standard to differentiate cats with enlarged cardiac size from
those with normal cardiac size. Right lateral thoracic radiographs obtained at the point
of peak inspiration were used; two-dimensional cardiothoracic area was calculated as
the percentage area of the cardiac silhouette relative to the thoracic area using a computer software program. All measurements were made in triplicates by the same
observer (E.A.H.) and the average was calculated. Receiver operating characteristic
(ROC) curve analysis was used to determine the diagnostic accuracy of cardiothoracic
ratio in evaluating cardiac size.
Results
In right lateral thoracic radiographs obtained at the peak inspiration, the mean (±SD)
cardiothoracic ratio of normal cats was 17.17 % ± 1.70 % while in cats with enlarged
cardiac size was 26.7 % ± 3.97%. The cutoff value of cardiothoracic ratio for diagnosing enlarged cardiac size was 19.97%, the area under the curve of the ROC curve
analysis was 0.977 ± 0.004 with a 95 % confidence of interval (0.988- 1.000).
Two-dimensional cardiothoracic ratio obtained at the point of peak inspiration may
provide a clinically useful objective tool for evaluating cardiac size in cats.
References
Torad FA, Hassan E.A. Two-dimensional cardiothoracic ratio for evaluation of cardiac
size in German shepherd dogs. J
Vet Cardiol. 2014 Dec;16(4):237-44.
23
ISINGLE AND MIXED FELINE LUNGWORM INFESTATION: CLINICAL, RADIOGRAPHIC AND TOMOGRAPHIC FEATURES OF THIRTY-FOUR CASES. E. Febo1,
P.E. Crisi1, D. Traversa1, M. Paninarova2, A. Luciani1, D. Santori1, S. Pantaleo1,
A. Boari1, L. Cavallo2, M. Vignoli1,2. 1 - Faculty of Veterinary Medicine, University
of Teramo, Italy, 64100. 2 - Veterinary Clinic Modena Sud, Italy, 41057.
[email protected]
Different parasitic nematodes affect the respiratory tract of domestic cats, including
Aelurostrongylus abstrusus and Capillaria aerophila. Recently, also Troglostrongylus
brevior, a lungworm affecting wildcats, has been recorded in domestic hosts from
some geographic regions. Radiographic changes could occur prior to the onset of clinical signs of the disease. Computed Tomography (CT) examination in cats affected
by aelurostrongylosis recently proved useful for a thorough characterization of pulmonary and mediastinal lesions and their severity. The aim of the study was to describe
radiographic features of thirty-four cats naturally infected by single and mixed lungworm infestation. The CT features for eight of them were also described.
Methods
In 2013-2016, 34 cats diagnosed with lungworm infection at the VTH of the University
of Teramo, Italy, underwent physical examination, hematobiochemical analysis and to
two- or three-radiographic projections of the thorax. Eight animals underwent also a
CT examination with a multidetector CT scanner, at the Veterinary Clinic Modena Sud,
Italy. Lung density was measured for different patterns. All cats received an anthelmintic therapy.
Results
Infections by A. abstrusus (21/34), T. brevior (4/34) and C. aerophila (1/34) and
co-infections by T. brevior/A. abstrusus (7/34) and T. brevior/C. aerophila (1/34) were
diagnosed. Twenty-four cats showed respiratory signs, while 10 were subclinically
infected. Respiratory signs recorded were coughing (12 cats), increased vesicular
sounds (10), dyspnoea (9), tachypnoea (6), abdominal breathing (5), oculo-nasal
discharge (5), sneezing (4), wheezing (2) and crackles (1). Thirty-three cats had radiographic patterns: interstitial in 30 (25 recorded as reticular and 5 as nodular), bronchial
in 26, alveolar in 10 and vascular in 2 cats. No abnormalities were observed in an 8
month old cat affected by troglostrongylosis. The nodular pattern, was more severe in
cats with C. aerophila or mixed infestation by T. brevior/A. abstrusus. The 8 cats that
also underwent CT scans did not show any clinical sign: 6 were affected by A. abstrusus, while 2 had a T. brevior infection and a co-infection by T. brevior/A. abstrusus,
respectively. Interestingly, a multilobar involvement was highlighted by CT in all
animals. Computed Tomography gave additional information compared to radiology
for bronchial/peribronchial changes (6/8), alveolar involvement (6/8), interstitial pattern, like ground glass opacity (8/8) and nodular (4/8). A mean normal lung density was
‒ 730 HU vs ‒ 515 of ground glass opacity areas vs – 51 HU for alveolar pattern.
This study showed the severity of lung lesions in cats affected by lungworms, also
when subclinically infected, either by radiography and CT scan. Moreover, as previously observed, CT provided a more accurate evaluation of the pulmonary lesions compared to radiology.
24
CORRELATION BETWEEN COMPUTED TOMOGRAPHIC AND CLINICAL
FINDINGS IN IDIOPATHIC PULMONARY FIBROSIS IN WEST HIGHLAND WHITE
TERRIERS. F. Thierry1, I. Handel1, G. Hammond2, L.G. King3, B.M. Corcoran1,
T. Schwarz1. 1 - The University of Edinburgh, Royal (Dick) School of Veterinary
Studies, UK, EH25 9RG. 2 - School of Veterinary Medicine, Glasgow University, UK,
G61 1QH. 3 - School of Veterinary Medicine, University of Pennsylvania, USA, 19104.
[email protected]
Introduction
Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease of unknown aetiology
resulting in progressive and fatal interstitial fibrosis described in humans and several
animal species. West Highland White Terriers (WHWT) have a known predisposition
for it. In humans computed tomography (CT) has a diagnostic and prognostic value,
which plays a major role in IPF staging process. Objectives of this study were to
establish a comprehensive description of tomographic findings and to evaluate correlation between CT, clinical findings and survival times in canine IPF.
Methods
A retrospective cross-sectional study of WHWT diagnosed with IPF by exclusion and
without respiratory disease was performed in which CT under anaesthesia following
hyperventilation, bronchoscopy, bronchoalveolar lavage, echocardiography and
routine haematology and biochemistry were performed. Survival times were recorded.
The main lung pattern on thoracic CT images and clinical data were blindly and
separately graded – by T.S. and B.M.C respectively – as mild, moderate or severe
and analysed with Spearman and Mann-Whitney tests.
Results
Twenty-one WHWTs with IPF and 11 controls were included. The severity of pulmonary tomographic findings was positively correlated to the severity of clinical signs
(ρ=0.51, p=0.018). Affected dogs had higher lung attenuation (median: -563 Hounsfield Units (HU), range: -696 to -425HU) than control dogs (median: -761HU, range:
-842 to -708HU), p<0.001.
Conclusion
CT findings are correlated to severity of clinical signs in WHWTs with IPF. This imaging
modality is a valuable tool for diagnosis and staging of the pathology, but is not correlated to survival time in our population.
25
CORRELATION BETWEEN RADIOGRAPHIC FEATURES AND UNDERLYING
CAUSE IN DOGS AND CATS WITH NONCARDIOGENIC PULMONARY EDEMA.
S. Bouyssou1, S. Specchi2, L. Desquilbet1, P. Pey1,3. 1 - National Veterinary School
of Alfort, France, 94700. 2 - Veterinary Institute of Novara, Italy, 28060. 3 - ANTECH
Imaging Services, USA, 92614. [email protected]
Pulmonary edema is usually classified as cardiogenic or noncardiogenic. Differentiation between cardiogenic and noncardiogenic pulmonary edema and differentiation
between types of noncardiogenic pulmonary edema is crucial because these conditions imply different therapeutical approaches. Little is known about noncardiogenic
pulmonary edema in small animals. The purpose of this study was to describe the
radiographic findings in a case series of dogs and cats affected by noncardiogenic
pulmonary edema and to correlate radiographic appearance with the underlying
cause.
Methods
Radiographic database of the National Veterinary school of Alfort from 2006 to 2014
was screened for dogs and cats with noncardiogenic pulmonary edema. Fortynine
dogs and 11 cats with history, radiographic findings and follow-up consistent with noncardiogenic pulmonary edema, resulting from airway obstruction (n=23), direct pulmonary injury (n=13), severe neurologic stimulation (n=12), systemic disease (n=6), near-drowning (n=3), anaphylaxis (n=2) and blood transfusion (n=1), were reviewed by
one board certified radiologist, blinded to the cause of noncardiogenic pulmonary
edema, to assess lung pattern and distribution of lesions. Correlation with the cause
of noncardiogenic pulmonary edema was evaluated with a Fisher’s exact test statistical analysis. To verify the multiple comparisons, a Benjamini-Hochberg false discovery rate was used.
Results
Mixed, symmetric, peripheral, multifocal, bilateral and dorsal lung pattern were observed in 44 (73.3%), 46 (76.7%), 55 (91.7%), 46 (76.7%), 46 (76.7%) and 34 (57.6%)
of 60 animals, respectively. When the distribution was unilateral, pulmonary infiltration
involved mainly the right lung lobes (85.7%). Pulmonary changes were more often
asymmetric (p=0.031), unilateral (p=0.030) and dorsal (p=0.027) in post-obstructive
pulmonary edema compared to other types of noncardiogenic pulmonary edema, but
these p-values did not stay significant after adjusting for multiple comparisons.
This study is the first description of radiographic findings in a large cohort of dogs and
cats with noncardiogenic pulmonary edema. A mixed, symmetric, multifocal, peripheral and dorsal changes distribution was the most common radiographic feature. Asymmetric, dorsal and unilateral radiographic distribution could be more often observed in
post-obstructive pulmonary edema, but, considering the large number of tests used,
other studies should be performed to compare specifically radiographic appearance of
post-obstructive pulmonary edema with other causes of noncardiogenic pulmonary
edema to confirm this hypothesis.
26
THURSDAY / 01.09.2016
08:30 - 08:45
ANNOUCEMENTS
08:45 - 10:30
SESSION III, Chairperson: PATRICK KIRCHER
08:45 - 09:30
Keynote Lecture - Fraser McConnell: DWI AND PWI - USEFUL OR USELESS?
09:30 - 09:42
A. Hartmann: DIFFUSION WEIGHTED MRI OF THE BRAIN OF DOGS SUFFERING FROM IDIOPATHIC
EPILEPSY IN COMPARISON TO NORMAL DOGS
09:42 - 09:54
N. Ondreka: CAN WE DIFFERENTIATE RELEVANT INTERNAL HYDROCEPHALUS FROM
SUBCLINICAL VENTRICULOMEGALY BASED ON MAGNETIC RESONANCE IMAGING?
09:54 - 10:06
Y. Choi: QUANTITATIVE EVALUATION OF THIRD VENTRICULAR ALTERATIONS OF TOY-BREED DOGS
IN LOW FIELD MAGNETIC RESONANCE IMAGING
10:06 - 10:18
E. Stanczyk: PROTON MAGNETIC SPECTROSCOPY IN CANINE AND FELINE INTRACRANIAL
MENINGIOMAS: THE ROLE OF GLUTAMATE-GLUTAMINE COMPLEX AND GLUTATHIONE
10:18 - 10:30
M.J. Schmidt: PERFUSION WEIGHTED MAGNETIC RESONANCE IMAGING OF BRACHYCEPHALIC
DOGS WITH VENTRICULOMEGALY
Opera House - Foyer
10:30 - 11:00
COFFEE BREAK
11:00 - 12:30
SESSION IV, Chairperson: JUSTYNA OSTROWSKA
11:00 - 11:30
Masterclass Lecture - Tod Drost: CT OF THE GI TRACT
11:30 - 11:42
S. Specchi: EVALUATION OF THE COMPUTED TOMOGRAPHIC SENTINEL CLOT SIGN TO IDENTIFY
THE BLEEDING ABDOMINAL ORGAN IN DOGS WITH HEMOABDOMEN
11:42 - 11:54
A.B. LeRoux: SHORT COLON SYNDROME IN CATS
11:54 - 12:06
G. Gory: NORMAL ULTRASONOGRAPHIC FEATURES OF THE PYLORUS IN 153 DOGS AND
CLINICAL APPLICATIONS
12:06 - 12:18
S. Specchi: “TANGLE SIGN” ON THE VENTRO-DORSAL PROJECTION OF ABDOMINAL
RADIOGRAPHS OF SPAYED FEMALE CATS CORRESPONDS TO A SPLENO-SYSTEMIC SHUNT
12:18 - 12:30
P. Borusewicz: CONTRAST ENHANCEMENT IN DYNAMIC LIVER MRI AFTER ADMINISTRATION OF
GADOXETIC ACID IN HEALTHY BEAGLE DOGS
12:30 - 13:30
LUNCH
(sponsored by:
)
Opera House - Foyer
27
THURSDAY / 01.09.2016
13:30 - 15:30
13:30 - 14:00
14:00 - 15:30
28
SESSION V,
Chairpersons: EBERHARD LUDEWIG and TOBIAS SCHWARZ
Masterclass Lecture - Åste Søvik: PET FOR PETS – POSSIBILITIES AND PITFALLS WITH PET/CT
POSTER PRESENTATIONS
14:00 - 14:03
A. L. E tienne: TEACHING VETERINARY RADIOLOGY: DOES COMPARISON HELP?
14:03 - 14:06
A. Carstens: COMPARATIVE CONVENTIONAL, SMARTPHONE APPLICATION AND RADIOGRAPHIC
GONIOMETRIC TECHNIQUES OF THE EQUINE METACARPOPHALANGEAL JOINT
14:06 - 14:09
L. Evrard: EVALUATION OF DISTAL INTERPHALANGEAL JOINT SYNOVIAL EFFUSION ON
RADIOGRAPHS: AN EX-VIVO STUDY ON 12 EQUINE FEET
14:09 - 14:12
C. De Guio: RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC FEATURES OF OESTRUS OVIS
INFESTATION IN A SHEEP
14:12 - 14:15
M. Spriet: USE OF 18F-FLUORIDE PET FOR THE DETECTION OF BONE LESIONS IN THE EQUINE
DISTAL LIMB: PILOT DATA
14:15 - 14:18
P. Pey: USE OF COMPUTED TOMOGRAPHIC BASED MODELISATION SOFTWARE TO EVALUATE THE
PRESSURE OF THE AIR FLOW IN THE UPPER AIRWAYS: A PILOT STUDY ON BRACHYCEPHALIC VS
MESO- AND DOLICHOCEPHALIC DOGS
14:18 - 14:21
U. Geissbuhler: POSTMORTEM COMPUTED TOMOGRAPHY (PMCT) FINDINGS IN THE NORMAL
CANINE LUNG
14:21 - 14:24
C. S. Baptista: COMPUTED TOMOGRAPHIC DIAGNOSIS OF PULMONARY ALVEOLAR
MICROLITHIASIS IN A BOXER
14:24 - 14:27
D. Troiano: ABERRANT RIGHT SUBCLAVIAN ARTERY CAUSING MEGAESOPHAGUS IN A CAT
14:27 - 14:30
N. Linta: CONTRAST-ENHANCED ULTRASOUND FEATURE OF GASTROINTESTINAL ISCHEMIA IN
DOGS AND CATS: A CASE SERIES
14:30 - 14:33
A. Cordella: USE OF CONTRAST-ENHANCED ULTRASONOGRAPHY FOR THE CHARACTERIZATION
OF MALIGNANT VENOUS THROMBOSIS IN DOGS
14:33 - 14:36
A. Agut: IMAGING FEATURES OF A DUODENAL DUPLICATION CYST IN A YOUNG CAT
14:36 - 14:39
A. Carloni: REVERSE COMPUTED TOMOGRAPHIC (CT) PATTERN OF VACUOLAR HEPATOPATHY
WITH FAT ACCUMULATION IN CANINE AND FELINE LIVER
14:39 - 14:42
M. A. Waschk: RETROGRADE AND INTRAVENOUES CONTRAST-ENHANCED COMPUTED
TOMOGRAPHIC FINDINGS OF A CYSTIC UTERUS MASCULINUS WITH INGUINAL HERNIATION
IN A SEVEN-MONTH OLD MALE ENTIRE MINIATURE SCHNAUZER
14:42 - 14:45
S. Hecht: THE EFFECT OF TISSUE SAMPLING ON THE MAGNETIC RESONANCE IMAGING AND
COMPUTED TOMOGRAPHY APPEARANCE OF SKIN AND LYMPH NODES IN HEALTHY CATS
14:45 - 14:48
F. Pankowski: CASE SERIES: CT EVALUATION OF SKELETAL SYSTEM INJURIES IN 5 WILD
MAMMALS AFTER ROAD COLLISIONS
THURSDAY / 01.09.2016
14:48 - 14:51
C. Gordon: MORPHOLOGICAL VARIATION OF THE CAUDAL FOSSA OF DOMESTIC CAT SKULLS
ASSESSED WITH COMPUTED TOMOGRAPHY AND GEOMETRIC MORPHOMETRIC ANALYSIS
14:51 - 14:54
J. Lodzinska: ASSESSMENT OF CRANIUM AND MANDIBULAR MORPHOLOGICAL VARIATION IN
DOMESTIC CATS AND SCOTTISH WILDCATS USING COMPUTED TOMOGRAPHY AND GEOMETRIC
MORPHOMETRIC ANALYSIS
14:54 - 14:57
N. Czubaj: COMPARISON OF VOLUMETRIC INDEX OF THE CRANIAL CAUDAL FOSSA IN NEWBORN
PUPPIES AND ADULT DOGS
14:57 - 15:00
N. Czubaj: CAUDAL EXTENT OF THE FRONTAL SINUS IN ADULT MESATI- AND DOLICHOCEPHALIC
DOGS IN CT IMAGING - PRELIMINARY RESULTS
15:00 - 15:03
J. Bonecka: CASE REPORT - MICROTOMOGRAPHICAL STUDY OF PARANASAL SINUSES IN
CRASEONYCTERIS THONGLONGYAI BAT - PRELIMINARY RESULTS
15:03 - 15:06
J. Bonecka: ANAPLASTIC OLIGODENDROGLIOMA IN CERVICAL SPINAL CORD WITH VERTEBRAL
INVOLVEMENT OF A CAT - CASE STUDY
15:06 - 15:09
P. Mantis: MAGNETIC RESONANCE IMAGING FINDINGS IN DOGS WITH INFLAMMATORY BRAIN
DISEASE
15:09 - 15:12
B. Moreno-Aguado: MAGNETIC RESONANCE IMAGING OF DEGENERATIVE ENCEPHALOPATHY IN A
NOVA SCOTIA DUCK-TOLLING RETRIEVER
15:12 - 15:15
E. Stanczyk: IMAGING THE CENTRAL NERVOUS SYSTEM OF BIRDS OF PREY WITH 3T MRI:
ANATOMIC STUDY
15:15 - 15:18
M. Kuricova: LUMBOSACRAL MORPHOMETRY IN GERMAN SHEPHERD DOGS AND BAVARIAN
MOUNTAIN DOGS
15:18 - 15:21
A. Liotta: COMPUTED TOMOGRAPHY-GUIDED INJECTION OF MUSCLE-DERIVED MESENCHIMAL
STEM CELLS IN THE LUMBOSACRAL INTERVERTEBRAL DISC OF DOGS AFFECTED BY NATURAL
DISC DEGENERATION: CLINICAL SAFETY AND INTERVERTEBRAL DISC IMAGING ASSESSMENT
15:21 - 15:24
S. Strohmayer: CT FINDINGS AND RELATIONSHIP BETWEEN SPONDYLARTHROSIS AND
INTEVERTEBRAL DISC DEGENERATION IN DOGS: A PRELIMINARY STUDY
15:24 - 15:26
G. Bolen: COMPUTED TOMOGRAPHIC FINDINGS OF A FAR LATERAL LUMBAR DISC EXTRUSION
IN A DOG
15:26 - 15:28
Y. Vali: HAS RADIOGRAPHIC CONTRAST MEDIUM AN EFFECT ON FELINE RENAL VOLUME?
15:28 - 15:30
A. Destri: MRI FINDINGS IN A CASE OF CUTANEOUS TUBERCULOSIS IN A CAT
15:30 - 17:00
EAVDI ANNUAL GENERAL MEETING
17:00 - 19:00
GUIDED CITY TOUR
Meeting at Opera House
29
Medici DR Systems
Medici
Systems
Mobile
andDR
stationary
DR retrofits
Mobile and stationary
DR retrofits
Medici
DR Systems
.........
and
and
and
have
have
have
always
always
always
been.
been.
been.
Mobile and stationary
DR retrofits
30
OR Technology (Oehm und Rehbein GmbH)
OR Technology (Oehm und Rehbein GmbH)
s
stem
y Sy
a
r
m
ry s
eo X
ysntae
tio
S
Amad
drastya s ry
n
a
X
o
bele
stem na
PAomratadX-raynsdy statiostems
Sys
le a srya
b
styem
a
t
r
Po e
-oraXyX
nary
d
a
a
t tio
Am
nd s ems
a
le
b
st
Porta X-ray sy
dicomPACS vet
R
PACS
software
dicom
PACS with
vet
Cloud solution
PACS software with
Cloud
dicomsolution
PACS vet
Portable X-ray
suitcase solution
Portable X-ray
suitcase solution
PACS software with
Cloud solution
Portable X-ray
suitcase solution
R
R
Divario CR Systems
CR systems
Divario
CR Systems
with cassettes
CR systems
with cassettes
Divario
CR Systems
CR systems
with cassettes
ORCA
Leonardo DR nano
Cloud based
archive and
ORCA
teleradiology solutions
Cloud based archive and
teleradiology
solutions
ORCA
Portable X-ray
Leonardo
DR nano
backpack solution
Portable X-ray
backpack
solution
Leonardo
DR nano
Cloud based archive and
teleradiology solutions
Portable X-ray
backpack solution
Our in-house solutions are used in more than 70 countries
Our in-house solutions are used in more than 70 countries
Active in veterinary medicine for 25 years
Ourinin-house
solutions
arefor
used
more than 70 countries
Active
veterinary
medicine
25 in
years
Several thousand satisfied customers in the
ActiveSeveral
in veterinary
medicine
25
years medicine
thousand
satisfied
customers
in the worldwide
fieldfor
of veterinary
field of veterinary medicine worldwide
Several thousand satisfied customers in the
field of veterinary medicine worldwide
[email protected]
www.or-technology.com
[email protected]
www.or-technology.com
SESSION III
III
KEYNOTE LECTURE
DWI AND PWI - USEFUL OR USELESS
Fraser McConnell, Liverpool, UK
In man the use of advanced MRI techniques (e.g. MR spectroscopy, SWI, Diffusion (DWI) and
perfusion weighted imaging (PWI) etc.) in addition to conventional MRI has been shown to
increase diagnostic accuracy and can give additional prognostic information.Reports of the
usefulness of DWI and PWI in small animals are currently limited and results are variable or
conflicting.
Diffusion-weighted Imaging provides image contrast predominately based upon the random
movement of water molecules (Brownian motion) and gives information on tissue architecture
which complements other MRI sequences. Molecular diffusion is non-uniform (anisotropic)
in most normal tissues and is restricted by tissue microarchitecture (cell membranes, microtubules, macromolecules etc. DWI is more sensitive than other sequences for detecting
pathology (e.g. infarcts) but can also be used to quantify integrity of tissues, most commonly
white matter (Diffusion tensor imaging).
DWI is commonly performed using an EPI sequence which is prone to susceptibility artefacts
which often leads to poor or non-diagnostic images in the spine, and adjacent to frontal
sinuses and tympanic bullae. Recent advances in pulse sequences have greatly improved
image quality of brain DWI in small animals which may increase its usefulness and potentially
allow DWI of areas other than the brain (spine, body).
DWI is widely used in human MRI for the early diagnosis and assessment of stroke. In ischemic stroke restricted diffusion occurs within minutes of ischemia, before pathology is visible
on conventional MRI sequences (T2W, FLAIR). Classically acute ischemic infarcts show highly
restricted diffusion, and similar changes are seen in small animals. Several studies have
shown the difficulties in differentiating tumours from strokes and other pathology in small
animals. DWI has been reported to be useful in increasing confidence of diagnosis of stroke
and this is also the authors experience. Additionally DWI is useful in ageing of ischemic
infarcts, particularly when onset of signs is unknown. Quantification of diffusion is possible
by measuring the apparent diffusion co-efficient (ADC) with greater restriction causing a lower
ADC. Whilst acute ischemic infarcts generally have lower ADC values than other pathologies,
due to the effects of infarct age on ADC values, ADC values are not specific for ischemia.
Restricted diffusion will also occur in other causes of cytotoxic oedema e.g. post-ictal
changes, some encephalitidies, toxicoses etc and also in highly viscous fluid (abscesses)
and some neoplasms (most commonly lymphoma and some gliomas).
Perfusion-weighted imaging (PWI) aims to measure the perfusion of tissue at the capillary
level and is a method of non-invasively obtaining physiological information. PWI can be
performed by a variety of methods using either exogenous tracers (i.e. gadolinium) or
endogenous tracers (magnetically labelled blood). Each technique has advantages and
disadvantages which need to be understood. Dynamic susceptibility contrast (DSC) is the
most commonly used method and involves a dynamic EPI acquisition following a bolus
injection of contrast. Following injection of the contrast there is a transient drop in signal within
the tissue due the T2* effects of gadolinium. Using mathematical modelling relative cerebral
blood flow, relative cerebral blood volume and bolus kinetics data (e.g. mean transit time)
can be calculated.. PWI can help in differentiating different types of pathology on MRI e.g.
infarcts versus gliomas and can also show abnormalities which do not result in gross structural changes. E.g reduced perfusion in cases of transient ischemic attack. In man there
is correlation between PWI parameters and tumour grade and prognosis with glial cell tumours
and it is possible similar prognostic information may be possible with PWI in small animals.
31
DIFFUSION WEIGHTED MRI OF THE BRAIN OF DOGS SUFFERING FROM
IDIOPATHIC EPILEPSY IN COMPARISON TO NORMAL DOGS. A. Hartmann1,
S. Sager1, C. Söffler1, K. Failing2, A. Schaubmar2, M. Kramer1, M. Schmidt1.
1 - Department of Vet. Clinical Sciences, Clinic for Small Animals, JLU, Germany,
35392. 2 - Unit for Biomathematics and Data Processing, Justus Liebig-University,
Germany, 35392.
Introduction
Idiopathic epilepsy is one of the most common neurologic disorders in dogs with
refractory epilepsy occurring in up to 25% of the patients. Diffusion and perfusion
weighted imaging are used in human medicine to identify epileptogenic foci to allow
for more invasive treatments. The purpose of our study was to evaluate brain diffusion
in dogs with idiopathic epilepsy (IE) and compare them to previously published data
from healthy dogs.
Material and Methods
Dogs presented to the JLU Giessen during 2013 with a final diagnosis of IE were
included. MR examination was performed using a 1.0 Tesla MR system. Dorsal and
transverse diffusion-weighted images using a single shot EPI sequence with a b value
of b=800 s/mm2 were acquired. On apparent diffusion coefficient (ADC)-maps various
regions of interest were drawn. The ADC values were recorded and compared to data
of healthy patients1. Statistical analysis was performed analogous to the analysis in
healthy dogs1. A two-way ANOVA was used to evaluate the effect of diseased versus
healthy.
Result
Seventeen client-owned dogs of 10 different breeds met the inclusion criteria. There
was a significant difference in the ADC comparing this data to published data of healthy dogs1 for the piriform lobe, the hippocampus, the semioval centre and the cerebral cortex (p < 0.05). With lower ADC values for the hippocampus and higher values
in the other regions, greatest in the cerebral cortex. The spatial distribution of values
was similar to healthy dogs.
Discussion
In human patients with epilepsy hippocampal changes are well documented. In veterinary medicine, a link between hippocampal changes and epilepsy has also been described. In hippocampal sclerosis neuronal loss and gliosis lead to an increase of the
ADC. This is in contrast to the reduced ADC we discovered. We can only speculate
about the reason. A small hypermetabolic foci may be present, as described in some
perfusion studies in human medicine, possibly leading to cell swelling and reduction in
the extracellular space, thus reducing diffusion. The increased diffusion in the cerebral
cortex in diseased dogs is possibly related to what is called a functional deficit zone in
human medicine.
References
Hartmann A., Sӧffler C., Failing K., Schaubmar A., Kramer M. Schmidt M.J., (2014):
Diffusion-weighted magnetic resonance imaging of the normal canine brain. Veterinary Radiology & Ultrasound 55, 592–598.
32
CAN WE DIFFERENTIATE RELEVANT INTERNAL HYDROCEPHALUS FROM
SUBCLINICAL VENTRICULOMEGALY BASED ON MAGNETIC RESONANCE
IMAGING? N. Ondreka1, S. Laubner1, K. Failing2, M.J. Schmidt1. 1 - Department
of Veterinary Clinical Sciences, Small Animal Clinic, University of Giessen, Germany.
2 - Department of Biomathematics, University of Giessen, Germany, 35392. Nele.
[email protected]
Introduction: There is a need for solid criteria discriminating clinically significant internal hydrocephalus from subclinical ventriculomegaly based on Magnetic Resonance
Imaging (MRI). Identifying those discriminators is challenging because of the wide
range of ventricular volumes between individual dogs and breeds. The objective of this
study was to determine criteria of clinically significant increase in intraventricular pressure based on MRI findings.
Materials and methods: MRI studies of the brain of dogs were retrieved from the
patient archive using the terms “within normal limits”, “ventriculomegaly” or “enlarged
ventricles” and “internal hydrocephalus”. Three groups were formed based on clinical
and imaging criteria: a normal group comprising dogs examined for diseases not directly related to the brain such as orbital inflammation, facial nerve paralysis, middle
ear disease, or seizures and without visible structural changes of the brain, a group
with subclinical ventriculomegaly and a group with severe clinically relevant internal
hydrocephalus. The Ventricle/Brain-Index (VBI) and a number of potential morphologic & morphometric signs of increased intraventricular pressure were recorded and
compared between the groups by two observers (DECVDI, DECVN) independently.
Chi-square or Fisher’s exact test were used to determine the siginificance of morphologic differences. One-way analysis of covariance and Student-Newman-Keuls test
were perfomed for morphologic criteria. Significance of differences in the VBI between
the groups was tested using a simple t-test for independent samples. A threshold value was estimated using a parametric reference interval calculation. Receiver operating characteristic (ROC) analysis was performed to optimize the sensitivity and specificity of the threshold. The interrater variability was determined using Bland-Altman
analysis.
Results: 67 dogs of various breeds, skull conformation and weight met the inclusion
criteria of this study. The normal group comprised n = 20, the group with subclinical
ventriculomegaly n = 25 and the group of dogs with clinical internal hydrocephalus
n = 22 dogs. Dogs with a clinically relevant hydrocephalus had a significantly higher
VBI (p < 0.001). A VBI of 0.6 was identified as threshold value between internal hydrocephalus and subclinical ventriculomegaly. Other morphologic criteria found to be
associated with a clinically apparent hydrocephalus were dorsal displacement of
the corpus callosum (p < 0.01), dorsoventral flattening of the interthalamic adhesion
(p < 0.0001), periventricular edema (p < 0.0001), dilation of the olfactory recesses
(p < 0.0001), thinning of the cortical sulci (p < 0.0001) and/or the subarachnoid space
(p < 0.0027) as well as disruption of the internal capsule adjacent to the caudate nucleus (p < 0.0001).
Conclusion: Criteria of an increase in intraventricular pressure based on MRI findings
were identified that are helpful in differentiating dogs with subclinical ventriculomegaly
from those with a relevant internal hydrocephalus. A combination of the abovementioned criteria supports the diagnosis of a hydrocephalus that requires treatment.
33
QUANTITATIVE EVALUATION OF THIRD VENTRICULAR ALTERATIONS OF
TOY-BREED DOGS IN LOW FIELD MAGNETIC RESONANCE IMAGING. Y. Choi1,
K. Kim1, H. Oh1, S. Lim1, S. Sung1, A. Yi1, Y. Jung2, and K. Lee1. 1 - College of Veterinary Medicine, Chonbuk National University, South Korea, 54596. 2 - Research
Promotion Team, Office of Research Management, Korea University, South Korea,
28503. [email protected]
In small animal practice, hydrocephalus has been frequently diagnosed via magnetic
resonance imaging (MRI) of the brain. Although enlargement of the third (3rd) ventricle is less distinctive, clinicians encounter patients with 3rd ventricle enlargement and
often describe 3rd ventricular expansion. As the 3rd ventricle is morphologically complex, to the best of author’s knowledge, there has been no previous attempt to assess
the 3rd ventricle size. Hence, the purpose of this study was to analyze the volume of
the 3rd ventricle in normal adult toy-breed dogs and hydrocephalic dogs, using low
field MRI.
Methods
Medical records from November 2009 to March 2016 were searched for hydrocephalus patients, patients with dilation of the quadrigeminal cistern and 3rd ventricle, and
patients with normal brains using low-field MRI (at 0.25 Tesla). All patients of the hydrocephalic group had seizures whereas patients in the normal group only had clinical
signs related to cervical intervertebral disc disease. Quadrigeminal cyst group had no
neurological symptom related to brain. 3rd ventricular width was defined in the transverse plane at the interthalamic adhesion level. The height of the 3rd ventricle was
measured in mid sagittal plane. The width and height to brain ratio was calculated. The
distance from the interthalamic adhesion to a thin membrane between 3rd ventricle
and quadrigeminal cistern in mid sagittal plane was considered the 3rd ventricular
length and was compared with lateral ventricle height. Based on results, unpaired t
test was conducted to verify significant difference between each group. All the measurements were obtained by one observer.
Results
Twenty-one hydrocephalic patients (lateral ventricle to brain height ratio >25%), 5 patients with quadrigeminal cysts and 3rd ventricular dilation, and 5 intervertebral disc
disease patients with normal brain MR images were selected. Among all the measurement, the 3rd ventricular width to brain ratio in the transverse plane of normal dogs
was significantly lower than that of the 21 hydrocephalic patients and 5 quadrigeminal
cyst patients. The 3rd ventricle height ratio of normal dogs and hydrocephalic patient
were 45% and 37%, and 3rd ventricular width ratio were 9% and 13% respectively.
The 3rd ventricle height ratio and 3rd ventricular width ratio of quadrigeminal cyst dogs
were 47% and 14% respectively.
It could be concluded that enlargement of the 3rd ventricle may be easily assessed by
obtaining height measurements in the mid-sagittal plane and width measurements in
the transverse plane. In addition to lateral ventricle to brain height and volume ratio,
3rd ventricle width and height to brain ratio might be considered another parameter to
evaluate hydrocephalus.
34
PROTON MAGNETIC SPECTROSCOPY IN CANINE AND FELINE INTRACRANIAL
MENINGIOMAS: THE ROLE OF GLUTAMATE-GLUTAMINE COMPLEX AND
GLUTATHIONE. E. Stańczyk, P.R. Kircher, I. Carrera. Clinic for Diagnostic Imaging,
Vetsuisse Faculty of Zurich, University of Zurich, Switzerland, CH-8057.
[email protected]
Introduction
Proton magnetic resonance spectroscopy (1H MRS) is a non-invasive technique that
provides metabolic information in intracranial diseases, such as neoplasms and meningoencephalitis. The metabolic bioprofile of neoplasms is characterized by increased choline concentration due to membrane cell turnover or breakdown, and reduced
or absent N-acetyl aspartate (NAA) due to neural death or dysfunction. Lactate and
lipids may be present. Differences in the metabolic profile between intra-axial and
extra-axial neoplasms have not been reported to date, and therefore they cannot be
yet differentiated by using 1H MRS. The aims of this study were to study the metabolic
bioprofile of feline and canine meningiomas and search specific metabolites that may
serve as metabolic markers.
Materials and Methods
3.0 Tesla magnetic resonance imaging (MRI) of the brain with single voxel, short echo
time 1H-MRS of intracranial histologically confirmed meningiomas was the inclusion
criteria for this retrospective study. MRS data were analyzed with post-processing fitting algorithm software (LCModel), and metabolite concentration relative to water were
calculated, and compared to a control group consisting of ten healthy beagle dogs
previously reported using the same 1H MRS technique. A Mann-Whitney U test was
used to evaluate normality, and independent 2-sided t tests were performed.
Results
Six cases were included: there were 4 cats and 2 dogs. Three meningiomas were
classified as meningotheliomatous meningioma, 2 as transitional meningioma and
1 as psammomatous meningioma. All were considered benign meningiomas. The 1H
MRS of all meningiomas was characterized as: severe elevation of choline concentration (2.8±0.4 mmol/L), extremely small or absent NAA peak and absent creatine.
All meningiomas included in this study had very high concentration of glutamate-glutamine complex (Glx) (16.3±2.4) and three of them had high concentration of glutathione (5.3±1.2). When compared to healthy dogs, all metabolite reached significant
differences (p<0.01)
Discussion
This study has demonstrated abnormally elevated Glx and glutathione in meningiomas. Further studies are required to assess if elevated Glx and glutathione may be
characteristic in meningiomas and if this could help to differentiate meningiomas from
other intracranial neoplasms.
35
PERFUSION WEIGHTED MAGNETIC RESONANCE IMAGING OF BRACHYCEPHALIC DOGS WITH VENTRICULOMEGALY. M.J. Schmidt1,, A. Hartmann1, K.H. von
Pückler1, L. Hähnsen2, N. Ondreka1, 1 - Department of Veterinary Clinical Sciences,
University of Giessen, Germany. 2 - Department of Biomathematics, University
of Giessen, Germany.
Introduction
It has been shown that ventriculomegaly in dogs is associated with a loss of periventricular white matter comparable to clinical relevant internal hydrocephalus or normal
pressure hydrocephalus (NPH). The pathophysiology of ventricular distension is
unclear currently. The aim of this study was to compare brain perfusion in dogs with
and without ventriculomegaly using perfusion weighted-magnetic-resonance-imaging
to clarify, as to whether abnormal perfusion might be involved in the pathophysiology
of ventriculomegaly.
Materials and methods
Perfusion was measured in 23 Cavalier King Charles spaniels with ventriculomegaly,
10 healthy Beagle dogs were examined as a control group. Perfusion-weighted
images were acquired using a dynamic multi-shot fast field echo-EPI in a dorsal plane.
40 acquisitions were per slice were acquired. Contrast was automatically injected
using a automatic pump (0.2 mmol/kg body weight) in 20 ml crystalloid solution with an
injection rate of 5 ml/sec. Contrast was given at the 10th acqusition.
Perfusion was measured using free-hand regions of interest (ROI) in five brain
regions: periventricular white matter, caudate nucleus, parietal cortex, hippocampus
and thalamus using the STROKETOOL software tool. Time to peak (TTP), regional
cerebral blood flow (rCBF), regional blood volume (rCBV), and mean transit time (MTT)
was measured. Intraobserver variability was measured using kappa statistics.
Differences between groups were tested using Mann-Whitney U tests. Significance
level was <0.05.
Results
rCBF and rCBV were significantly lower in the periventricular white matter of the dogs
with ventriculomegaly compared to control dogs (p< 0.001) but not for the other ROIs.
Kappa statistics revealed substantial agreement between measurements (0.82).
Discussion
Based on the differences in periventricular perfusion ventriculomegaly should be
interpreted as a form of normal pressure hydrocephalus (NPH) as suggested previously. The impaired perfusion might be the reason for the reduced white matter volume
in these dogs. This has been shown in laboratory rodents with experimentally induced
hydrocephalus and humans with NPH. Cognitive studies should be conducted to
investigate a possible impairment of memory, learning, and spatial orientation as
present in humans with NPH.
36
SESSION IV
IV
KEYNOTE LECTURE
CT OF THE GI TRACT
Tod Drost, Columbus, USA
Vomiting in dogs and cats is a common clinical indication for making abdominal
radiographs. Equivocal radiographic signs often necessitate re-evaluation or additional imaging procedures. These additional imaging procedures could be follow up
radiographs, an upper GI, abdominal ultrasound or abdominal CT.
In a recent study involving 20 dogs (Fifteen [15] dogs with clinical signs of gastrointestinal disease and five [5] dogs without clinical signs of gastrointestinal disease and
normal intestinal radiographs), using computed tomography was more specific
and sensitive than abdominal radiographs in dogs for detecting mechanical intestinal
obstruction. However, for recommending surgery in these dogs, using abdominal
radiographs was more sensitive and specific than CT. Neither of these was statistically significant. Objective measurement of the intestines compared to the vertebrae
and ribs were calculated, but use of these objective data did not change the recommendation for surgery for experienced radiologists.
To test the effect of reader experience on detecting canine mechanical intestinal
obstruction, 3 readers evaluated the abdominal radiographic and abdominal CT
studies described in the paragraph above. One reader had 20 years of experience,
one reader was in the first year of an imaging residency and one reader was a second
year veterinary student. For each reviewer, no statistical differences were seen between abdominal radiographs and CT for the diagnosis of mechanical intestinal obstruction. For recommending surgery, the only difference was that the least experienced reviewer had a higher specificity using CT vs. radiographs. This re-emphasizes
the use of abdominal radiographs as an initial screening test for dogs with possible
mechanical intestinal obstruction across a range of image interpretation experience
levels.
In people, vascular compromise of intestines is a key indicator for distinguishing
patients that need surgery vs. those that do not need surgery. The CT appearance of
canine abdominal vascular is well described; evaluation of the vascular compromise
to the canine stomach or intestine may be possible and this information could be used
to give more accurate patient prognosis. The optimal timing of image acquisition
following intravenous contrast medium administration is not known.
CT may be useful in the evaluation of gastrointestinal mural disease. This would
include various neoplasms and inflammatory bowel disease. Using CT, other abdominal organs and regional lymph nodes would be easily assessed to determine potential
metastasis. The use of CT for the evaluation of the gastrointestinal tract has strong
potential. Given the advancement in CT technology and the increased availability
of the modality, the use of abdominal CT for the evaluation of the gastrointestinal tract
will hopefully increase.
37
EVALUATION OF THE COMPUTED TOMOGRAPHIC “SENTINEL CLOT SIGN”
TO IDENTIFY THE BLEEDING ABDOMINAL ORGAN IN DOGS WITH HEMOABDOMEN. S. Specchi1,3, E. Auriemma1, S. Morabito1, E. Zini1, Valentina Piola2,3,
P. Pey3,4, F. Rossi4. 1 - Veterinary Institute of Novara, Italy, 28060. 2 - Centro Diagnostico Veterinario TAC Luni Mare, Italy, 19034. 3 - ANTECH Imaging Services, USA,
92614. 4 - Clinica Veterinaria dell’Orologio, Italy, 40037. swan.specchi.rad@gmail.
com
In humans, computed tomography (CT) has been demonstrated to have high sensitivity for detection of small sources of bleeding in the peritoneal cavity. Furthermore,
clotted blood has a different CT appearance than lysed blood clots or free-flowing
blood because of greater density and hemoglobin content and the highest-attenuation
hematoma, also called “sentinel clot sign”, is the one nearest to the source of bleeding.
The aim of this study was to evaluate the presence of the “sentinel clot sign” on abdominal CT examinations of dogs with hemoabdomen. Our hypothesis is that the “sentinel clot sign” will be visible and localized adjacent to the bleeding organ in dogs with
hemoabdomen.
Methods
Surgical reports databases of three different institutions were retrospectively reviewed
to identify dogs with traumatic and non-traumatic hemoabdomen that underwent surgical intervention from 2012 to 2014. Dogs were included if at least pre-contrast abdominal CT was performed and if the origin of the bleeding was confirmed with surgery,
necropsy or active extravasation of contrast media within the peritoneal cavity on the
multidetector CT angiographic images. Images were reviewed from each institution’s
radiologist independently for the presence of the “sentinel clot sign”, its localization,
HU measurements of the “sentinel clot sign” and hemoabdomen, and presence of
extravasation of contrast media within the abdominal cavity defined as presence of
high attenuating heterogeneous material in proximity of the sentinel clot sign on the
post-contrast images.
Results
Nineteen dogs met the inclusion criteria. Mean age was 11 years (range from 5 to 15)
and there were two neutered males, six intact males, six neutered females and two
intact females. No predominant breed was observed. The “sentinel clot sign” was localized in proximity of the bleeding source as confirmed with surgery or necropsy in 14
of 16 (87.5%) dogs. One dog had traumatic liver rupture while the rest of the patients
had non-traumatic hemoabdomen. The median HU of the “sentinel clot sign” was 56
(range from 43 to 70) while that of the hemoabdomen was 34 (range from 20 to 45).
Post-contrast studies were available in all patients and active bleeding was detected
in three patients that had extravasation of contrast media within the peritoneal cavity
from the bleeding organ.
The “sentinel clot sign” was visible in the majority of CT studies in this cohort of dogs
with hemoabdomen and it was adjacent to the bleeding organ in the major part of our
cases. Furthermore, we described for the first time extravasation of contrast media
during multidetector CT angiography as a CT sign of active bleeding. Identification of
the “sentinel clot sign” may help in recognizing the origin of abdominal bleeding and
special attention should be drawn to detect this feature if organ rupture is suspected in
dogs with hemoabdomen.
38
SHORT COLON SYNDROME IN CATS. A.B. Le Roux1, T. Donovan2, D. Palma3,
L. Hoyt4, A. Fischetti1. 1 - Diagnostic Imaging unit, 2 - Histopathology unit, 3 - Internal
Medicine unit, The Animal Medical Center, New York, USA. 4 - Radiology unit, Blue
Pearl, New York, USA. [email protected]
Introduction
Feline short colon syndrome has been sporadically described in Veterinary Medicine,
with previous case reports documenting a lack of visualization of the ascending and
transverse colon, and a subjective radiographical colonic shortening. This study describes a larger case series of cats diagnosed with short colon.
Methods
Descriptive study including prospective and retrospective cases from our institution.
Inclusion criteria were shortening of the colon (subjective or quantitative, compared
to a normal reported post-mortem length of 32.6 ±5.1 cm) on abdominal ultrasound,
endoscopy, necropsy, or a combination of any of these 3 modalities.
Results
Fifteen cats (7 females/8 males) were included (12 retrospective/3 prospective), with
a mean age of 11.4 ±3.7 years. The most common clinical presentation was chronic
large bowel diarrhea, weight loss, ± hematochezia. Ultrasound was available in 13
cats. Subjective colonic shortening was reported ultrasonographically in 12 cats, with
lack of visualization of a normal ascending and transverse colon, and left displacement of the ileocolic junction (ICJ) toward the left kidney, immediately cranial to the
urinary bladder apex. Thickening of the wall was noted, with severe irregular submucosal and muscularis layer thickening, without intestinal layering effacement. Radiographs were available for 2 patients and showed a short descending colon, lack of
ascending or transverse colon visualization, with an average colonic length of 16 cm.
Endoscopy was performed in 7 cases, with erythematous thickened wall, and
increased friability commonly visualized. Endoscopic measurements were available
for 4 of the cases, with an average of 17 ±2 cm in length. Finally, short colon was
diagnosed at necropsy in 2 patients, with an abnormal ICJ, shortened or even absent
cecum, and a markedly shortened colon observed (9 cm in length reported for one
case). Histological samples (7 endoscopic/2 post-mortem) were available for 7
patients and revealed mild-to-moderate active chronic neutrophilic to lympho-plasmacytic colitis, with none (2/9), mild (5/9) and moderate (2/9) mucosal fibrosis.
Discussion
Short colon pathological mechanism remains poorly understood. A congenital origin,
with agenesis of the proximal colon has been considered, although clinical signs in
most of the patients appear later in life, rather than in a young age, as would be expected with a congenital origin. Acquired causes, such as chronic colitis with severe fibrosis, have also been considered. However, based on our study, colonic wall retraction
secondary to chronic fibrosis was considered less likely, as the amount of mural fibrosis was only mild-to-moderate histologically. Finally, abnormal contractility or morphology of the intestinal smooth muscle layers could serve as mechanism, yet further
evaluation would be required to confirm this hypothesis.
39
NORMAL ULTRASONOGRAPHIC FEATURES OF THE PYLORUS IN 153 DOGS
AND CLINICAL APPLICATIONS. G. Gory1, D.N. Rault2, L. Gatel3, L. Couturier2,
E. Cauvin2. 1 - Olliolis, 83190 Ollioules, France, 2 - Azurvet, 06800 Cagnes-sur-Mer,
France, 3 - Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820,
Belgium. [email protected]
The pylorus has rarely been described ultrasonographically in dogs despite being
involved in many disorders. The aim of this study was first to evaluate normal ultrasonographic features of the pylorus, compare ultrasonographic with histological findings,
and illustrate clinical applications.
Methods
A hundred and fifty three dogs free from gastrointestinal signs were assessed without
sedation, in dorsal recumbency. Four weight groups were created. Pyloric sphincter
wall (Pw) and pyloric sphincter muscularis (Pm) thicknesses were measured and the
effect of body weight on these measurements was analyzed statistically (Spearman’s
rank correlation test). Seven dogs were euthanized for reasons unrelated to digestive
tract disorders and ultrasonographic features were then compared with histopathological findings. Seven dogs with anorexia and/or vomiting were also evaluated to
illustrate clinical applications.
Results
Normal ultrasonographic features correlated well with the normal histological structure
described in the literature and observed in 7 euthanized dogs: 5 concentric layers
could be identified. In longitudinal images, the pylorus had a hypoechoic, triangular
shaped muscularis and the proximal duodenal submucosa is thick. Mean (± SD)
values obtained for Pw were 5.3mm (± 1), 6.2mm (± 0.9), 6.8mm (± 1.3), 7.4mm (± 1)
for dogs weighing less than 10 kg, 10-19.9kg, 20-29.9kg and over 30kg respectively.
Mean (± SD) values obtained for Pm were 2.9mm (± 0.7), 3.2mm (± 0.5), 3.4mm
(± 0.8), and 3.9mm (± 0.9) for the same weight groups respectively. The outcomes of
the 7 clinical cases were: duodenogastric reflux, mucosal hypertrophy, pyloric polyp,
pyloric abscess, gastric ulcers and a foreign body.
Our study provides a detailed description of the canine pylorus and thickness measurements of this region, based on a large number of dogs and good correlation with
histological findings. The proximal duodenal submucosa is thick because of the
presence of numerous Brunner’s glands that help neutralize the acidic chyme from the
stomach and thus protect the duodenal mucosa. The 4 weight groups created allowed
us to demonstrate a significant positive correlation between thickness measurements
and the animals’ weight. The pylorus can be assessed accurately in most dogs using
ultrasound. It could help assess and differentiate healthy pylorus from clinically
or subclinically abnormal gastroduodenal junction in dogs. For these reasons, identification and evaluation of the pylorus should be part of the routine ultrasonographic
abdominal examination.
40
“TANGLE SIGN” ON THE VENTRO-DORSAL PROJECTION OF ABDOMINAL
RADIOGRAPHS OF SPAYED FEMALE CATS CORRESPONDS TO A SPLENO-SYSTEMIC SHUNT. S. Specchi1,3, A.M. Adrian2, G. Spattini3, P. Pey4, M. Paek5.
1 - Istituto Veterinario di Novara, Italy, 28060. 2 - Dick White Referrals, UK, CB8 0UH
3 - Clinica veterinaria Castellarano, Italy, 42014. 4 - ANTECH Imaging Services, USA,
92614. 5 - Hope Advanced Veterinary Center, USA, 20850. [email protected]
Introduction/Purpose: On digital radiographs of some feline patients, we observed
the presence of a tubular tortuous soft tissue opacity within the mid-left abdominal
cavity on the ventrodorsal projection. This tubular structure was usually localized
caudal to the spleen, and lateral to the left kidney. Spleno-systemic shunts have been
recently described in feline patients, with spayed females being overrepresented. The
acquired or congenital origin of these shunts and their clinical significance has not
been established. These vessels originated from the splenic vein and ended at the
level of the left renal vein, ovarian vein, or caudal vena cava. Our hypothesis is that
the tubular tortuous soft tissue opaque structure visible on the abdominal radiographs
of some cats, corresponds to spleno-systemic shunts.
Methods: Radiographic report databases of the Hope Advanced Veterinary Center
and the Istituto Veterinario di Novara were reviewed from 2014 to 2015 to identify
feline patients with the presence of a tubular tortuous soft tissue opacity within the
left abdominal cavity on the ventro-dorsal radiographic projection. Patients were
included if concomitant abdominal ultrasound (US) or computed tomography (CT)
were available. Presence of hepatic disease or portal hypertension were recorded
if present.
Results: Eleven cats met the inclusion criteria. All cats were female spayed. The age
of the patients ranged from 9 to 15 years and all were domestic shorthair cats. On all
radiographs this tortuous tubular soft tissue opacity demonstrated a „tangle-like” appearance. Presence of a tortuous vessel originating from the splenic vein in proximity of
the splenic hilus and anastomosing at the level of the left renal vein or caudal vena
cava, consistent with a spleno-systemic shunt, was confirmed with US or CT in all
patients. One patient had a hepatic liposarcoma with no evidence of portal vein
invasion or signs of portal hypertension. The rest of the cats had ureteral obstruction
(n=2), gastroenteritis (n=1), pancreatic neoplasia (n=2), cholangiohepatitis/pancreatitis (n=1), hyperthyroidism (n=1), maxillary bone neoplasia (n=1), cystitis (n=1) and
enteritis (n=1).
Discussion/Conclusions: This study confirmed the presence of spleno-systemic
shunts in feline patient with “tangle like” soft tissue opacity visible in the left central
abdomen on the ventrodorsal projection. Hence we propose the term „tangle sign” to
describe these spleno-systemic shunts on radiographs. All the patients included in the
study were spayed female confirming the previous hypothesis where this category of
patients may be predisposed to spleno-systemic shunt. Spleno-systemic shunts may
have no clinical significance given the fact that most of the patients in this study had
no signs of portal hypertension. The “tangle sign” may be localized within the area of
projection of the peripheral left pancreatic limb and should not be interpreted as focal
loss of serosal detail nor a mass as could be seen with acute pancreatitis, left pancreatic lobe neoplasia, carcinomatosis/sarcomatosis or abdominal effusion.
41
CONTRAST ENHANCEMENT IN DYNAMIC LIVER MRI AFTER ADMINISTRATION
OF GADOXETIC ACID IN HEALTHY BEAGLE DOGS. P. Borusewicz1, E. Stańczyk2,
K. Kubiak1, J. Spużak1, K. Glińska-Suchocka1, M. Jankowski1, J. Nicpoń2,
P. Frelkiewicz2, P. Podgórski3. 1 - Department of Internal Medicine, 2 - Center of
Experimental Diagnostics and Innovative Biomedical Technology, Faculty of
Veterinary Medicine, University of Environmental and Life Sciences, Wroclaw, Poland,
50-366. 3 - Department of General and Interventional Radiology and Neuroradiology,
Wroclaw Medical University, Poland, 50-566. [email protected]
Introduction
Gadoxetic acid is a liver-specific contrast agent widely used in human medicine to
detect and characterize hepatic nodular lesions. Gadoxetic acid acts similar to extracellular contrast media in the vascular phase and accumulates in hepatocytes and
causes T1-shortening of normal liver parenchyma in the hepatobiliary phase. In veterinary medicine, little is known about the kinetics of this process. This knowledge is
important to design an optimal imaging protocol to evaluate the liver parenchyma. The
aim of this study was to examine the dynamic changes in contrast enhancement of the
liver parenchyma in healthy dogs after the administration of gadoxetic acid.
MRI was performed on eight healthy beagle dogs using a 1.5T scanner (Philips Ingenia, The Netherlands) and a 32-channel torso phased array coil. The imaging protocol
consisted of breath triggered T1, T2 and dynamic T1 weighted sequences performed
in the transverse plane. The dynamic T1 weighted sequence was performed with
single, 10 mm thick slice at the level of the gallbladder. During the dynamic sequence,
gadoxetic acid (Primovist®, Bayer Pharma, Germany) was administered (0.025 mmol/
kg, i.v.) through a self-constructed infusion pump. The examination was subsequently
continued for 120 minutes in four dogs and 150 minutes in the remaining dogs. Three
ROIs were placed in the liver parenchyma for a quantitative analysis (Extended MR
Work Space 2.6.3.5, Philips Medical Systems, The Netherlands).
Results
Complete MRI was performed in seven dogs; the examination was discontinued 80
minutes after contrast administration in one case due to anesthetic concerns. In the
pre-contrast examination, the liver parenchyma was homogeneous, mildly T1 hyperintense and moderately T2 hypointense in comparison to the spleen. Following contrast
administration, hepatic enhancement increased quickly, reaching maximal values
within 26 minutes. The plateau phase was short (15-30 minutes) and was followed
by a long period of slow decrease of contrast enhancement. The values of contrast
enhancement did not decrease below 71.6% during the observation time in any of the
animals. The maximum relative enhancement 217.23% (SD = 71.33), time to peak
1552.61 s. (SD = 218.79) and wash in rate 25.79/s (SD = 10.47) were determined
based on the contrast enhancement curve.
Conclusions
According to the authors’ knowledge, this is the first report of a dynamic gadoxetic
acid enhanced MRI study evaluating the hepatic parenchyma in healthy beagle dogs.
Data from this study may be used to design an optimal imaging protocol to evaluate
MRI of contrast enhancement of lesions within the liver parenchyma.
42
SESSION V
V
MASTERCLASS LECTURE
PET FOR PETS – POSSIBILITIES AND PITFALLS WITH PET/CT
Åste Søvik, Østerås, Norway
PET/CT is a powerful tool for obtaining both anatomical and functional information
during a single diagnostic imaging session. The use of PET/CT is rapidly increasing in
human medicine, and PET/CT is also starting to make its way into veterinary radiology.
The PET/CT scanner consists of a full ring coincidence detector for positron emission
tomography, mounted on the same gantry as a CT system. Functional information is
obtained from positron decay of a radiotracer that has accumulated in the tissue
of interest, while the CT gives detailed anatomical information on the location of the
region of increased radionuclide uptake, as well as information used for attenuation
correction of the PET images. The most commonly used radiotracer in PET is the
glucose analogue fluorodeoxyglucose (FDG), labelled with the positron emitter 18F.
FDG accumulates in tissues with increased glucose metabolism, both from pathological and physiological processes, e.g. in neoplasia and in normal brain tissue, respectively. Hence, a thorough understanding of both the pathophysiology of the disease
in question, as well as the normal physiology of the species being imaged is essential
for interpretation of PET images and this will be addressed during this presentation.
Examples of alternative PET tracers, such as 18F-labelled fluoromisonidazole
(FMISO) for visualization of hypoxia and fluorothymidine for visualization of proliferation, will also be given.
In both human and veterinary medicine, the main application of PET/CT is in oncology,
where PET/CT is used for diagnosis, staging, treatment planning and monitoring and
response assessment. Other applications of PET/CT include neurology, cardiology,
infectious diseases and orthopedics. In this presentation, I’ll provide an overview of
veterinary applications of PET/CT published so far and then discuss in more detail its
oncological uses, both in human and veterinary medicine.
PET/CT offers the possibility of true quantitative imaging, and numerical values are
often recorded and reported as part of PET/CT studies, in particular for response
assessment in oncology. The metabolic rate of glucose, derived from dynamic PET
images through pharmacokinetic modelling, is often considered the gold standard for
quantitative PET/CT imaging. However, since dynamic PET/CT is rarely performed in
a routine clinical setting, the standardized uptake value (SUV), a simplified measure
that can be obtained from static images, is the most commonly used semi-quantitative
measure used in PET/CT image interpretation. In this presentation, I’ll describe how
the SUV is calculated and used in image analysis, as well as the factors influencing
the SUV and some of the potential pitfalls in quantitative image analysis. To round off,
I’ll discuss some of the latest developments in PET/CT imaging research.
43
TEACHING VETERINARY RADIOLOGY: DOES COMPARISON HELP?
Anne-Laure Etienne¹, Catherine Delguste2, Valeria Busoni¹. 1 - Diagnostic Imaging
Section, Department of clinical sciences, Faculty of Veterinary Medicine, University
of Liège, 4000 Liège, Belgium. 2 - General Services of Faculty of Veterinary Medicine,
University of Liège, 4000 Liège, Belgium. [email protected]
Comparison learning is an approach for learning complex visual tasks. As described in
human medicine, by comparing radiographs with pathology and without pathology,
veterinary students could learn to discriminate relevant disease-related information to
recognize the disease. We hypothesized that exposure to a training by side-by-side
comparison of normal to abnormal radiographs would lead to higher visual diagnostic
accuracy and possibly to a higher ability to describe the features of a known disease
on canine thoracic radiographs.
Material and methods
Twenty veterinary students were randomly assigned to either a group that compared
radiographs showing thoracic disease with normal images (group 1) or to a group that
only studied abnormal radiographs (group 2). All students had their theoretical radiology
teaching and 13 of them had also received the practical teaching of the study curriculum,
evenly distributed between the 2 groups. All participants gave written informed consent.
Twenty-nine radiographs of small animal thorax were used. The procedure consisted
in three experimenter-supervised phases: 1. training, 2. visual recognition test, 3.
feature description test. In the training phase, each screen showed two radiographs
with the name of the disease present in each. In the group 1 (pathology/normal
condition), a radiograph of a patient and a normal image were shown next to each
other. In the group 2 (pathology/pathology condition), two radiographs of patients with
the same disease were shown next to each other. The 9 screens were presented
twice, with the diseases in a different order for the first and second runs. A MannWhitney test was used to compare the success rates of groups of students.
Results
On visual recognition test, there was no statistical difference in visual diagnostic
accuracy between groups. The number of false negatives was very low in comparison
to false positives. When students gave the wrong answer, they often diagnosed the
item as another disease of similar distribution (diffuse or focal). Students who received
the practical teaching and students of group 1 had a higher accuracy for normal
thoracic radiographs. On feature description test, no significant effect of comparison
learning was found, but focal diseases were better described than diffuse diseases
with a significant difference between these.
Results show that comparison with normal images did not help in recognizing or
describing thoracic pathologies but helps to recognize normal images.
44
COMPARATIVE CONVENTIONAL, SMARTPHONE APPLICATION AND RADIOGRAPHIC GONIOMETRIC TECHNIQUES OF THE EQUINE METACARPOPHALANGEAL JOINT. K. Ross1, V. Geddes1, A. Carstens2, 1 - Equine-Librium College,
South Africa, 6600. 2 - University of Pretoria, South Africa, 0110.
[email protected]
Goniometry is the measurement of the angles through which a joint is able to flex and
extend to quantitate the range of motion to establish baseline limitations of motion,
decide on and document appropriate therapeutic interventions and document their
effectiveness. The use of smart phone applications in goniometric application has
been reported in humans and dogs. Radiographic joint angle measurement is the gold
standard but has logistic limitations in the physical therapy workplace. A goniometric
smartphone application could be a useful applicable bedside application. Correlation
of the universal goniometer (UG), “DrGoniometer” (DrG) smartphone application (app)
and radiographic measurements of the metacarpophalangeal (MCP) joint angle of the
horse was conducted.
Methods
Both fore metacarpophalangeal joint angles were measured in thirty horses using a
UG, the photography-based DrG app and a lateral digital radiograph. For Part 1 of the
study a dorsally placed known angle template in the form of a cast was used to
standardise the angle of the MCP joint; in Part 2 the MCP joint was held in full flexion
by one of the authors. The examiner holding the limb was blinded to the readings while
the other recorded the UG values, and took the photograph and radiograph.
Radiographic angles were measured and the positioning of the markers for DrG
photograph angle measurements was determined. Correlations (Pearson’s) and an
ANOVA was performed (P<0.05). There was no conflict of interest for any of the
authors; all animals were treated according to the ethical requirements of the Equine–
Librium College. Partial funding was provided by the National Research Foundation.
Results
Flexed angles correlated well: the DrG app versus radiographs showing the highest
correlation (0.922), the UG versus radiographic correlation was ρ=0.909 and the UG
versus DrG app correlation was ρ=0.873. Cast correlations were less accurate: UG
versus DrG being ρ=0.681, DrG versus radiograph ρ=0.526 and radiograph versus
UG ρ= 0.515. Significant angle differences were found between cast and flexed
(P<0.0001), between cast UG and radiograph (P=0.009), and no difference among the
flexed angles.
This indicates, the DrG app to be a reliable tool to measure the angles of MCP flexion
in the horse, appearing to be more accurate than the conventionally used UG compared
to radiographs. Benefits of smartphone goniometric apps include automatic angle
calculation, ease of use, convenience and cost effectiveness. Patients can be monitored
in the stables and images are easily added to the patients’ records.
45
EVALUATION OF DISTAL INTERPHALANGEAL JOINT SYNOVIAL EFFUSION
ON RADIOGRAPHS: AN EX-VIVO STUDY ON 12 EQUINE FEET.
P. Mendoza1, L. Evrard2, J.-M. Denoix3, S. Rabba4, V. Busoni2. 1 - Universidad Andres
Bello, Escuela de Medicina Veterinaria, Servicio de Imagenologia – Chile – 8370251.
2 - Université de Liège, FMV, Service d’Imagerie Médicale - Belgium – 4000. 3 - CIRALE, ENVA - France – 14430. 4 - Istituto Veterinario de Novara, diagnostica per immagini - Italy - 28100
This ex-vivo study aimed to establish sensitivity, specificity, predictive values and accuracy of radiographs in detection of distal interphalangeal joint (DIPJ) synovial effusion on 12 isolated feet and to correlate degree of effusion to a radiographic score.
Methods
Seventy-two radiographs were obtained on 12 distal forelimbs (normal at inspection
and at radiographic examination) of adult warmblood horses euthanized for reasons
unrelated to the study. Isolated limbs were placed in extension using a rope system,
screwed to the hoof wall, in order to simulate standing position. The joint was emptied
and 4 consecutive lateromedial views were taken before and after filling the joint with
a total of 3, 6 and 12 ml of water. Dorso75°lateral-palmaromedial and dorso75°medialpalmarolateral oblique views were also taken after maximal joint filling. The radiographs were randomized and presented to 4 readers for independent and blinded scoring
(0: no distension; 1: mild distension; 2: moderate distension; 3: severe distension).
Average scores were then calculated. Sensitivity, specificity, predictive values and
accuracy were calculated on lateromedial views for absence or presence of effusion.
Correlation between injected volume and radiographic scores on lateromedial and
oblique projections was also calculated using respectively Spearman and Wilcoxon
signed-rank tests.
Results
Radiographs identified synovial effusion with a sensitivity of 0.81, specificity of 0.83,
positive predictive value of 0.90 and negative predictive value of 0.69. Accuracy was
calculated at 0.82. There was a positive correlation between injected volume and radiographic scores (r2 = 0.82571, p<0.05). A trend toward higher percentage of correct
scoring was observed in non-distended compared to distended joints. A trend toward
underestimation of distension was seen on oblique views.
Results of this study suggest that lateromedial view of the equine foot can be considered reliable to assess presence and degree of DIPJ effusion on isolated limbs, and
obliquity should be avoided as this may potentially result in a lower detection rate of
effusion. However, on clinical cases radiography does not allow to discriminate fluid
effusion from proliferation of the synovial membrane.
46
RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC FEATURES OF OESTRUS
OVIS INFESTATION IN A SHEEP. C. De Guio, K. Nottrott, M.Schramme, G. Bourgoin,
E. Segard. VetAgro Sup, France, 69280. [email protected]
Introduction
Infestation by Oestrus ovis larvae is a very common disease in Mediterranean regions
such as the south of France. Oestrus ovis larvae are obligatory parasites of the nasal
and sinus cavities in sheep and goats. To the authors’ knowledge, no specific case
reports of the radiographic and computed tomographic features are available in the
literature.
Case report
An 8-year-old sheep was presented because of chronic dyspnea and bilateral
mucopurulent nasal discharge. The sheep had been treated unsuccessfully with
several courses of albendazole. On physical examination, the sheep was depressed
but in good body condition. Respiratory effort was increased at rest (75 bpm) and
tachycardia (90 bpm) and hyperthermia (39.8 °C) were present. Percussion of the left
frontal sinus elicited a dull sound. Submandibular lymph nodes were enlarged.
Lateral and dorsoventral radiographs of the skull revealed diffuse, homogeneous, soft
tissue opacity in both right and left maxillary and lacrimal sinuses. Three well-delineated,
ovoid, partially mineralized structures were seen in both maxillary sinuses. A similar,
irregularly shaped but more circular structure was visible rostral to the ethmoid bone
in the right lacrimal sinus.
Computed tomographic images of the head were acquired in helical scan mode
(CT GE brightspeed 16 Elite®), at 120 kV and 100-225 mA tube settings, a pitch of
0,938 and 1,25 mm slice thickness. Images were reconstructed with bone and soft
tissue algorithms.
The left and right maxillary, lacrimal and palatine sinuses were completely or partially
filled by soft tissue density. Ovoid structures with a hyperdense rim were present in the
rostral part of the right and left maxillary sinuses. In the other sinuses of both sides,
several smaller hyperdense structures were also seen.
These findings were consistent with chronic infestation by partially mineralized parasitic
larvae and secondary chronic sinusitis.
Partially mineralized larvae and tissues were extracted from the sinuses during
a frontomaxillary sinusotomy. The morphological analysis of extracted larvae confirmed
the presence of third-instar larvae of Oestrus ovis.
Discussion/conclusion
This case constitutes the first radiographic and computed tomographic description of
a chronic infestation by Oestrus ovis. This presentation is considered unusual for
Oestrus ovis infestation. Radiographic examination of a larger number of sheep would
allow for a more precise evaluation of the prevalence of chronic infestation with
mineralized Oestrus ovis.
47
USE OF 18F-FLUORIDE PET FOR THE DETECTION OF BONE LESIONS IN THE
EQUINE DISTAL LIMB: PILOT DATA. M. Spriet1, P. Espinosa1, A. Z. Kyme1,
K.L. Phillips1, S.A. Katzman1, L.D. Galuppo1, D. Beylin2. 1 - School of Veterinary
Medicine, University of California, Davis, CA, 95616, USA. 2 - Brain Biosciences Inc.,
Rockville, MD, 20852, USA. [email protected]
The recent development of compact portable positron emission tomography (PET)
scanners has made this modality available for imaging the equine distal limb. Amongst
the large variety of radionuclides available for PET imaging, 18F- Sodium Fluoride
(18F-NaF) is of particular interest in orthopedic imaging. 18F-NaF PET has been found
useful for detection of early osteoarthritis and occult subchondral bone lesions in
humans. The goals of this project were: (1) to define and validate a protocol for 18F-NaF
PET imaging in the horse and (2) to obtain preliminary data to confirm the potential
utility in the horse.
Methods
Three research horses with lameness due to lesions of the distal limb were included in
the study. Horses were placed under general anesthesia and administered 740 MBq
(20 mCi) of 18F-NaF intravenously. Imaging was performed using a portable PET
scanner with a 22 cm axial field of view and 2 mm spatial resolution (PiPET10, Brain
Biosciences Inc., Rockville, MD, USA). Imaging started 45 minutes after injection.
Both front feet and fetlocks were imaged on each horse. The imaging time for each
area was 15 minutes. A CT scan of the distal limb was performed during a separate
anesthetic episode. MRI and bone scintigraphy were performed under standing
sedation. The PET images were fused with the CT images for interpretation. The PET
findings were compared with the other imaging modalities assessed by 2 independent
radiologists.
Results
The 18F-NaF scans demonstrated a wide variety of abnormal uptake, for example at
ligament attachments, subchondral bone, periarticular areas and solar margin of the
distal phalanx. Several findings were not identified with other modalities. These
included uptake in the central part of the flexor cortex of the navicular bone, at the
attachment of the chondrosesamoidean ligament on the distal phalanx, and in the
subchondral bone of phalanges or third metacarpal bone. Among the osteophytes,
enthesophytes and osseous fragments identified on CT, some but not all demonstrated
18F-NaF uptake.
18F-NaF PET provided functional bone data with a higher spatial resolution than
scintigraphy and with the advantage of cross-sectional imaging. This led to the
detection of lesions not identified using other imaging modalities. 18F-NaF PET also
allowed differentiation between active and inactive osseous lesions. Although further
work is needed to confirm the findings of this pilot study, these results suggest that
18F-NaF PET/CT could be an invaluable tool to improve early diagnosis and monitoring
of lesions in clinical patients.
48
USE OF COMPUTED TOMOGRAPHIC BASED MODELISATION SOFTWARE TO
EVALUATE THE PRESSURE OF THE AIR FLOW IN THE UPPER AIRWAYS:
A PILOT STUDY ON BRACHYCEPHALIC VS MESO- AND DOLICHOCEPHALIC
DOGS. Rocio Fernandez-Parra1, Pascaline Pey1,2, Luca Zilberstein1, Mauro Malvè3.
1 - National Veterinary School of Alfort, France, 94700. 2 - ANTECH Imaging Services,
USA, 92614. 3 - Aragon Institute of Engineering Research, University of Zaragoza,
Spain; Centro de Investigacion en Red en Bioingenierıa, CIBER-BBN, Biomateriales
y Nanomedicina, Zaragoza, Spain; Departamento de Ingenierıa Mecanica,
Energetica y de Materiales, Universidad Publica de Navarra, Pamplona, Spain.
[email protected]
Introduction
This study aimed to assess the feasibility of the computational fluid dynamics (CFD)
for the evaluation of airflow (pressure, flow and resistances) through the upper airway
of dogs with different skull conformation. The model of the Brachycephalic Obstruction
Airways Syndrome (BOAS) was taken to test the feasibility and evaluate if this new
non-invasive technique could illustrate the increased negative pressure in
brachycephalic dogs as other non-imaging techniques do.
Nine healthy dogs (three dolichocephalic, three mesocephalic and three brachycephalic)
were enrolled. Their conformation was determined based on calculation of their
cephalic index obtained on CT images. After sedation, using always the same
standardised protocol, computed tomographic images (CT, Brilliance 64; Philips,
Netherlands) of the complete upper airway tract (from the nose to the main stem
bronchi) were acquired on non-intubated, sternally recumbent dogs. Geometrical
reconstructions (MIMICS software; Materialise, Belgium) from the nostrils to the carina
of the trachea were carried out and fluid dynamics analyses were performed (Ansys
Software, USA).
Results
No adverse effects due to the sedation protocol or CT examination were observed. In
the geometry pre-processing of the upper airways, anatomical differences were noticed
between brachycephalic and other types of dogs. The virtual peak inspiratory flow was
1.125 L kg -1 min-1 and 0.83 L kg -1 min-1 for dolicho- and mesocephalic and for
brachycephalic dogs respectively. Flow (L min-1), pressure (cmH2O) and resistance
(cmH2O L-1 min-1) were computed from nose to pharynx and to trachea. Computed
resistances and pressure drops in tracheas were higher in the brachycephalic dogs.
Discussion
The CFD technique combined to CT-images was a safe non-invasive technique that
allowed identification of high airway resistance in healthy brachycephalic dogs. This
approach may become clinically useful provided in vivo measurements support the
obtained results.
49
POSTMORTEM COMPUTED TOMOGRAPHY (PMCT) FINDINGS IN THE NORMAL
CANINE LUNG. W.R. Pownall1, K. Gendron2, A. Christe3, U. Geissbühler1.
1 – Section of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse
Faculty, University of Bern, Switzerland, CH-3001. 2 - Section of Diagnostic Imaging,
Cornell University Hospital for Animals, Ithaca, USA. 3 – Radiology Institute, Association
of Human Hospitals, Bern, Switzerland. [email protected]
The owner compliance for pet autopsies is decreasing due to the increasing social
value of pets, and imaging modalities are potential alternatives to conventional autopsy.
Aim of this study was to describe postmortem computed tomography (PMCT) changes
in the normal canine lung to serve as a reference for radiologists.
Methods
Four Bernese Mountain dogs without history of respiratory disease were scanned
within 2.25 and 113.5 hours after euthanasia. PMCT findings of the diaphragm, trachea,
bronchi, pleural space and lung tissue were reviewed by all 4 authors. Each lung lobe
(LL) was evaluated separately and decisions were taken by consensus. The cranial
and caudal segment of the left cranial LL were considered as separate lobes. Autopsy
was performed on every dog after PMCT. Autopsy findings reported autolytic pulmonary
changes in most subjects, but no thoracic abnormalities.
Results
Fluid was identified in the bronchi of 8/12 of dependent LL. Increasing pulmonary
density from hypodense (non-dependent side) to hyperdense (dependent side)
appeared after death and increasing Hounsfield Units of the lungs over time after
death was observed. Every dog had nodular changes in at least one LL, most commonly
small centrilobular ill-defined nodules (11/28 LL). Reticular modifications were found in
all dogs (24/28 LL) with parenchymal bands present in 15/28 LL. Ground glass opacity
was present in all four dogs. Livor mortis was detected in 3/4 dogs in the non-dependent
LL, except for the dog with the shortest time between euthanasia and CT scan.
Consolidation was found in 18/28 LL, with a peripheral and/or subpleural distribution
in 8/18 and a sternal distribution in 6/18. Bronchiectasis was documented in 23/28 LL
and ranked as mild in 17 and moderate and severe each in 3/23 LL. Most frequently
bronchiectasis was located within 1cm to the pleural surface (18/28 LL). A subpleural
bulla was found in one LL.
CT findings of the normal postmortem canine thorax are highly different to CT findings
of the normal thorax of living dogs. Radiologists have to acquire additional engrams to
be able to evaluate PMCT studies of the canine thorax. According to the human
literature bullae, bronchiectases are no normal postmortem findings. They can be
overlooked during a routine autopsy protocol.
50
COMPUTED TOMOGRAPHIC DIAGNOSIS OF PULMONARY ALVEOLAR
MICROLITHIASIS IN A BOXER. J.C. Santos1, A. Canadas2, C. Landolt1, C. Gomes1,
P. Dias-Pereira2, M. Faria1, C.S. Baptista1. 1 - ICBAS-UP, UPVet, Portugal, 4050-313.
2 - ICBAS-UP, Department of Molecular Pathology and Immunology, Portugal,
4050-313. [email protected]
In humans, pulmonary alveolar microlithiasis (PAM) is a very rare genetic lung disease
in which multiple microscopic calcium phosphate microliths are deposited within the
alveoli of both lungs. Non-invasive imaging modalities such as computed tomography
(CT) are an important diagnostic tool because it can provide highly characteristic
features of this disease. Very little is known in dogs and cats due to the paucity of
cases reported and to the author`s best knowledge none have described CT features
of this disease. The aim of this case report is to describe the CT characteristics of a
histologically confirmed PAM in a Boxer.
Methods
A 7-year-old female spayed Boxer was presented with a history of paroxismal loss of
consciousness with strong emotions, with one week duration. The main differentials
were seizures, syncope (cardiovascular, neurally mediated, respiratory, hypoglycemia)
and narcolepsy cataplexy. Physical examination, blood work, Holter and three-view
thoracic radiographs were performed. CT of the head and thorax, before and after
intravenous injection of iodinated contrast medium (740 mg I/Kg) administered into the
cephalic vein, was also performed with a 16-slices scanner. The animal was premedicated with methadone, anesthetized with propofol and maintained with isofluorane.
Axial images were acquired using helical 1.3-2.5 mm thickness with bone, soft tissue
and lung algorithms. A necropsy was performed.
Results
Physical examination, blood work, Holter and CT of the head were within normal limits.
Thoracic radiographs revealed micronodular calcified opacities predominantly localized
in the cranial left and right lung lobes giving a sandstorm appearance. CT scans of the
thorax showed numerous mineralized high density agglomerates of multiple sizes (up
to 3.8 mm) throughout the parenchyma. There was also thickening of the pleural lining
and interlobular septal forming a diffuse honey combing pattern. In the caudal right,
caudal left and accessory lobes was visible a ground glass opacity with clear bronchial
and vascular margins. On necropsy examination lungs were dense, rigid and gritty.
The visceral pleura exhibited an irregular, rough thickening. Histological examination
revealed multiple spherical concentrical calcified concretions in the interstitium and
alveolar lumen. Based on the morphological and imaging findings, a final diagnosis of
pulmonary alveolar microlithiasis was achieved.
It was not possible to establish a correlation between clinical signs and PAM, as in
humans where clinical-radiological dissociation is a hallmark of the disease. However,
CT features correlate well with specific pathologic findings, so the diagnosis of PAM
can be made on the basis of the typical radiological pattern. In this case report, the
presence of elevated number and size of microliths and intense calcified fibrosis of the
pleural lining and interlobular septa strongly suggests the diagnosis of pulmonary
alveolar microlithiasis, as seen in human advanced cases.
51
ABERRANT RIGHT SUBCLAVIAN ARTERY CAUSING MEGAESOPHAGUS
IN A CAT. D.Troiano1, D. Della Santa2. 1 - Clinica Veterinaria Etiopia, Rome, Italy.
2 - Vet Hospital H24, Florence, Italy. [email protected]
Megaesophagus secondary to a vascular ring anomaly is a relatively common disease
in dogs, but it is much less frequently encountered in cats. Multidetector Computed
Tomographic Angiography (MD-CTA) of the thorax is the best diagnostic method
available in order to correctly diagnose the type of vascular ring anomaly involved
because the abnormal vessels can be easily depicted with great anatomic details thus
allowing a correct diagnosis and preoperative assessment. Aim of this study is to
describe the imaging findings of an adult cat with megaesophagus secondary to an
aberrant right subclavian artery (RSA).
Methods
A five-year-old, neutered male domestic shorthair cat was presented because of
dyspnea and dysphagia of a few days duration; historically the cat had been showing
frequent episodes of regurgitation since two months of age. No diagnostic test had
been performed in the past. Survey thoracic radiographs, endoscopy and a thoracic
MD-CTA were performed.
Results
Survey thoracic radiographs showed severe esophageal dilation cranial to the heart
base. Esophagoscopy identified an extramural ring causing a focal narrowing of the
esophageal lumen at the heart base, the mucosa appeared inflamed with disseminated
areas of necrosis. MD-CTA indicated an aberrant RSA originating from the aortic arch
approximately 10 mm distally to the brachiocephalic trunk, then coursing dorsal to the
esophagus in a craniolateral direction (to the right) causing its narrowing in combination
with the trachea and the aorta. The aortic arch, brachiocephalic trunk and left subclavian
artery did not show any abnormalities. Megaesophagus secondary to an aberrant
RSA was diagnosed. Because of the severe changes affecting the esophageal
mucosa, a percutaneous gastrostomy tube was placed in order to rest the esophagus.
A second CT examination, performed two weeks later, did not show any improvement.
The owners did not accept surgery and the cat died because an infection developed
at the gastrostomy site 30 days later.
Megaesophagus secondary to an aberrant RSA is a rare occurrence in the cat.
MD-CTA is an important diagnostic step in the diagnostic evaluation of patients with
a suspected vascular ring anomaly because the surgical approach to the right
subclavian artery (fourth right intercostal space) differs from that used for the more
common persistent right aortic arch (fourth left intercostal space). Accordingly, detailed
preoperative imaging of the aberrant vessel is fundamental in order to accurately plan
surgical intervention. In this case the lack of improvement in the second CT examination
warranted a guarded prognosis even with surgery; most likely early diagnosis is the
key for a rewarding surgical intervention.
52
CONTRAST-ENHANCED ULTRASOUND FEATURE OF GASTROINTESTINAL
ISCHEMIA IN DOGS AND CATS: A CASE SERIES. N. Linta1, M. Baron Toaldo1,
A. Cordella1, P. Pey2, M. Quinci1, M. Cipone1, A. Diana1. 1 - Department of Veterinary
Medical Sciences, School of Veterinary Medicine, University of Bologna, Italy, 40064.
2 - ANTECH Imaging Services, USA, 92614.
Gastrointestinal (GI) ischemia is a potentially fatal disorder characterized by a rapidly
progressive course leading to gastric or intestinal necrosis. In human medicine a
prompt diagnosis of this condition is essential in order to discriminate a surgical versus
non-surgical management. Gray-scale ultrasonography (US) is not accurate for
evaluating this condition, but is useful to identify GI wall abnormalities and patency of
mesenteric vessels. Furthermore, color flow Doppler (CFD) and power Doppler US
are not suitable for the detection of GI micro perfusion due to the low flow velocity. In
humans, several studies have demonstrated the accuracy of Contrast-Enhanced
Ultrasonography (CEUS) for the detection of bowel ischemia. In dogs and cats, CEUS
is useful for evaluating normal transmural bowel wall perfusion. The aim of this study
is to describe the use of CEUS in a case series of small animals with confirmed GI
ischemia.
Methods
Medical records from the Veterinary Teaching Hospital of Bologna University (20122016) were searched for reports of dogs and cats with GI ischemia detected by direct
observation during a surgical procedure and/or histological examinations of GI
samples. Criteria for inclusion in the study were a complete abdominal US examination
including specific CFD and CEUS examination of GI lesions. All images and videoclips were reviewed by the same experienced operator and the distribution of contrast
medium within GI lesions was evaluated.
Results
Five animals (1 dog and 4 cats) with different GI ischemic lesions were included in the
study. There was one case of gastric lesion due to thrombosis of short gastric arteries
secondary to a gastric dilatation-volvulus; one case of duodenal injury due to a
perforating ulcer; two cases of jejunal lesions due to transmural necrotizing enteritis
and iatrogenic damage of jejunal arteries during a surgical procedure, respectively;
one case of colonic lesion due to perforation of the distal colon. On conventional US
all GI lesions were characterized by a focal hypoechoic thickening of the gastric/
intestinal wall with loss of normal layering associated with hyperechoic mesentery
surrounding the affected GI tract. In two cases intramural gas was also present. On
the other hand CEUS showed markedly reduced (1 case) or absent (4 cases)
enhancement of the GI lesions compared to the normally perfused surrounding gastric/
intestinal wall.
Focal GI wall thickening can be a conventional US feature of GI ischemia, but it is
nonspecific and may also suggest an inflammatory or neoplastic disease. The CEUS
features observed in our patients with GI ischemia are similar to those reported in
humans. These preliminary findings demonstrated the feasibility and usefulness of
CEUS for the detection of canine and feline GI wall impaired perfusion.
53
USE OF CONTRAST-ENHANCED ULTRASONOGRAPHY FOR THE CHARACTERIZATION OF MALIGNANT VENOUS THROMBOSIS IN DOGS.
A. Cordella1, M. Baron Toaldo1, N. Linta1, P.Pey2, M. Quinci1, M. Cipone1, A. Diana1.
1 -Department of Veterinary Medical Sciences, School of Veterinary Medicine,
University of Bologna, Italy, 40064. 2 - ANTECH Imaging Services, USA, 92614.
Tumors of adrenal and thyroid glands have been associated with vascular invasion (so
called tumor thrombi) in both humans and dogs. The detection and characterization of
venous thrombi is an important diagnostic step in patients with primary tumors for both
surgical planning and prognosis. In humans, contrast-enhanced ultrasonography
(CEUS) is considered an accurate diagnostic technique for differentiating malignant
from benign portal vein thrombosis in hepatocellular carcinoma. The aim of this study
is to assess the applicability of CEUS for the characterization of malignant venous
thrombosis.
Methods
Medical records from Veterinary Teaching Hospital of Bologna University (2012-2016)
were searched for reports of dogs with primary masses and associated venous thrombi.
Criteria of inclusion in the study were: ultrasound (US) examination of the mass and
associated thrombus, including 2D US, color flow Doppler (CFD) and CEUS, and
a cytological or histological diagnosis of malignancy.
The following US, CFD and CEUS features of venous thrombosis were evaluated:
vascular distension (present or absent); thrombus-tumor continuity; effect on vessel
(occlusive or non-occlusive); vascularity on CFD (present or absent); vessels within
thrombus (present or absent); arterial-phase enhancement (present or absent) and
washout in the venous phase (present or absent) on CEUS.
Results
Seven dogs met the inclusion criteria: 5/7 dogs had caudal vena caval thrombosis
associated with adrenal carcinoma (2/5), pheocromocytomas (2/5) and retroperitoneal
liposarcoma (1/5). Two dogs presented thyroid veins thrombosis associated with a
thyroid carcinoma (2/7). On US, vascular distension and thrombus-tumor continuity
were seen in 3/7 and 2/7 cases, respectively. On CFD, all the thrombi seemed nonocclusive and only 2/7 presented vascularity. On CEUS, 2/7 cases presented formed
vessels within the thrombus. Arterial-phase enhancement and washout in the venous
phase were observed in all cases (7/7).
On the basis of these preliminary experience CEUS appeared to be useful for the
characterization of malignant intravascular invasion. In particular, the presence of an
arterial-phase enhancement of the thrombus and a washout in the venous phase were
consistently identified for the malignant thrombi characterized in this study and further
work is warranted to determine the specificity of these findings.
54
IMAGING FEATURES OF A DUODENAL DUPLICATION CYST IN A YOUNG CAT.
A. Agut, J.D. Carrillo, M. Martínez, J. Murciano, M.A. Gómez, A. Bernabé, M. Soler.
Teaching Veterinary Hospital. University of Murcia, Spain, 30100. [email protected]
Enteric duplication cysts are uncommon congenital abnormalities that originate
anywhere along the alimentary tract. In cats, duplication has been reported in the
ileum, the colon, the rectum and the duodenum. The objective of this report is to
describe a duodenal cyst in a cat where the final diagnosis was obtained by
ultrasonographic findings and corroborated by computed tomography (CT).
Methods
A 7-month-old 2.8 kg intact female Siamese cat was evaluated for repetitive and
intermittent courses of vomiting and anorexia of 6 weeks duration. Physical examination,
hematological and biochemical analyses were carried out. A complete imaging study
(radiographs, ultrasound exam and CT scan) of the abdomen was performed.
Results
Physical examination revealed a round, firm, non-painful mass located in the right
cranial abdomen. Complete blood cell count and biochemical panels were normal.
Abdominal radiography demonstrated a well-circumscribed soft tissue mass cranial to
the right kidney. On ultrasound examination, a cyst structure located adjacent to the
descending duodenum was observed. The structure had an anechoic content and the
wall consisted of an inner hyperechoic rim that was surrounded by a thin hypoechoic
layer. All other structures were within normal limits. Fine needle aspiration was
performed with ultrasound guidance, and cytological examination was consistent with
mesothelial cells and degenerated neutrophils. Results of bacteriologic culture were
negative. Based on the ultrasonographic findings a duodenal duplication cyst was
diagnosed. After administration of Iopramide (5 mL at a concentration of 150 mgI/mL)
into the cyst with ultrasound guidance, an abdominal radiograph was taken. No
communication between the cyst and duodenum was observed. A native and two postcontrast CT scans at immediately and 3 minutes after contrast medium (Iopramide
300 mgI/mL, at 2 ml/Kg) administration into cephalic vein catheter were performed. A
lobulated cystic mass (length about 5 cm, width 2.5/1.3 cm, and 2.3 cm height) was
well visualized, located in the antimesenteric border of the descending duodenum.
The duodenal lumen was obliterated along the length of the largest cyst. The cyst wall
showed a smooth contrast-enhancing rim and the content was not enhanced.
Laparotomy was performed and the cyst was removed from the duodenum. The cat
recovered uneventfully from the surgery. The histopathologic examination of the tissue
revealed that the cyst wall contained all of the normal layers of the gastrointestinal
tract. The definitive diagnosis was intestinal duplication cyst.
Ultrasound has been stated as a technique to obtain a final diagnosis of enteric
duplication cyst if the lesion presents features of the gastrointestinal tract. The
characteristic ultrasonographic appearance consists of an inner hyperechoic rim
correlating to the mucosa-submucosa and an outer surrounding hypoechoic layer
reflecting muscularis propia. These findings have been described as double wall or
“muscular rim” sign. This sign has been suggested to be characteristic of duplication
cyst. To the authors knowledge, this is the first case where the double wall or “muscular
rim” has been observed in a cat.
55
REVERSE COMPUTED TOMOGRAPHIC (CT) PATTERN OF VACUOLAR
HEPATOPATHY WITH FAT ACCUMULATION IN CANINE AND FELINE LIVER.
A. Carloni1, M. Paninarova1, E. Venturelli1, D. Cavina1, A. Toson2, G. Albarello2,
F. Arboit2, M. Romanucci3, L. Della Salda3, S. Teodori1, M. Vignoli1,3.
1 - Veterinary Clinic Modena Sud, 41057 Spilamberto (MO), Italy. 2 - Blucenter srl,
45100 Rovigo, Italy. 3 - Faculty of Veterinary Medicine, University of Teramo, 64100
Piano d’Accio (TE), Italy. [email protected]
Different conditions can lead to severe vacuolar hepatopathy with fat accumulation in
canine and feline liver. Hepatic lipidosis, in cats, usually results from chronic anorexia
and weight loss due to different causes. In dogs, steatosis is generally associated with
diabetes mellitus and with hepatocellular vacuolar changes occurring in canine
hyperadrenocorticism. The definitive diagnosis is histological, but ultrasonographic or
tomographic images may allow a non-invasive description of vacuolar hepatopathy. In
human medicine, unenhanced CT is considered the best way to assess fat accumulation
within the liver. The aim of the study was to describe an uncommon tomographic
pattern of canine and feline vacuolar hepatopathy with fat accumulation.
Methods
One Labrador retriever and one domestic shorthair cat were referred to our centers
after hematology, biochemistry and abdominal ultrasound, for a total body CT due to a
suspicion of hyperadrenocorticism syndrome and hepatic disease, respectively. Blood
tests revealed an increase of liver enzymes in both animals, albumin/globulin ratio in
the cat and blood urea nitrogen, glucose and triglycerides in the dog. Ultrasonography
showed an increased liver echogenicity and - in the dog - increase in size of the left
adrenal gland. Plain and post-contrast (600 mg/kg i.v. Iodine) total body CT acquisition
with soft tissue algorithm was performed. Circular regions of interest (ROI) with an
area of 2 cm2 were drawn over the liver avoiding major hepatic and portal vessels. For
each ROI, mean (standard deviation, SD) attenuation values (HU, Hounsfield Units)
were recorded. Mean (SD) hepatic attenuation values of the two investigated animals
were compared to the mean (SD) hepatic attenuation values measured in 10 dogs and
10 cats which underwent CT for unrelated liver diseases, used as control. Fine needle
aspiration (FNA) and tissue core biopsy of the liver were also performed in the cat and
in the dog, respectively.
Results
On pre-contrast images, the liver of the dog had a mean (SD) hepatic attenuation
value of -18,39 HU (12,78) (Fig. 1), while the liver of the cat had attenuation of -25,04
HU (7,15) (Fig. 2). The average of the mean (SD) hepatic attenuation values in all
dogs without hepatic diseases was 63,85 HU (12,03), while it was 55,25 HU (6,77) in
the cats with normal liver. Post-contrast CT images revealed a mean (SD) hepatic
attenuation value of 30,04 HU (15,7) in the dog and 25,61 (10,48) in the cat. The
control animals presented an average of the mean (SD) hepatic attenuation values of
136,28 (15,02) in dogs and 129,25 (9,66) in cats. (Fig. 3). The tomographic diagnosis
of lipidosis in the cat and steatosis/hyperadrenocorticism in the dog were confirmed by
cytological and histopathological examination, respectively.
Negative hepatic attenuation values with fat storage describe a hypoattenuating
reverse CT pattern of the parenchyma, when compared to hepatic vascular structures.
56
RETROGRADE AND INTRAVENOUES CONTRAST-ENHANCED COMPUTED
TOMOGRAPHIC FINDINGS OF A CYSTIC UTERUS MASCULINUS WITH INGUINAL
HERNIATION IN A SEVEN-MONTH OLD MALE ENTIRE MINIATURE SCHNAUZER.
M.A. Waschk1, A. Hermann2, U. Rytz2, C. Perez Vera3, C. Precht1. 1 - Divisions of
Radiology, 2 - Small Animal Surgery, 3 - Emergency and Critical Care, Department of
Clinical Veterinary Medicine, University of Bern Switzerland. maja.waschk@vetsuisse.
unibe.ch
Introduction/Aim: Cystic uterus masculinus or a cystic persistent mullerian duct is an
uncommon cause of morbidity in dogs. It has been described to cause a range of
specific urinary tract clinical signs such as incontinence, polyuria and polydipsia and
stranguria as well as unspecific gastrointestinal signs. In human literature, the
differentiation between a cystic uterus masculinus and a prostatic utricle cyst is
controversial, especially in regard to communication with the urethra and histological
features of the tissue. The radiographic and ultrasound features have previously been
described in veterinary case reports and series but have not included a case with
inguinal herniation. A description of computed tomographic (CT) findings including
multiple contrast studies has not been previously made. The aim of this study was to
describe the CT and surgical findings in a dog with bilateral inguinal herniation of
a cystic uterus masculinus.
Methods: A seven-month-old male entire Miniature Schnauzer was presented with
a one-week history of diarrhoea and tenesmus. Three days prior he had also developed
incontinence, dysuria and testicular pain. The referring veterinarian had undertaken
an ultrasound examination, which showed an abnormal fluid filled cavity dorsal to the
bladder. The dog was referred with suspicion of ectopic ureters or other congenital
abnormality in the lower urinary tract. On presentation, the clinical examination
revealed a tense and painful caudal abdomen and testicles. Urinalysis, urine culture,
haematology and biochemistry were all completed. Significant findings included
a moderate leucocytosis, mild proteinuria, haematuria and small numbers of leukocytes.
Urine culture was sterile. Subsequently, multiple contrast CT scans were performed
including excretion ureterography (EU) and retrograde urethro-cystography (RUC).
Results: The CT study showed a tubular fluid filled structure between the urinary
bladder and rectum, which diverged into a bilateral tubular structure that continued
through the inguinal canal. This structure was associated caudally with the prostate
and diagnosed as an inguinal herniated cystic uterus masculinus. EU showed a normal
course of the ureters, urinary bladder and urethra. RUC did not show contrast within
the uterus masculinus. Surgery confirmed the CT findings. The uterus masculinus was
removed and the dog routinely castrated. Additionally, a cystoscopy was performed,
which did not show any abnormality. Histology was consistent with uterine tissue. Fluid
within the structure was determined to be urine. The patient recovered uneventfully.
Discussion/Conclusion: The case highlights the CT findings associated with
a herniated cystic uterus masculinus and the importance of various contrast studies
for its final diagnosis. Although laboratory analysis concluded that the fluid within the
uterus masculinus was urine, ante and retrograde contrast study, as well as cystoscopy
failed to prove the communication. This may have been due to an insufficient pressure
gradient in combination with the size of the communication. This malformation should
be included as a differential diagnosis for testicular pain and urinary incontinence
in young dogs.
57
THE EFFECT OF TISSUE SAMPLING ON THE MAGNETIC RESONANCE IMAGING
AND COMPUTED TOMOGRAPHY APPEARANCE OF SKIN AND LYMPH NODES
IN HEALTHY CATS.
S. Hecht, S.D. Allstadt, L. Balouzian. Department of Small Animal Clinical Sciences,
University of Tennessee College of Veterinary Medicine, Knoxville, TN 37996, USA.
[email protected]
The initial diagnostic work-up for superficial tumors in cats may involve biopsy and fine
needle aspiration of the lesion and regional lymph nodes, as well as advanced imaging
with computed tomography (CT) and/or magnetic resonance imaging (MRI) for surgical
or radiation therapy planning. It is currently unknown how sampling procedures affect
the appearance of tissues on CT and MRI and how long any sampling induced changes
persist. The purpose of this study was to investigate the effects of skin biopsy and
lymph node aspiration on MRI and CT appearance of these tissues in healthy cats.
Methods
The study was approved by the Institutional Animal Care and Use Committee. Three
healthy cats underwent pre and post contrast MRI and CT examinations of the head
and cervical region. Punch biopsies of the cervical skin and fine needle aspiration of
a mandibular lymph node were performed on a randomly chosen side. Lidocaine was
administered at the biopsy site and for control purposes the contralateral side
subcutaneously. MRI and CT examinations were repeated immediately after tissue
sampling and on day 7, 14, 21, and 28. The appearance of the skin and lymph nodes
were compared to the initial scans by a blinded radiologist.
Results
All cats had post procedural changes in appearance of soft tissues at the biopsy and
lidocaine injection sites consisting of swelling, tissue irregularity, and effacement of
subcutaneous fat on both CT and MRI, gas inclusions on CT, and increased T2/STIR
signal intensity and contrast enhancement on MRI. Post-procedural soft tissue changes
had resolved by day 7 on CT, and by day 14 (n=2) and day 21 (n=1) on MRI, respectively.
All cats had changes in appearance of the aspirated lymph nodes and adjacent tissues
on CT and MRI immediately following the procedure, which resolved by day 7.
Conclusions
Tissue sampling can affect the appearance of soft tissues on MRI and CT, and
procedure induced changes may persist for days to weeks. This may represent a
diagnostic pitfall as sampling induced changes may mimic neoplastic or inflammatory
conditions or may result in inaccurate size measurements of a neoplastic lesion.
Partial financial support for the study was provided by the Summer Student Program,
Center of Excellence, University of Tennessee College of Veterinary Medicine.
58
CASE SERIES: CT EVALUATION OF SKELETAL SYSTEM INJURIES IN 5 WILD
MAMMALS AFTER ROAD COLLISIONS.
F. Pankowski, B. Bartyzel, J. Sterna, T. Szara, J. Bonecka. 1 - Warsaw University of
Life Sciences, Faculty of Veterinary Medicine, Poland, 02-787. [email protected]
Expansion of road infrastructure and increased car traffic in areas inhabited by wild
animals usually results in higher incidence of vehicle accidents involving wildlife. These
collisions are often deadly for animals, especially smaller ones. Purpose of this study
was to evaluate on Computed Tomography (CT) scan the severity and extensity of
skeletal system injuries in small wild mammals, which were hit by a car. Additionally, it
was a unique opportunity to obtain general CT anatomy of three wildlife species.
Methods
One European otter (Lutra lutra), one pine marten (Martes martes) and three red
squirrels (Sciurus vulgaris) were found dead by the road located in their natural habitat.
It was assumed that they were hit and killed by a car. CT scan was performed in
ventral recumbency using 16-slice CT scanner (Philips). The whole skeletal system
was evaluated in terms of post-traumatic abnormalities.
Results
Evident post-traumatic changes in the skeletal system were visible in every animal.
Each of the five animals had multiple complete, displaced fractures of the skull and
single fractures of the mandible. The calvarial bones, base of skull and bony palate
were particularly affected. The pine marten and two squirrels had sternal luxations
located between the manubrium and second sternebrae. The otter and two squirrels
had vertebral column injuries, with atlanto-occipital and atlantoaxial fracture-luxations
being most prominent. One squirrel had sacral fracture and sacroiliac luxation, as well
as ribs and limb fractures (ulnar, metatarsal).
Severe head injuries were present in every animal and were probably the cause of
sudden death, because of the central nervous system dysfunction. Brain hemorrhages
may sometimes be detected in plain CT examinations as areas of increased attenuation,
but no such areas were found in these case series. Contrast-enhanced CT studies
could help with better visualization of post-traumatic lesions in the brain and spinal
cord. A description of the CT anatomy of wild species could be developed on the basis
of CT examinations of dead animals after collision, since restraining of living wildlife to
perform CT scan raises ethical objections. However, a larger number of animals would
be needed to achieve this.
59
MORPHOLOGICAL VARIATION OF THE CAUDAL FOSSA OF DOMESTIC CAT
SKULLS ASSESSED WITH COMPUTED TOMOGRAPHY AND GEOMETRIC
MORPHOMETRIC ANALYSIS. C. Gordon, J. Lodzinska, J. Schoenebeck, T. Liuti, T.
Schwarz, Royal (Dick) School of Veterinary Studies & Roslin Institute, The University
of Edinburgh, EH25 9RG, UK. [email protected]
Introduction
Whilst the evolutionary changes in skull morphology of felids have been described,
there is scarce information regarding the variation in normal skull morphology of the
domestic cat. The objective of this study was to investigate differences and demonstrate
a normal range of variation in morphological features of the caudal fossa of the cranium
in domestic cats.
Methods
Computed tomography (CT) of 29 domestic cat heads of 10 mesaticephalic feline
breeds were included in the study. Twelve geographic landmarks were placed on the
internal and external surfaces of the caudal fossa of each skull using three dimensional
imaging software. Subsequently a geometric morphometric analysis was performed
using MorphoJ (Klingenberg, 2011). Principle components analyses were performed
to establish individual and breed-level differences.
Results
CT skull images of all cats were sufficiently detailed to allow consistent placement of
all landmarks on stereotyped locations of the internal and external surfaces of the
caudal fossa. Size-independent differences in caudal fossa morphology were identified
across breeds. Most variability was observed at the foramen magnum; specifically the
basion and internal points of the exoccipital bone, at the dorsum sellae of the
basisphenoid, and at the internal occipital protuberance.
Conclusions
There is a wide range of normal morphometric variation of the feline caudal fossa. As
advanced imaging modalities are becoming more frequently used in domestic felines,
an established range of normal is necessary for discrimination between pathological
changes and normal variation, and for the recognition of potential trends towards
disease.
60
ASSESSMENT OF CRANIUM AND MANDIBULAR MORPHOLOGICAL VARIATION
IN DOMESTIC CATS AND SCOTTISH WILDCATS USING COMPUTED
TOMOGRAPHY AND GEOMETRIC MORPHOMETRIC ANALYSIS.
J. Lodzinska1, C. Gordon1, A.C. Kitchener2, D. Gunn-Moore1, T. Schwarz1,
J.J. Schoenebeck1. 1 - Royal (Dick) School of Veterinary Studies & Roslin Institute,
The University of Edinburgh, UK EH25 9RG. 2 - Department of Natural Sciences,
National Museums Scotland, UK EH1 1JF. [email protected]
Introduction
The Scottish wildcat (Felis silvestris) is the last surviving wild felid species in the UK.
Understanding morphological variation between Scottish wildcats and domestic cats
(Felis catus) is a major goal for wildcat conservation and understanding of diseases.
Objectives of this study were to assess whether computed tomography (CT) offers
sufficient anatomical detail for geographic morphometric analysis and to compare the
variation in morphological features of cranium and mandible between the two felid
populations.
Methods
Helical CT of 19 skeletally mature Scottish wildcat skulls and 26 heads of living
domestic cats over 12 months of age was performed with 1mm slice width, 1.5 pitch,
130mAs, 120kV and 0.75s rotation time. Thirty-one external landmarks were placed
on the skulls and analyzed using geometric morphometrics (Stratovan, Sacramento,
USA, and MorphoJ, Klingenberg, 2011). Principal components and discriminant
function analyses were performed to establish individual- and population-level
differences.
Results
Reconstructed three-dimensional CT skull images of all felids were sufficiently detailed
to consistently place 31 landmarks on stereotyped locations of the external skull
surface. Our analyses reveal differences in cranium and mandibular morphology
between the two species. Most variability was observed in the nuchal crest and
zygomatic process of the cranium and the symphysis, coronoid, condyloid and angular
process of the mandible.
Discussion
Thin-slice CT allows detailed visualization of skull anatomy, making it an excellent tool
for skull morphology assessment for comparative biological or aetiopathological
studies. Morphological differences between domestic and wildcat skulls give important
clues for phenotypical evolution in felids and for determining introgressive hybrids.
61
COMPARISON OF VOLUMETRIC INDEX OF THE CRANIAL CAUDAL FOSSA
IN NEWBORN PUPPIES AND ADULT DOGS. N. Czubaj1, J. Bonecka2, K. Barszcz1,
W. Sokołowski1, M. Wąsowicz1, P. Jurka2, A. Ruszczak2, S. Kanafa2, J. Sobczyński3.
1 - Department of Morphological Sciences, Faculty of Veterinary Medicine, Warsaw
University of Life Sciences – SGGW, Poland, 02-776. 2 - Department of Small Animal
Diseases with Clinic, Faculty of Veterinary Medicine, Warsaw University of Life
Sciences – SGGW, Poland, 02-776. 3 - Veterinary Clinic “Bemowo” Warsaw, Poland,
01-495. [email protected]
Introduction
Chiari-like malformation (CLM) is not fully explained complex skull disorder of the
miniature and brachycephalic dogs characterized by volume mismatch between brain
parenchyma and cranial cavity. CLM can lead to syringomyelia (SM) – pathology of
the spinal cord. Volumetric index of the cranial caudal fossa (VIccf) is a ratio of volume
of the cranial caudal fossa (CCF) to volume of cranial cavity (CC). The aim of the study
was to determine if there is a difference in the VIccf between newborn puppies and
adult dogs.
Methods
Two groups were distinguished: newborn puppies born dead or dead within 5 days of
age (n = 22) and cadavers of adult dogs (n = 32). Fifty-four skulls of three morphotypes
were scanned using sixteen-slice CT scanner (Siemens SOMATOM Emotion 16,
Siemens) with the following CT protocol: 130 kV, 220 mAs and 0.75 mm slice width.
Images were reconstructed using bone window. The volume of the CC was measured
by manually tracing the internal boundaries of the skull on each slice. The same
protocol was used for assessment of CCF volume – space bounded by dorsum sellae,
petrous parts of the temporal bone, tentorium osseum and foramen magnum.
Measurements were made using Osirix software. Statistical analysis was performed
using IBM SPSS v23.0. One way ANOVA (GLM procedure) and post-hoc Scheffe test
were applied (p≤0.05).
Results
There were no statistically significant differences in the VIccf between morphotypes in
newborn puppy group. In adult group dolichocephalic breeds differed from
mesaticephalic and brachycephalic group. There were statistically significant
differences in that index between newborn and adult dogs within each morphotype.
Results are presented in Table 1.
Conclusions
The VIccf is a rather constant parameter in newborn puppies. With the age of the dog
the CCF tends to be relatively greater in all morphotypes and in dolichocephalic breed
that tendency is more pronounced. It is worth stating that CM/SM syndrome has not
been described in any dolichocephalic breed. This research may contribute to
understanding the pathogenesis of CM/SM syndrome as affected dogs belong only to
brachycephalic and mesaticephalic dogs. There is need for further research regarding
CC volumetrics taking into account individuals breed.
62
CAUDAL EXTENT OF THE FRONTAL SINUS IN ADULT MESATI- AND
DOLICHOCEPHALIC DOGS IN CT IMAGING – PRELIMINARY RESULTS.
N. Czubaj1, K. Barszcz1, J. Bonecka2, W. Sokołowski1, M. Wąsowicz1, M. Kupczyńska1,
W. Kinda3, Z. Kiełbowicz3. 1 - Department of Morphological Sciences, Faculty of
Veterinary Medicine, Warsaw University of Life Sciences – SGGW, Poland, 02-776.
2 - Department of Small Animal Diseases with Clinic, Faculty of Veterinary Medicine,
Warsaw University of Life Sciences – SGGW, Poland, 02-776. 3 - Department of
Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life
Sciences, Poland, 50-366. [email protected]
Introduction
Available literature provides no comprehensive description of the frontal sinus in dogs
taking into account its diversity. The anatomy of the canine head varies enormously
between breeds leading to changes on frontal sinus morphology. Diseases of the nasal
cavity, mainly fungal infections and neoplasia, constitute a serious clinical problem
concerning mainly mesati- and dolichocephalic breeds.
Methods
The study was conducted on 35 cadaver skulls belonging to dogs of mesati- (n = 18)
and dolichocephalic morphotype (n = 17). Dogs were scanned using a sixteen-slice
CT scanner (Siemens SOMATOM Emotion 16, Siemens) with the following CT protocol:
130 kV, 220 mAs and 0.75 mm slice width. Images were reconstructed using a bone
window to precisely define the bone margins of the sinuses. Multiplanar reconstructions
were used to obtain images of the skulls. Observations were carried out with use of
Osirix software.
Results
In all studied dogs a subdivision into three secondary sinuses (lateral, rostral, medial
portions of the frontal sinus) was observed. In most cases (86%, n = 30) its caudal
extent was observed at the level of the optic canal (n = 5), the orbital fissure (n = 11)
or the round foramen (n = 14). Taking clinical aspects into account these locations
could be correlated to the coronoid process, and were equivalent with its rostral border,
middle part and caudal border respectively. In the remaining animals (14%, n = 5),
which were dolichocephalic, the extent of the frontal sinus could be observed farther
caudally. In two individuals, the frontal sinus was observed to reach to the level of the
oval foramen whereas in three dogs it reached even further to the dorsum sellae.
Topographically these structures are equivalent with the level of the temporomandibular
joints.
Conclusions
In mesaticephalic breeds the frontal sinus tends to terminate at the level of the coronoid
process of the mandible. In dolichocephalic breeds the frontal sinus penetrates the
frontal bone almost to its caudal periphery. Variable frontal sinus anatomy should be
taken into consideration during treatment of sinonasal Aspergillosis and surgical
approach in that region. Understanding of the frontal sinus morphology in dogs is
incomplete and further research in that field should be carried out.
63
CASE REPORT - MICROTOMOGRAPHICAL STUDY OF PARANASAL SINUSES
IN CRASEONYCTERIS THONGLONGYAI BAT – PRELIMINARY RESULTS.
T. Szara1, J. Bonecka1, K. Turlejski2. 1 - Warsaw University of Life Sciences, Faculty of
Veterinary Medicine, Poland, 02-787. 2 - Cardinal Stefan Wyszynski University, Faculty
of Biology and Environmental Sciences, Poland, 01-938. [email protected]
Craseonycteris thonglongyai known also as Bumblebee Bat or Hog-nosed Bat is the
smallest species of bat and one of smallest mammals of the world. It is only extant
member of the family Craseonycterida, living in Thailand and Burma. Morphology of
paranasal sinuses varies greatly among bats and is often missing in small species.
Microtomography is an indispensable tool in studying inner structures of very small
skulls. Traditional morphometric methods are insufficient to describe nasal cavity and
sinuses within such small objects.
Methods
Micro-CT examination of an adult female Craseonycteris thonglongyai skull derived
from the Kywe cave in South Thailand was performed. Standard morphometric
measurements (length, height, width) of the facial skeleton were done with special
emphasis on paranasal sinuses. 3D Slicer 4.5 software was used to explore the
paranasal sinuses.
Results
Total length of the examined skull was 10.3 mm, facial length 3.4 mm. Paired maxillary
sinuses and palatine sinuses in horizontal plates of palatine bones were revealed. The
height of the right maxillary sinus was 1.39 mm, length 1.82 mm, and width 0.579
mm, for left maxillary sinus respectively: 1.41 mm, 1.17 mm and 0.558 mm. Length of
both palatine sinuses was 1.15 mm, height of right sinus 0.373 mm and 0.390 mm for
left sinus. Width of right palatine sinus was 0.879 and left one 0.857 mm.
The featured study revealed the presence of paired maxillary and palatine sinuses
within the facial skeleton of the skull that was examined. Some authors suggest that
skull of small bats is usually lacking the paranasal sinuses. Our results prove that even
in such small species air filled spaces pneumatize the palatine bone.
64
ANAPLASTIC OLIGODENDROGLIOMA IN CERVICAL SPINAL CORD WITH
VERTEBRAL INVOLVEMENT OF A CAT – CASE STUDY.
J. Bonecka, F. Pankowski, T. Szara, R. Sapierzyński, J. Sterna. Warsaw University
of Life Sciences, Faculty of Veterinary Medicine, Poland, 02-787. [email protected]
A three-year old female street cat was found with an incorrectly healed, painful femoral
fracture (pseudoarthrosis) of the left pelvic limb. Corrective surgery of the fracture was
performed. Four weeks post surgery the cat began having difficulties walking and
became anxious and painful. There was no improvement after analgesic treatment
and additionally neurological deficits in the thoracic limbs and opisthotonus developed.
A radiograph of the cervical spine was interpretated as normal at that time, so the
computed tomography (CT) as well as magnetic resonance imaging (MRI) examinations
were suggested.
Methods
The CT scan was performed in ventral recumbency using a 16-detector row CT scanner
(Phillips & Neusoft Medical Systems), with 120 kV, 40 mA and 0,75 mm slice thickness.
A radiograph of the cervical spine was repeated. An MRI of the brain and spinal cord
was performed using a 0,25T (Esaote) system with T1- and T2-weighted transverse,
saggittal and coronal planes and post-contrast T1-weighted protocol. The cat was
euthanized on the request of the curator and post-mortem a histopathological
examination was performed.
Results
Repeated radiographic imaging revealed osteolytic lesions of vertebrae C3 and C4.
On CT examination there was a bone remodelling: osteolysis, osteosclerosis, periosteal
reaction, predominantly on the right side of C3 and C4 vertebral arch, involving half of
the vertebral canal. On MRI there was a hypointense mass arising from the spinal cord
and invading the vertebrae visible in T1- and T2-weighted images and there was no
post-contrast enhancement in T1-weighted images. After euthanasia, necropsy and
histopathological examination was performed. Microscopic appearance of the
osteolytic lesions was consisted with anaplastic oligodendroglioma.
Based on diagnostic imaging neoplasia from bone tissue was suspected. Appearance
on MRI was atypical, because oligodendrogliomas are described as T1-weighted
hypointense, T2-weighted hyperintense lesions and with marked post-contrast
enhancement in T1-weighted images. Infiltration of neoplastic cells into the bone
structure, thus high contribution of mineralized tissue in the mass could be a reason of
this finding.
65
MAGNETIC RESONANCE IMAGING FINDINGS IN DOGS WITH INFLAMMATORY
BRAIN DISEASE. Panagiotis Mantis, Saul Levy, Ian David Jones. Royal Veterinary
College, U.K. AL9 7TA. [email protected]
Inflammatory brain disease has a variable clinical presentation and its definitive
diagnosis is often challenging. The aim of this study was to determine the sensitivity
and specificity of magnetic resonance imaging (MRI) in the detection of inflammatory
brain disease and to describe the imaging features of associated lesions.
Methods
Clinical records at the Queen Mother Hospital for Animals, Hertfordshire between 2010
and 2015 were reviewed. MRI examination of the brain and cerebrospinal fluid (CSF)
analysis were required for inclusion in the study. All examinations were performed
using the same 1.5T MRI. All studies included as a minimum: Transverse T1W (pre
and post contrast), T2W and fluid-attenuated inversion recovery (FLAIR) of the brain.
Dogs with CSF protein of >0.25g/dl and a total nucleated cell count (TNCC) of >5/mm3
were defined as having inflammatory brain disease. A control group of similar size was
also selected from the same period. The majority of dogs in the control group were
diagnosed with idiopathic epilepsy. All MRI scans were reviewed in a random order by
a board certified radiologist blinded to the final diagnosis.
Results
Twenty-nine dogs were included in the inflammatory brain disease group. Fourteen
were diagnosed with presumptive central nervous system inflammatory disease, 11
with granulomatous meningoencephalitis and 4 with meningoencephalitis. Thirty-four
dogs were included in the control group. The median age of dogs in the inflammatory
brain disease group was 4.5 years (range: 0.7 – 13.7 years), the median age of dogs
in the control group was 5.5 years (range 1.2 – 11.1 years). Breeds included in both
groups were similar, with more small breed dogs in the inflammatory brain disease
group and more medium and large breed dogs in the control group. Detection of
inflammatory brain disease using MRI had a sensitivity of 100%, a specificity of 97%
and an accuracy of 98%. Inflammatory lesions tended to be multifocal (76%) with
indistinct margins (62%); appear hypointense in T1W sequences (79%); demonstrate
intracranial contrast enhancement (93%) and appear hyperintense in T2W (93%) and
FLAIR (79%) sequences.
This study includes a higher number of dogs with inflammatory brain disease than
previously published reports. The sensitivity and specificity of MRI in the detection of
inflammatory brain disease was higher than that previously reported. This may be due
to the fact that only dogs with inflammatory brain disease were compared to
morphologically normal controls. Previous studies have reported meningeal
enhancement to be a common feature in dogs with inflammatory brain disease. In this
study, meningeal enhancement was only detected in 17% of dogs with inflammatory
brain disease.
In conclusion, MRI is a sensitive, specific, and accurate examination for the detection
of lesions in dogs with inflammatory brain disease.
66
MAGNETIC RESONANCE IMAGING OF DEGENERATIVE ENCEPHALOPATHY
IN A NOVA SCOTIA DUCK-TOLLING RETRIEVER. B. Moreno-Aguado, R. Trevail,
M. Pinilla. Southern Counties Veterinary Specialists, United Kingdom, BH24 3JW.
[email protected]
Degenerative Encephalopathy (DE) of the Nova Scotia Duck-Tolling Retriever (NSDTR)
is a recently recognized progressive neurodegenerative disease that causes necrosis
of the caudate nuclei. The clinical signs are variable and include behavioural changes,
ataxia and sleep disorders amongst others. Most dogs are euthanized by 3-5 years of
age due to poor quality of life. This report describes the MRI findings in an affected
dog.
Methods
A 4 year old, female entire NSDTR presented with a 3-months history of abnormal and
violent movements while asleep, behavioural changes, hind limb ataxia and weakness.
MRI of the brain was performed using a 1.5 Tesla MRI scanner and with following
sequences: T2-weighted (T2W) FSE sagittal, transverse and dorsal; Fluid Attenuation
Inversion Recovery (FLAIR) transverse, T1-weighted (T1W) 3D gradient echo
transverse, T2W gradient echo transverse, T1W SE transverse pre- and post-contrast,
T1W SE dorsal and sagittal post-contrast. The post-contrast sequences were acquired
after intravenous administration of 0.1mmol/kg Gadopentetate dimeglumine. Following
the MRI examination, DNA testing for the condition was performed.
Results
Two oval bilaterally symmetrical areas of increased T2W signal in the caudate nuclei
were observed. Suppression of the T2W signal was seen in the central part of the
lesions in FLAIR. There was subtle enhancement peripheral to the cavitated lesions
after contrast administration. The brainstem presented a slightly heterogeneous signal.
There was severe loss of grey/white matter differentiation on the rostral half of the
cerebellum. The findings were compatible with caudate nuclei necrosis and cavitation
with secondary cerebrospinal fluid (CSF) accumulation. The cerebellar and brainstem
changes were suspected to be part of the same neurodegenerative process. The DNA
test confirmed the patient to be affected by DE of the NSDTR.
A previous oral communication reviewed 8 NSDTR with similar clinical and MRI
findings as those described in our case, where histopathological examination revealed
malacia of the caudate nuclei. Our patient showed further cerebellar and brainstem
MRI abnormalities that have not been previously described. We suspect that these are
part of the same disease process. Further tests (e.g. CSF analysis) may have been
performed to help clarify the underlying pathology but ultimately a post-mortem
examination would be required to establish the nature of the cerebellar and brainstem
changes. However, this has not been performed, as the patient is currently stable 5
months after diagnosis. The lack of further deterioration suggests that other diseases
(e.g. inflammatory meningoencephalitis) are unlikely.
Special attention must be drawn if brainstem and cerebellar MRI changes are observed
in cases of suspected DE, particularly if histopathological examination is available.
The possible involvement of other areas of the central nervous system could allow
better understanding of the pathophysiology of DE of the NSDTR.
67
IMAGING THE CENTRAL NERVOUS SYSTEM OF BIRDS OF PREY WITH 3T MRI:
ANATOMIC STUDY. E. Stańczyk1, M.L Velasco Gallego2,M. Nowak3, J.M. Hatt2,
P.R. Kircher1, I. Carrera1. 1 - Clinic for Diagnostic Imaging, 2 - Clinic for Zoo Animals,
Exotic Pets and Wildlife, Vetsuisse Faculty of Zurich, University of Zurich, Switzerland,
CH-8057. 3 - Department of Pathology, Faculty of Veterinary Medicine, Wroclaw
University of Environmental and Life Sciences, Poland, 50-366. estanczyk@vetclinics.
uzh.ch
Introduction
Although there is an increasing interest in clinical neurology of birds, little is known
about the imaging appearance of the avian central nervous system (CNS), mainly
because of size limitations. High field MRI systems offer high contrast and spatial
resolution, which may increase greatly the quality of MRI examinations of the avian
CNS. The objectives of this study were to test the technical feasibility of 3 Tesla MRI
and to document the anatomic features of the central nervous system of the birds of
prey by means of high-resolution 3T magnetic resonance imaging system.
Methods
Wild birds of prey included in the study were animals that had to be euthanatized for
welfare reasons because rehabilitation was not possible. Imaging was performed
within 24 hours after euthanasia, using a 3 Tesla MRI scanner and high-resolution
microscopy coil and a 8-channel small extremity coil, for head and spine respectively.
All images were acquired in sagittal, transverse and dorsal plane in T1 and T2 weighted
turbo-spin-echo sequences. A necropsy with macro- and microscopic analysis of the
central nervous system was performed in one cadaver of each species within few
hours after MRI examination. For the microscopic examination brains were embedded
in paraffin and sliced in the sagittal, dorsal, or transverse plane. Subsequently the
magnetic resonance images and histologic slices of the brain and spinal cord were
compared and the anatomic structures were identified on the magnetic resonance
images.
Results
Fifteen cadavers of seven different species of the birds of prey were included. Very
good resolution and anatomic detail were obtained in all animals included in this study.
The following anatomical features were identified and correlated with anatomical
sections: the cerebral hemispheres, the lateral ventricles, thalamus, cerebellum, brain
stem, optic tectum and optic lobe. The cranial nerves visualized were the optic nerves,
olfactory bulb, emergence of the trochlear nerve, the ganglion of the trigeminal nerve,
the vestibulochoclear nerve and semicircular canals of the inner ear. Exquisite detail
was achieved on the ocular structures. The gray and white matter differentiation on the
spinal cord and the glycogen body could be well observed in all birds.
Conclusions
This prospective descriptive study establishes normal magnetic resonance imaging
anatomy of the brain and spinal cord in seven species of the birds of prey, which may
be used as a reference in the assessment of neurologic disorders in this group of
birds.
68
LUMBOSACRAL MORPHOMETRY IN GERMAN SHEPHERD DOGS AND
BAVARIAN MOUNTAIN DOGS.
M. Kuricova, T. Liptak, V. Ledecky. University of Veterinary Medicine and Pharmacy,
Kosice, Slovakia, 04001. [email protected]
The aim of this study was to evaluate the morphologic and morphometric data obtained
by assessing parameters within the lumbosacral junction. These indicators were
compared in two breeds, German shepherd dogs (GSD) and Bavarian mountain dogs
(BMD). While the GSD is a breed, which is very prone to lumbosacral diseases leading
to expression of cauda equina syndrome, in the BMD there is little data on the incidence
of these diseases.
Methods
Data were obtained retrospectively by one experienced observer by measurement of
standard radiographs taken for hip dysplasia (HD) evaluation in a standard extended
ventro-dorsal position. All dogs included in this study were free of any orthopedic or
neurological disease. We evaluated the length of the sixth lumbar vertebra, relative
length of the seventh lumbar vertebra (length of L6 divided by the length L7), the
relative length of the bony connection between os sacrum and os ilium (length of L6
divided by the length of this sacroiliac connection expressed as an average between
the right and left side), relative cranio-caudal width of the intervertebral disc space
(IVDS) L7-S1 (in relation to the length of L6), and we also assessed the overlap of the
cranial endplate of the first sacral vertebra (S1) by the wings of the Ilia. All parameters
were measured using a software for image analysis (ImageJ). Data were expressed
as Mean ± SD and differences between breeds were analyzed with t-test and ANOVA.
Values were considered significant as p ≤ 0.05 (*) and extremely significant as p ≤ 0.01
(**).
Results
We evaluated radiographs of 16 BMD and 13 GSD and found a statistical difference
between the breeds in the length of L7 (*) and L6 (**). When comparing the relative
lengths of these vertebrae it was apparent that L7 was slightly shorter in GSD. In most
BMD the endplate of S1 was located caudal to the cranial border of the ilia, but in 6
GSD the endplate was located cranial to the ilia. The sacroiliac connection in GSD
was longer than in BMD and the width of the IVDS was smaller in GSD (*).
The results of many authors showed significant variability in the arrangement of the
lumbosacral junction in healthy dogs, and dogs affected by cauda equina syndrome.
Our work supplements previous studies, which have focused on lateral projections.
Focusing on differences in morphology and morphometry between different breeds,
which may reflect different biomechanics may help to identify why GSD are predisposed
to lumbosacral disease. When considering pathology in assessing radiographs it is
necessary to take into account these morphologic and morphometric indicators and
variability and to develop an objective assessment for certain breeds.
69
COMPUTED TOMOGRAPHY-GUIDED INJECTION OF MUSCLE-DERIVED
MESENCHIMAL STEM CELLS IN THE LUMBOSACRAL INTERVERTEBRAL
DISC OF DOGS AFFECTED BY NATURAL DISC DEGENERATION: CLINICAL
SAFETY AND INTERVERTEBRAL DISC IMAGING ASSESSMENT.
A. Liotta1, C. Sandersen1,2, J. Ceusters2, M. Girod1, D. Peeters1, G. Bolen1.
1- Faculty of Veterinary Medicine, University of Liege, B-4000, Belgium. 2- Centre for
Oxygen R & D (CORD) University of Liege, B-4000, Belgium. [email protected]
Pre-clinical randomized controlled animal trials have been conducted to evaluate the
effects of mesenchymal stem cell (MSCs) transplantation on intervertebral disc (IVD)
degeneration (IVDD). According to their histological results and to IVD imaging
assessment, MSCs intradiscal injection stops or slows IVDD, and is associated with a
low complication rate. Few of these studies were focused on canine artificially IVDD,
using bone marrow or adipose-derived MSCs. Therefore a systematic study on
naturally IVDD using autologous muscle-derived MSCs is still lacking. The aims of this
study were to evaluate the clinical effects of intradiscal injection of muscle-derived
MSCs and its effects on IVD imaging features.
Methods
Eight experimental Beagles dogs (12-18 kg) were included with the approval of the
University’s Animal Care and Use Committee. Inclusion criteria were a naturally
degenerated lumbosacral IVD detected on magnetic resonance (MRI) images and the
obtaining of 3 x 106 autologous muscle-derived MSCs. Mesenchymal stem cells
diluted in 0.2 ml of Hypothermosol-FRS were injected in the lumbosacral IVD. A
computed tomography (CT) and MRI examinations (sagittal T1-w and T2-w) were
performed before and 2 months after the procedure and 13 IVD imaging parameters
(such as IVD height and “A index”) were assessed. The same operator performed the
injection and the IVD measurements. A linear model with a mixed procedure was used
for statistical analysis (P-value ≤ 0.05). Clinical examinations were performed regularly
for a period of 1 month after the procedure.
Results
Six dogs met the inclusion criteria. The remaining 2 dogs did not undergo intradiscal
injections, but were used as control group. No complications were recorded during the
procedure or during the clinical examinations. No statistically significant changes of
IVD imaging features were noticed.
Lumbosacral intradiscal injection of muscle-derived MSCs is clinically safe and it is not
associated with any progression of the IVDD, detected by CT or MRI imaging. Further
studies are needed to assess its efficacy as treatment for the canine natural IVDD.
70
CT FINDINGS AND RELATIONSHIP BETWEEN SPONDYLARTHROSIS AND
INTEVERTEBRAL DISC DEGENERATION IN DOGS: A PRELIMINARY STUDY.
C. Strohmayer1, S. Kneissl1, A. Anson1. 1 - University of Veterinary Medicine,
Department for Companion Animals and Horses, Diagnostic Imaging, Austria, 1210.
[email protected]
Intervertebral disc (IVD) and facet joints form the functional spinal unit. Experimentally,
degeneration of the facet joints was thought to be secondary to IVD degeneration
(IVDD) in animal models. In dogs little is known about facet joint pathologies or the
associated pathogenesis. Aims of the study were (1) to evaluate the relationship
between IVDD and spondylarthrosis (SA) and (2) to develop a grading system for SA
in dogs.
Methods
Computed tomography images of 30 facet joints with SA from 19 dogs were
retrospectively assessed by two observers who agreed on presence or absence of CT
findings. The presence of disc herniation, narrowing of the IVD space, mineralization
of the IVD, vacuum phenomenon, endplate sclerosis or subchondral cysts were
evaluated. Degree of SA was scored on three-point scale: grade 1 (mild), 2 (moderate),
and 3 (severe) according to joint space narrowing, osteophytes, facet joint hypertrophy,
sclerosis and subchondral erosions.1 Degree of spondylosis was graded on a scale of
1 to 3 according to a previously described method.2
Results
In all cases SA was associated with signs of IVDD. The breeds consisted of Labrador
Retriever (n=2), Golden Retriever (n=2), German Shepherd (n=2), Mix-breed dogs
>25 kg (n=4), Mix-breed dog <25 kg (n=1), and one of each: Berger Blanc Suisse,
Border Collie, French Bulldog, Dachsbracke, Dalamtian, Husky, Irish Wolfhound,
Rottweiler. The dogs were between 3 and 13 years. Regarding SA, 4/30 joints were
considered grade 1, 13/30 grade 2, and 13/30 grade 3. SA was associated with
narrowing of the IVD space in 26/30, spondylosis in 22/30, disc herniation in 19/30,
endplate sclerosis in 9/30, mineralization of the IVD in 8/30, vacuum phenomenon in
1/30, and subchondral cysts in 1/30.
Spondylarthrosis was associated in all cases with signs of IVDD, being most frequently
detected with narrowing of the IVD space and disc herniation. This would support the
hypothesis that IVDD precedes SA, however larger studies including MRI are needed
to confirm the presence of IVDD in dogs with SA.
References
1. Pathria M, Sartoris DJ, Resnick D. Osteoarthritis of the facet joints: accuracy of
oblique radiographic assessment. Radiology 1987;164:227–230.
2. Langeland M, Lingaas F. Spondylosis deformans in the boxer: Estimates of
heritability. J Small Anim Pract 1995;36:166–169.
71
COMPUTED TOMOGRAPHIC FINDINGS OF A FAR LATERAL LUMBAR DISC
EXTRUSION IN A DOG.
M. Rizza1, B. Bouvy1, N. Shimizu1, M. Heimann2, G. Bolen1. 1 - Department of Small
Animals and Equidae Clinics, FARAH, Faculty of Veterinary Medicine, University of
Liège, Belgium. 2 - Laboratory Anapet SPRL, Belgium.
Introduction
In human medicine, far lateral lumbar disc extrusion (FLLDE) represents 7 to 12% of
all disc herniations and MRI is the method of choice for diagnosis. MRI findings of a
FLLDE has been reported in one dog and the aim of this case report is to describe
computed tomographic (CT) findings of a FLLDE in a dog.
Methods
A six-year-old neutered female Beagle with a good general health status was presented
with a month history of left hind limb pain with shivering of this limb. Clinical examination
revealed a left hind proprioceptive deficit but no pain was elicited at palpation.
Results
A CT scan pre- and post- contrast studies of the lumbosacral spine and a myelographicCT were performed. A 1.3x0.6x0.3 cm homogeneous hyperattenuating (+/- 350 HU)
ovoid structure was observed at the left lateral aspect of L6-L7 intervertebral disc
space. The L6-L7 intervertebral disc nucleus pulposus was calcified but the annulus
fibrosus had a normal non-calcified attenuation and seemed intact apart from a very
thin hyperattenuating line next to the ovoid structure. This change was well circumscribed
by an even hyperattenuating rim (1000HU) mimicking a thin dense cortex and was in
close proximity with the annulus fibrosus and the left transverse process of L7.
Perineural fat was not observed and contrast enhancement was visualized at the level
of the left sixth lumbar nerve root with impingement and thickening of this root. No
compression of the spinal cord was observed at this level on the myeloCT. These
findings were suggestive of a dystrophic mineralization or an osteochondromatosis. At
surgery some mixed gelified calcified material consistent with disc material was
removed at the level of the left L6-L7 nerve root tract and disc fenestration was
performed. The histological analysis confirmed the presence of degenerated herniated
vertebral disk.
In human medicine, MRI and CT scan are the main diagnostic modalities employed for
diagnosis of FLLDE. In veterinary medicine, CT is often used to assess spinal diseases
because of its availability. To the authors’ knowledge, CT findings of a FLLDE have not
been described previously in dogs. Moreover, the thin dense cortex appearance
surrounding the disc material was surprising. In conclusion, FLLDE should be included
in the differential diagnosis of a calcified ovoid structure lateral to the spine even if the
annulus fibrosus appears normal and if this structure is in close relation with the
vertebral transverse process.
72
HAS RADIOGRAPHIC CONTRAST MEDIUM AN EFFECT ON FELINE RENAL
VOLUME? Y. Vali, M Molazem. Department of Radiology and Surgery, Faculty of
Veterinary Medicine, University of Tehran, Tehran, Iran. Postal Code: 14155-6453.
Email: [email protected]
Introduction
Computed tomographic urography (CTU) is considered an optimized imaging
procedure for evaluation of the urinary system, and renal volume (RV) that is an
important indicator during evaluation of renal conditions. The purpose of this study
was to evaluate the effect of contrast medium injection during CTU on the feline RV.
Ten kidneys of 5 anesthetized cats without evidence of renal disease on clinical and
laboratory examinations were scanned before and immediately after intravenous bolus
injection of iohexol (600 mgI/kg BW) without any intravenous fluids administration
during examination. RV was determined in plain scans and after cortical enhancement
by hand-tracing option with a 1mm image reconstruction and the same WL and WW
(40, 300 respectively). The volumes were recorded and compared statistically by
paired sample T-test (SPSS software).
Results
Mean ± SE of the volumes before and after contrast injection were calculated as 15.52
± 0.73 and 16.65 ± 0.38 cm3 respectively, representing a statistically significant
difference in measured volumes before and after contrast medium injection (P<0.05).
Feline RV may be altered by several pathological conditions, and volume alteration
may be a good predictor for disease progression; however, CTU may help to provide
a more definitive diagnosis. This study suggests that the injection of contrast medium
for CTU increases RV in cats, which should be considered during interpretation. The
effects of patient and observer related factors (e.g. diuresis, special pathology and
reconstruction algorithm settings) on the volumetry of kidneys has not been evaluated
in this study and should be considered in future studies. Findings from this study may
be valuable for a more accurate diagnosis, and avoiding incorrect interpretation of RV
changes as a pathological condition in post contrast images.
73
MRI FINDINGS IN A CASE OF CUTANEOUS TUBERCULOSIS IN A CAT
A. Destri, B. Walsh, The Veterinary Referral Center, RH9 8BP, UK. Email address:
[email protected]
Introduction
An 8 years old DSH was referred to our diagnostic imaging department with a 3 months
history of discharge and swelling ventral to the left eye not responding to antibiotic
therapy. Biopsies taken by the referring vet revealed a chronic active deep dermal and
pannicular granulomatous to pyogranulomatous process. The patient was referred to
our diagnostic imaging department for a magnetic resonance imaging (MRI) scan in
order to evaluate this further.
Methods
An MRI scan of the head was performed with an Esaote VET-MRI 0.2 Tesla. Transverse,
sagittal and dorsal STIR and pre and post contrast T1 sequences were obtained.
A sterile swab, fine needle aspirates and surgical biopsies were taken from the site of
the lesion and sent to the laboratory.
Results
An irregular, 10 cm long, 4 cm wide and 1.5 cm deep, discoid region of solid
subcutaneous tissue was found on the left side of the face extending from the base of
the ear to the nasal planus. A couple of very small hypointense foci (2 mm) were
present on all sequences in the subcutaneous tissues and each had a 1-2 mm
hyperintense focus immediately adjacent to it. These areas were also identified
surgically post MRI and confirmed to be subcutaneous gas bubbles and tiny fluid
pockets. The ipsilateral parotid salivary gland, medial retropharyngeal lymph node and
mandibular lymph node were moderately enlarged. No definitive foreign body or tracts
were seen. The main differential diagnosis were a cellulitis caused by a bite wound or
a fistula caused by a foreign body. The cytology showed small aggregates of large
foamy macrophages and neutrophils with occasional lymphocytes and rare eosinophils
surrounded by a small number of erythrocytes. Rare plump fusiform (fibroblast) and
one multinucleate giant cells were also observed, consistent with pyogranulomatous
inflammation with small numbers of fibroblasts.A Ziehl-Neelsen stain revealed rare
small positive staining rods with a morphology not entirely typical of mycobacteria.
PCR confirmed the presence of Mycobacterium Tuberculosis complex DNA, that
includes species like M.tuberculosis, M.bovis, and M.microti. A culture was not
performed in order to identify the species involved in the infection and for safety
reasons the cat was euthanized.
Discussion
Mycobacterial infections are recognized as a global health concern both in humans
and animals. In the UK, the majority of recently reported cases of feline mycobacterial
disease have been primarily cutaneous in nature and they presented with nodules,
draining tracts, ulceration and local lymphadenopathy that can mimic a foreign body
or an abscess. MRI was helpful in order to rule out a neoplastic disease or the
presence of a foreign body. This case shows the importance of further investigations
in order to prevent zoonosis.
74
We take pride in our work
Join a cutting-edge telemedicine company with a
commitment to quality that sets us apart from the rest.
• Evolve your skills
• Expand your experience
• Join a supportive world-class team
To find out more about working with us, please visit
www.vet-ct.com
75
FRIDAY / 02.09.2016
08:45 - 09:00
ANNOUCEMENTS
09:00 - 10:45
SESSION VI, Chairperson: RENATE WELLER
09:00 - 09:45
Keynote Lecture - Rachel Murray: THE AETIOPATHOGENESIS , DIAGNOSIS AND TREATMENT
OF PROBLEMS ASSOCIATED WITH THE PROXIMAL METATARSUS/DISTAL TARSUS
09:45 - 09:57
Z. Joostens: EFFECT OF UNIPODAL VS BIPODAL STANCE ON RADIOGRAPHIC EVALUATION
OF FOREFEET IN HORSES
09:57 - 10:09
C. De Guio: BONE MARROW OEDEMA-LIKE LESIONS OF THE METACARPAL CONDYLES:
A STUDY OF 135 SPORT HORSES
10:09 - 10:21
F. Audigie: DIAGNOSTIC IMAGING OF EQUINE DISTAL INTERPHALANGEAL DEGENERATIVE
JOINT DISEASE: RADIOGRAPHY, ULTRASONOGRAPHY, STANDING MRI
10:21 - 10:33
M. Spriet: MAGNETIC RESONANCE T1-MAPPING OF THE EQUINE DISTAL DEEP DIGITAL
FLEXOR TENDON
10:33-10:45
10:45 - 11:15
COFFEE BREAK
11:00 - 12:30
SESSION VII, Chairperson: MARIANNA BIGGI
Opera House - Foyer
11:15 - 12:00
Keynote Lecture - Gabriel Manso-Diaz: IMAGING OF THE HEAD: COMPARISON OF MODALITIES
12:00 - 12:12
S. Veraa: THE USE OF A SLIDING GANTRY CT IN THE STANDING SEDATED HORSE
12:12 - 12:24
T. Liuti: CLINICAL, RADIOGRAPHIC, COMPUTED TOMOGRAPHIC, GROSS PATHOLOGICAL
AND HISTOLOGICAL FINDINGS IN MAXILLARY CHEEK TEETH INFECTION IN 29 HORSES
12:24 - 12:36
T. Liuti: COMPUTED TOMOGRAPHIC, RADIOGRAPHIC, GROSS AND HISTOLOGICAL FINDINGS
IN ABNORMAL CHEEK TEETH EXTRACTED FROM EQUINE CADAVER HEADS
12:36 - 12:48
D. Gorgas: CONE BEAM COMPUTED TOMOGRAPHY OF THE HEAD IN STANDING HORSES
12:48 - 13:00
J. Ostrowska: COMPUTED TOMOGRAPHY CHARACTERISTICS OF EQUINE PARANASAL
SINUS CYSTS - A CASE SERIES
13:00-14:00
76
D. Berner: SERIAL MAGNETIC RESONANCE IMAGING OF NATURAL SUPERFICIAL DIGITAL
FLEXOR TENDON DISEASE IN HORSES OVER TWELVE MONTH
LUNCH
Opera House - Foyer
FRIDAY / 02.09.2016
14:00 - 16:00
SESSION VIII, Chairperson: KATHELIJNE PEREMANS
14:00 - 14:45
Keynote Lecture - Jeryl Jones: MANUSCRIPT PUBLICATION AND PEER REVIEW TIPS
14:45 - 14:57
G. Manso-Diaz: ULTRASONOGRAPHIC VISUALIZATION OF COLONIC MESENTERIC
VASCULATURE IN HORSES WITH ACUTE ABDOMINAL PAIN
14:57 - 15:09
C. Rowan: THE EFFECT OF RADIOOPAQUE MARKERS TO DELINEATE THE DORSAL
HOOF WALL ON IMAGE QUALITY IN DIGITAL EQUINE RADIOGRAPHY
15:09 - 15:21
C. Bergamino: EXPOSURE OF PERSONNEL ASSISTING IN EQUINE RADIOGRAPHY
OF THE STIFLE AND TARSUS
15:21 - 15:33
M. A. Mikkelsen: RADIATION PROTECTION IN EQUINE AMBULATORY PRACTICE IN NORWAY
15:33 - 15:45
M. Szulakowski: THE PHYSIOLOGICAL RADIOPHARMACEUTICAL UPTAKE PATTERN
OF THE SOUND EQUINE MAXILLARY CHEEK TEETH
15:45 - 15:57
M. Gumpenberger: DIAGNOSTIC IMAGING IN GIANT AFRICAN LAND SNAILS
(ACHATINA FULICAAND A. ALBOPICTA)
16:00 - 16:30
COFFEE BREAK
16:30 - 18:30
ECVDI ANNUAL GENERAL MEETING
18:30 - 20:00
FREETIME
20:00 - 01:00
GALA DINNER
Opera House - Foyer
OVO Hotel - Ballroom
Dinner
Awards and announcements
Charity auction
Concert
Party
77
VI
SESSION VI
KEYNOTE LECTURE
THE AETIOPATHOGENESIS, DIAGNOSIS AND TREATMENTS OF PROBLEMS
ASSOCIATED WITH THE PROXIMAL METATARSUS/DISTAL TARSUS
Rachel C. Murray, Newmarket, UK
Rachel Murray is a veterinary surgeon with a particular interest in sport horse injuries
and performance. She is a Diplomate of the American and European Colleges of
Veterinary Surgeons, and has led a number of studies investigating sport horse
training, injury and performance. She has published numerous articles on orthopaedic
problems and advanced imaging in horses, contributed to numerous books and edited
the standard book on Equine MRI.
Rachel graduated in veterinary medicine from the University of Cambridge, before
specialising in equine surgery. She spent 5 years working in the USA at the University of Missouri and Kansas State University before returning to England to become the
equine surgeon at the University of Cambridge, and subsequently completed a Ph.D.
investigating exercise-associated joint adaptation and injury in horses. She has been
based at the Animal Health Trust since 1997 in a variety of roles including Head of the
Centre for Equine Studies, and has been involved in development of MRI in horses.
She is currently Senior Orthopaedic Advisor at the Animal Health Trust where she is
in charge of the Equine Magnetic Resonance Imaging diagnostic service, runs the
orthopaedic research group and provides a clinical service focussed on poor performance in sports horses. Her research and clinical work is centred around sport horse
training, performance and injury development, and application of advanced imaging
techniques in the diagnosis of orthopaedic injury. She also works for the British
Equestrian Federation, providing scientific advice for the British Equestrian teams
and as a veterinary surgeon and Assistant Team Vet with the World Class Dressage
squads since 2009.
Rachel has ridden in a variety of equestrian sports, including competing to Grand Prix
level in dressage and achieving a silver medal at the European student championships in 1985. She has also competed to International level in rowing. She is married
to another vet, and they have two daughters competing internationally in dressage
at pony, junior and young rider level, including being part of the gold medal-winning
GB pony team at the European Championships in 2015.
.
78
EFFECT OF UNIPODAL VS BIPODAL STANCE ON RADIOGRAPHIC EVALUATION OF FOREFEET IN HORSES. Z. Joostens1, L. Evrard2, L. Olivier3, V. Busoni4.
1 - Université de Liège, FMV, Service d’Imagerie Médicale, Belgium, 4000. 2 - Université de Liège, FMV, Service d’Imagerie Médicale, Belgium, 4000. 3 - Université de
Liège, FMV, Pôle Equin, Belgium, 4000. 4 - Université de Liège, FMV, Service
d’Imagerie Médicale, Belgium, 4000. [email protected]
Lifting the contralateral forelimb is often used as a method of restraint when obtaining
forefeet radiographs in horses. This experimental study was conducted to evaluate the
effect of unipodal vs bipodal stance on several radiographic parameters in equine
forefeet. We hypothesized that unipodal stance would influence mediolateral and
sagittal balance by reducing lateral distal interphalangeal joint (DIPJ) space width
and increasing flexion of the distal interphalangeal joint (DIPJ).
Methods
Four non-lame horses with normal foot conformation were randomly selected.
Lateromedial (LM) and dorsopalmar (DP) projections were obtained on both forefeet,
squarely placed on blocks, using 2 x-ray generators in a fixed position laterally and
dorsally to the foot. Radiographs of each foot were made in a bipodal stance,
immediately followed by the same protocol in an unipodal stance (after lifting the
contralateral limb) without moving neither the foot nor the x-ray generator. Several
measurements were made: DIPJ space width at particular landmarks on DP and LM
projections; mediolateral joint balance on DP projections; deep digital flexor tendon
(DDFT) angle to solar surface of the distal phalanx (P3) and distance between P3
extensor process and dorsoproximal extent of the middle phalangeal (P2) condyle as
an indication of DIPJ flexion on LM projections. A matched pairs design and student’s
t-test with a 95% confidence level were used to test for statistical significance.
Results
Compared to a bipodal stance, lateral DIPJ space width was significantly reduced on
unipodal DP views (mean -0.75mm; CI ±0.35; p<0.005), whereas mediolateral joint
imbalance and to a lesser extent medial DIPJ space width were significantly increased
(mean +1.15mm; CI ±0.42; p<0.0005 resp. mean +0.40mm; CI ±0.18; p<0.005).
Although a statistically significant decrease in mean DIPJ space width was noted on
unipodal DP views (mean -0.17mm; CI ±0,19; p<0,05), the result was considered
negligible. No statistical difference was observed in mean DIPJ space width on LM
views between both conditions. The distance between the P3 extensor process and
the dorsoproximal extent of P2 condyle, as well as the DDFT angle, were significantly
increased in unipodal LM views (+1.98mm; CI ±0.83; p<0.0005 resp +10.54°; CI ±2.45;
p<0.0005), indicating a higher degree of DIPJ flexion in that condition.
Unipodal stance significantly affects the mediolateral balance of the DIPJ on DP
radiographs and significantly alters the phalangeal axis on LM radiographs. These
findings suggest that stance should be carefully taken into consideration when
radiographically evaluating equine forefeet, especially if assessing foot balance.
79
BONE MARROW OEDEMA-LIKE LESIONS OF THE METACARPAL CONDYLES:
A STUDY OF 135 SPORT HORSES. Cécile De Guio, Emilie Ségard, Aurélie Thomas,
Michael Schramme. VetAgro Sup, France, 69280. [email protected]
Introduction
Magnetic resonance (MR) signal abnormalities referred to as „bone marrow
oedema-like lesions” (BMOLL), can result from a degenerative process or have
a traumatic origin. To our knowledge, little information is available about BMOLLs
in the distal condyles of the third metacarpal bone (MCIII) in Sport horses.
Objectives
To evaluate the prevalence of BMOLLs in MCIII in Sport horses. To describe their
anatomic distribution. To correlate lesions with the presence of lameness and level
and type of activity.
All Sport horses undergoing standing low-field MRI (0.27T) of the front fetlock region
between 2009 and 2015 were included and divided in 3 groups according to the
results of diagnostic analgesia. Group 1 contained horses with a cause of lameness
located in the fetlock region, Group 2 consisted of horses with a cause of lameness in
the foot and Group 3 represented horses with a cause of lameness of uncertain
location (foot or fetlock).
STIR signal hyperintensity and T1 and T2* signal hypointensity were graded (0-3)
according to severity of the lesion in six different anatomical locations: palmar and
dorsal parts of the lateral condyle (LC), of the sagittal ridge area (SR) and of the
medial condyle (MC). For each limb, a total score was obtained as the sum of the six
scores. Severity scores were compared between groups using a Wilcoxon test.
Results
135 horses were included in the study. The prevalence of BMOLLs was 65%. Lesions
were located in the dorsal part of MCIII in 34% of these. The MC (37%) and the SR
(42%) were more commonly affected than the LC (23%). MRI of both limbs was
performed in 47% of the population, and lesions were frequently found bilaterally.
There was no significant difference in lesion severity between both limbs (mean/median: L: 1.77/1; NL: 2.07/1; p=0.19). Lesion severity was not significantly associated
with the location of the cause of lameness as the average/median lesion grade was
2.5/1 for horses in Group 1 and 1.3/0 for horses in Group 2 (p=0.10). BMOLLs were
considered to be the cause of lameness in 25 horses (19%). The average/median
lesion grade was 4.2/4.5 for these horses. The average/median lesion grade for
horses with other causes of lameness was 1.4/0.5 (significant difference (p=0.0001)).
Discussion
The prevalence of BMOLLs in MCIII is high in Sport horses. The clinical significance
of BMOLLs appears to be correlated with the severity of the lesions and not just with
their presence.
80
DIAGNOSTIC IMAGING OF EQUINE DISTAL INTERPHALANGEAL DEGENERATIVE JOINT DISEASE: RADIOGRAPHY, ULTRASONOGRAPHY, STANDING MRI.
F. Audigié, T. Rovel, L. Bertoni, V. Coudry, S. Jacquet, J-M. Denoix. CIRALE-ENVA,
USC INRA BPLC 957, France, 14430. [email protected]
Introduction/Purpose: The definitive diagnosis of distal interphalangeal degenerative joint disease (DIP-DJD) remains an intricate task due to the limitations of routine
imaging (radiography and ultrasonography=US) for the evaluation of the articular cartilage of the joint. In most cases, standing MRI (sMRI) represents the advanced imaging technique conducted in equine foot lameness when routine imaging is inconclusive. Thus, the purpose of the study was to: 1) document the use of sMRI compared
with routine imaging for the diagnosis of DIP-DJD based on a retrospective study and
2) describe the associated abnormal imaging findings.
Methods: Horses with a diagnosis of DIP-DJD based on clinical data, imaging
findings and ruling out other lesions that may account for the clinical signs were
selected among horses referred for sMRI including the foot region at the CIRALE over
a 3 year period. Radiographic and US examinations were performed prior to sMRI.
The foot sMRI was conducted using a standard protocol of 5 different sequences (the
T1w 3D GRE high resolution sequence being performed both in transverse and dorsal
planes) with additional sequences selected based on the pre-imaging differential
diagnoses and results of sMRI standard protocol.
Results: A diagnosis of DIP-DJD was obtained in 10 patients on the 218 examined
horses (9 showjumpers and 1 racing Trotter horse; median age: 9 years old). The median duration of clinical signs related to DIP-DJD was 3.5 months. This condition was
diagnosed by the referring veterinarian prior to sMRI in 1 case and suspected in 2
cases. DIP joint distension and peri-articular remodeling were absent or mild in 4 horses. In all of the 10 patients on sMRI, a thinning of the articular cartilage was observed
most frequently diffuse and characterized by a lack of separate identification of the
articular cartilage of the middle (P2) and distal (P3) phalanges, associated with either
focal or extended signal abnormalities. This thinning was not identified or suspected in
only 2 cases on comparative radiographic images of both feet obtained at CIRALE
prior to MR examination. sMRI has revealed subchondral bone lesions undetected
radiographically: bone marrow edema like lesions (BMEL) were found in the navicular
bone (6 cases) most frequently its dorsal aspect, the distal part of P2 (3 cases) and
proximal aspect of P3 (2 cases). In contrast, peri-articular remodeling and synovial
membrane proliferations were underestimated by sMRI compared to routine imaging
(6 cases). Follow-up of these 10 horses has shown the poor prognosis of such imaging findings: only 1 showjumper has returned to competition but to a lower level.
Discussion/Conclusions: sMRI allow to go further in the diagnosis of DIP-DJD in
a clinical setting or when follow-up imaging is required by identifying subchondral bone
lesions and providing a detailed evaluation of the articular cartilage compared to
routine imaging. Follow-up of these cases confirm nevertheless that routine imaging
and sMRI may have limitations compared to high-field MRI to identify early signs of
DIP-DJD particularly before the occurrence of a foot lameness with a poor prognosis.
Acknowledgements: Authors thank the Conseil Régional de Normandie and the
European Regional Development Funds (FEDER) for their financial support.
81
MAGNETIC RESONANCE T1-MAPPING OF THE EQUINE DISTAL DEEP DIGITAL
FLEXOR TENDON. M. Spriet, A.J. DeRouen, C.W. Chang, K.H. Griffin, T.C. Garcia,
L.G. Griffiths, B. Murphy. School of Veterinary Medicine, University of California,
Davis, 95616, USA. [email protected]
Introduction/Purpose: Quantitative magnetic resonance imaging (MRI) provides the
potential of detecting in vivo changes at the molecular level. The longitudinal relaxation time constant, T1, depends on the macromolecular environment. Increased
T1 values have been reported with lesions of the human Achilles tendon and equine
flexor tendons in the metacarpal area. The distal aspect of the deep digital flexor
tendon (DDFT) is a common site of lesions in the horse. The goals of this study were:
(1) to establish the normal T1 values and their regional distribution in the equine distal
DDFT, (2) to assess T1 changes in horses with distal DDFT lesions, and (3) to correlate these results with DDFT histology and biochemical analysis.
Methods: Cadaver limbs from 12 horses were used in the study. Six of the horses had
been diagnosed ante-mortem with lameness attributed to the distal DDFT based on
clinical examination and MRI. Both forelimbs from these horses were included and
constituted the “lesion group” (L) (most lame limb) and the “contralateral group”
(contralateral limb). The other 6 horses had no history of forelimb lameness. A single
limb from each of these horses was randomly selected to compose the “control
group”(C). Limbs were imaged with a 1.5T MRI using conventional imaging sequences. Limbs were then positioned in a custom-made jig designed to optimize presence
of the magic angle effect in the distal DDFT to allow T1 mapping. Specifically designed
spin echo proton density and inversion recovery sequences (TI = 350 ms) were used
to generate T1 maps using a custom-made Matlab application. Histology was performed. Collagen and sulfated glycosaminoglycan (sGAG) content of the DDFT were
quantified biochemically.
Results: T1 maps demonstrated higher T1 values at the dorsal aspect of the DDFT
adjacent to the navicular bone in all horses, correlating with presence of fibrocartilage
demonstrated on histology. Lesions were associated with locally increased T1 values.
The lesion group had higher T1 values than the control group (L: 291.2 (286.3-332.5)
ms (median (interquartile range)), C: 262.8 (238.0-278.5) ms, Mann-Whitney
P=0.0043). The collagen content was significantly lower in the lesion group than the
control group (L: 0.39 (0.37-0.41), C: 0.45 (0.42-0.50) mg/mg dry weight, P=0.017),
whereas sGAG was significantly higher in the lesion group (L: 11.42 (5.77-15.02),
C: 5.63 (4.96-9.59) µg/mg dry weight, P= 0.026). A significant linear correlation
was identified between T1 values and sGAG measurements (Pearson’s P = 0.033,
R2 = 0.269), but not with collagen content (P=0.341).
Discussion: T1 maps of the equine distal DDFT can be acquired using magic angle
imaging with a conventional MRI system. Regional variation in distribution of T1
values exists. Increased T1 values are associated with increased sGAG content, which
has been reported as a degenerative change to the tendon matrix. The proposed
technique has potential to detect in vivo changes at the molecular level in the tendon
matrix. This method may be useful for early detection of lesion as a clinical diagnostic
tool or to improve understanding of the pathophysiology of DDFT lesions.
82
SERIAL MAGNETIC RESONANCE IMAGING OF NATURAL SUPERFICIAL
DIGITAL FLEXOR TENDON DISEASE IN HORSES OVER TWELVE MONTH.
D. Berner1, W. Brehm1,2, K. Gerlach1, J. Offhaus1, D. Scharner1, J. Burk1,2,3. 1 - Large
Animal Clinic for Surgery, 2 - Translational Centre for Regenerative Medicine, 3 - Institute of Veterinary Physiology, University of Leipzig, Germany, 04103. dagmar.berner@
gmail.com
Tendon diseases are common in both equine and human athletes. Ultrasonography is
routinely used for the evaluation of healing progress in equine superficial digital flexor
tendon (SDFT) lesions. However, in human medicine magnetic resonance imaging
(MRI) is also used for evaluation of Achilles tendon diseases. Therefore, the purpose
of this study was to evaluate naturally occurring SDFT lesions with MRI over a period
of 12 months.
Methods
Eight horses with a clinical SDFT lesion in at least one forelimb were included in this
study. After the initial MRI examination all horses were treated intralesionally with
allogenic mesenchymal stromal cells. Transverse T1-weighted (w) and T2*w gradient
echo sequences as well as T2w fast spin echo (FSE) and short tau inversion recovery
(STIR) FSE sequences of the lesions were acquired with a 0.27 Tesla dedicated
standing equine MRI system. Follow up examinations were performed over a period
of 12 months (2, 4, 8, 12, 24 and 48 weeks). MRI series were anonymized and the
level of maximal tendon injury was determined on T1w images by two observers
in consensus. For calculation of lesion percentage the cross-sectional area of the
SDFT and the lesion was measuredin all sequences. Additionally, signal intensities
of the lesions and the unaltered deep digital flexor tendons were determined with
region of interests (ROI) and normalized to the background.
Results
Lesion percentage decreased over time in all sequences. At any time point signal
intensity of the lesions was lower in T2w images and higher in T1w images compared
to the other sequences. After twelve months complete resolution of signal hyperintensities was found in T2w sequences in six lesions, of which three showed additional
resolution in STIR sequences. The remaining two forelimbs showed re-injuries of the
SDFT at different sites.
In this study we were able to demonstrate the healing progress in tendon lesions in
a period of twelve months. Resolution of lesions in T2w sequences at this time was
indicative for tendon healing without re-injurie as well as return to intended use.
83
VII
SESSION VII
KEYNOTE LECTURE
IMAGING OF THE HEAD: COMPARISON OF MODALITIES
Gabriel Manso-Diaz, Madrid, Spain
Olivier Taeymans. Newmarket, UK
The equine head is a highly complex anatomic area, as it contains part of the respiratory, digestive and nervous systems as well as the organs of vision and audition
(König and Liebich, 2010). Therefore, many different disorders of potentially major
clinical importance can settle in this region with clinical signs varying largely on the
affected structures, making the diagnosis of these conditions often challenging.
The diagnostic approach of head diseases must start with a thorough physical
examination (MacDonald, 1993). However, the information obtained from physical
examination is commonly limited, and often needs to be complemented by ancillary
diagnostic tests with diagnostic imaging techniques playing a crucial role (Mair et al.,
2013; Tucker and Farrell, 2001).
Diagnostic imaging modalities used for studying this area include radiography,
ultrasonography, scintigraphy and advanced cross sectional techniques, such as
computed tomography (CT) and magnetic resonance imaging (MRI). Indications
for each modality depend on the affected area as well as the clinically suspected
condition (MacDonald, 1993).
84
THE USE OF A SLIDING GANTRY CT IN THE STANDING SEDATED HORSE.
S.Veraa, M. Beukers, A.J.M. van den Belt. Division of Diagnostic Imaging, Faculty of
Veterinary Medicine, Utrecht University, 3584 CM, Utrecht, The Netherlands.
[email protected]
Computed tomography (CT) has proven its value in the assessment of the equine
head. The evaluation of dental structures, (para-) nasal sinuses, fractures, temporo-mandibular joints have been described. A limiting factor for the use of CT as a readily
accessible diagnostic modality in diagnosing head pathology of the horse has been
the need for general anesthesia. More recently, the introduction of CT examinations in
the standing sedated horse has overcome this limitation. With the introduction of the
sliding gantry CT in human hospital emergency rooms, a new application was also
created for veterinary medicine. The aim of this study was to evaluate the use of the
64-slice Siemens sliding gantry Definition AS CT scanner in combination with a custom-built, in height adjustable platform in the standing sedated horse.
Patient data of all horses that underwent CT during a 1-year period (March 2015
- March 2016) were retrieved from the available picture archiving system (PACS).
Recorded were the presenting clinical complaints and CT diagnosis. The number
of horses scanned, number of scans/horse in this 1-year period, the presence of
significant movement influencing diagnosis and whether the CT was performed
standing or under general anesthesia were recorded. Furthermore, the experiences
of technicians, anesthesiologists and radiologists involved were evaluated.
Results
115 horses were scanned; 4 were scanned twice. Movement was recorded, but
affected diagnostic value in only 2 horses. General anesthesia was necessary in
9 horses that did not tolerate the system (n=3), had severe neurological signs (n=2)
or were scanned for limb or thorax/abdomen (n=4). Horses presented most frequently
for nasal discharge, oro-sinusal fistula and skull fractures. Other indications for
scanning included ethmoidal haematoma, cranial nerve deficits, headshaking, focal
soft tissue swelling and exophthalmia. CT diagnoses consisted mostly of alveolitis with
or without secondary sinusitis and fractures. Unusual diagnoses included, amongst
others, a digastricus muscle rupture with guttural pouch distention and primary gastric
impaction in a miniature horse. The use of the 64-slice sliding gantry CT system
combined with an adjustable platform proved user-friendly and allowed for scanning
without any personal present in the CT room in all cases. Scanning time of the head
to C2-3 was around 23-35 seconds average (0.6mm slice thickness). Sedation was
performed with a start bolus and thereafter top-ups. Scanning the limbs without
experiencing table movement due to weight of the horse was also considered an
advantage. Quality of the scans was considered good to excellent by all radiologists.
Introduction of a sliding gantry in veterinary medicine enables a very user-friendly way
of scanning the head and cranial cervical spine in the standing horse and is considered an excellent technique for scanning heavy recumbent (anesthetized) animals.
85
CLINICAL, RADIOGRAPHIC, COMPUTED TOMOGRAPHIC, GROSS PATHOLOGICAL AND HISTOLOGICAL FINDINGS IN MAXILLARY CHEEK TEETH INFECTION
IN 29 HORSES. T. Liuti, S. Smith, P.M Dixon. Royal (Dick) School of Veterinary
Studies and Roslin Institute, University of Edinburgh, Midlothian, EH25 9RG, United
Kingdom. [email protected]
To correlate the clinical findings in horses with dental sinusitis with radiographic and
computed tomographic (CT) imaging, and pathological findings in the extracted
maxillary cheek teeth.
Twenty nine horses presented to the R(D)SVS with sinonasal disease diagnosed
secondary to apical infection of maxillary cheek teeth were included in this study.
Clinical examination, standard radiographic projections, standing CT, gross evaluation
and histological examination of extracted maxillary cheek tooth were undertaken.
A total of 33 teeth were extracted from 29 horses and 4 normal teeth extracted from
cadavers were used as controls.
Results
In 10/29 sinusitis cases, no dental abnormalities (such as clinical crown fracture
or pulpar exposure) were detected on oral examination but CT showed changes
indicative of maxillary cheek teeth apical infection in all 10 cases. Radiography
showed apical changes in only 5/10 cases. Gross examination of the extracted
teeth showed abnormalities in just 3/10 teeth and histological changes were present
in 5/10 with 5 showing no detectable histological changes. In 10/29 cases, idiopathic
maxillary cheek teeth fractures were identified on clinical examination in 14 teeth and
CT showed changes consistent with apical infection in all 14 teeth. Radiography
showed changes in 12/14 teeth. Gross apical changes were present in 9/14 teeth.
All 14 teeth were abnormal histologically. In 9/29 cases occlusal pulpar exposure
was identified on oral examination; all 9 cases had apical changes on CT and 5/9
had radiographic changes. Histological changes were present in 4/9 teeth, with the
5 histologically normal teeth all having radiographic changes.
Changes indicative of apical infection were identified on CT were identified in all 33
extracted cheek teeth in this series. Histology is considered the gold standard in
determining the presence of apical disease, but histopathology only correlated to CT
findings in 60% of these teeth. However, histology could detect inflammatory changes
and cemental/dentine destruction not appreciated on CT. In 72% of the samples,
radiography detected equivocal changes related to apical infection. On gross
examination, 66% of extracted teeth did not have any detectable apical changes,
with 34% considered abnormal. The inflammatory changes and cemental/dentin
presence of pathological changes confined to the periodontal tissue at the apex
and not involving the dental pulp or calcified tissues could explain the disparity
between imaging and pathological findings in this study.
86
COMPUTED TOMOGRAPHIC, RADIOGRAPHIC, GROSS AND HISTOLOGICAL
FINDINGS IN ABNORMAL CHEEK TEETH EXTRACTED FROM EQUINE
CADAVER HEADS. T Liuti, S.Smith, P.M. Dixon. Royal (Dick) School of Veterinary
Studies and Roslin Institute, University of Edinburgh, Midlothian, EH25 9RG,
United Kingdom. [email protected]
To correlate the computed tomographic (CT), radiographic, gross and histological findings in abnormal cheek teeth extracted from equine cadaver heads.
Forty equine cadaver heads with unknown histories collected from a local abattoir
were subjected to CT (3mm slice thickness) and standard radiographic projections:
(Lateral, Dorsoventral, and 2 Obliques for maxillary and mandibular arcade). CT images were acquired in tranverse with the use of a Helical 4 slice CT scanner: 100 mAs
and120 kV with H70 and H40 were used
Results
Based on imaging findings, 33 abnormal cheek teeth were identified in 12 of these
heads. CT changes were mainly: gas within the pulp, blunting, lysed or fragmented
roots, widened alveolar space, dysplastic, or supernumerary teeth. The abnormal
teeth (29 maxillary and 4 mandibular) were extracted and examined grossly and
histologically.
Two supernumerary maxillary cheek teeth were morphologically normal on CT,
radiographically and on gross examination however, histologically one contained bacteria within the pulp cavity. Pulpar changes were observed in 20 cheek teeth on CT
imaging. A later CT scan of these teeth after they were extracted at 0.5mm slice
thickness confirmed gas in the pulp of 18 teeth: 12 of these were confirmed histologically as having at least one infected pulp.
Radiographically, 28/33 teeth were considered abnormal; 4/5 radiographically normal
teeth were also considered histologically normal. In all 28 samples, there was a good
correlation between radiography with CT, although radiographic changes were primarily related to tooth root blunting.
Gross changes were only observed in 14/33 teeth; with 3/14 of these teeth normal
histologically. Overall, histological changes were present in 22/33 teeth, including pulpar changes in 9; changes in the pulp, periodontal ligaments, cementum and dentine
in 6; and changes in the cementum, periodontal ligaments and dentine but not in the
pulp in 7 teeth. Thinner CT slices confirmed the presence of gas in the pulp in 18 of 20
teeth
Heads selected for this study had changes in the maxillary and mandibular cheek
teeth. CT scanning using 3mm slice is a relatively sensitive imaging modality to detect
equine cheek teeth apical changes as confirmed by histological examination.Good
correlation was found between radiography and CT images however radiographic
changes were less sensitive at detecting apical changes
87
CONE BEAM COMPUTED TOMOGRAPHY OF THE HEAD IN STANDING
HORSES. M. D. Klopfenstein Bregger1, C. Precht2, C. Koch1, D. Gorgas2. 1 - Swiss
Institute for Equine Medicine, 2 - Divison of Clinical Radiology, Department of Clinical
Veterinary Medicine, Vetsuisse-Faculty University of Bern and Agroscope
Avenches, Switzerland, 3012. [email protected]
Computed tomography (CT) in standing sedated horses has revolutionised diagnostic
imaging, enabling cross sectional imaging of the equine head without the requirement
for general anaesthesia. Cone beam computed tomography (CBCT) allows for rapid
volumetric image acquisition from a single low radiation dose scan and is routinely
used for the diagnostic evaluation of osseous abnormalities of the head in humans.
The o-arm (Medtronic®), a CBCT with a large gantry opening (96.5cm), is designed
for intraoperative spinal and orthopaedic imaging in humans. The aim of this study is
to describe the technical set-up and use of the o-arm to accomplish CBCT in standing
horses for equine head disorders.
Methods
The mobile CBCT has been placed in a room fulfilling the radiation protection requirements of Switzerland. Between February 2015 and April 2016, horses presented because of diseases related to the head with indication for cross sectional imaging were
examined. Horses were sedated and positioned in a stock; the head was positioned
on a mobile table and fixed within a vacuum cushion. 2D images were acquired and
position, height and tilt of the gantry of the o-arm were adjusted to the area of interest.
Acquisition of the 3D cylindrical volume of a length of 16 cm and a diameter of 20 cm
takes 13s. During scanning, no personnel were within the room.
Results
Thirty-nine horses underwent a CBCT examination in standing position. Motion during
examination hampered diagnostic image quality in two horses and no images of
diagnostic quality could be obtained. In the remaining horses a radiologic diagnosis
was established: dental disease (19), fracture (4), primary sinusitis (3), sinus cyst (2),
neoplastic lesion (2), temporohyoid-osteoarthropathy (2), primary rhinitis (1), primary
sinusitis (1), suture periostitis (1), soft tissue abscess (1). In one horse, no abnormalities were detected. Bone and teeth were displayed with a diagnostic spatial and
contrast resolution, however the contrast resolution of soft tissue was limited and no
differentiation between soft tissue qualities could be made.
CBCT allowed to establish a radiological diagnosis and is therefore considered as
a valuable imaging modality for equine head disorders. The advantages of CBCT
compared to multislice CT are no fixed installation, mobility of the gantry in all dimensions and reduced radiation dose. The disadvantages of CBCT such as sensitivity
to motion artefact, increased scatter, low soft tissue contrast and the limited field
of view size have to be considered.
88
COMPUTED TOMOGRAPHY CHARACTERISTICS OF EQUINE PARANASAL
SINUS CYSTS – A CASE SERIES.
J.Ostrowska1, T.Tóth1, L.Lindström3, K.Hansson2, M.Uhlhorn1, C.J.Ley2. 1 - University
Animal Hospital, 2 - Dept of Clinical Sciences, 3 - Dept of Biomedical Sciences and
Veterinary Public Health, Swedish University of Agricultural Sciences, Sweden, SE750 07. [email protected]
Differentiating paranasal sinus cysts (PSC) from other paranasal sinus diseases in
horses based on diagnostic imaging is challenging. The aim of this study was to
identify the pattern of CT features, typical for PSC, by retrospective comparison
to other diseases of the equine paranasal sinuses.
Methods
Nine CT scans of 8 horses (disease reoccurred after one year in one horse) with
typical surgical appearance of PSC (7 confirmed with histopathology) were retrospectively reviewed (group-1). Imaging findings were compared to a group of 11 horses
with paranasal sinus disease of other origin (2 neoplasia, 7 chronic sinusits/granuloma, 2 progressive ethmoid hematoma), with all horses in this group having
surgery/necropsy and culture/histopathology confirmation of the diagnosis (group-2).
Thirteen of the horses received contrast; intravenous Iohexol 300mgI/ml, 20ml/sec,
400mL/horse, scanned approximately 2 and 7 minutes post contrast. Mean HU values
of the soft tissue/fluid density lesions were obtained for 3 regions of interest in
3 different slices. Student t-test for independent samples, p<0.05 considered
significant, was used to compare mean density of the cystic content with free sinus
fluid in group-1 and soft tissue/fluid density lesions in group-2.
Results
In 6 horses the presumed wall of the cyst was at least partially mineralized. Subtle
post-contrast enhancement of the cystic wall was seen in 2 horses in which the
mineralized wall was absent. Presence of focal or spicule-like, peripheral mineralizations were seen in two group-1 horses and in one group-2 horse with a paranasal
sinus granuloma. All cysts were filled with soft tissue/fluid density (mean±SD, 25±11HU),
except one that contained only air. No significant difference was found between
the mean density of the cystic content and the soft tissue/fluid density lesions in
group-2 (mean±SD, 25±11 vs 42±23HU, p=0.06), or between the free sinus fluid
surrounding the cysts (mean±SD, 25±11HU vs 34±17HU, p=0.2). Cortical destruction
was detected in 4 group-1 and 2 group-2 horses. Seven horses in each group had
cancellous bone thinning/destruction, which always involved at least the infraorbital
canal. Bone distortion was most frequent/severe in group-1 horses and bone
production was most common in group-2 horses with sinusitis.
PSCs often have mineralization in the cyst wall and this feature may be useful to
differentiate PSC from other paranasal sinuses diseases in CT images. Despite the
benign character of PSC cortical destruction is common in horses with PSC. There
is considerable overlap between HU values of the contents of PSC and the
fluid/tissue present in other paranasal sinus diseases.
89
VIII
SESSION VIII
KEYNOTE LECTURE
MANUSCRIPT PUBLICATION AND PEER REVIEW TIPS
Jeryl Jones, Clemson, USA
Dr. Jeryl (Jeri) Jones is a Diplomate in the ACVR and the Editor-in-Chief for Veterinary
Radiology & Ultrasound. She completed her Bachelor of Science degree at Clemson
University, and her Doctor of Veterinary Medicine degree at the University of Georgia.
She worked in private small animal veterinary practice for 7 years before completing
her residency/PhD program at Auburn University. Since then, Dr. Jones has been
a faculty member in the Department of Small Animal Clinical Sciences at the Virginia
Maryland College of Veterinary Medicine, and in the Department of Animal and
Nutritional Sciences at West Virginia University. She is currently a Professor in the
Department of Animal and Veterinary Sciences at Clemson University.
90
ULTRASONOGRAPHIC VISUALIZATION OF COLONIC MESENTERIC VASCULATURE IN HORSES WITH ACUTE ABDOMINAL PAIN.
G. Manso-Díaz1, F.J. López-Sanromán1,2. 1- Hospital Clínico Veterinario Complutense. 2 - Dpto. de Medicina y Cirugía Animal. Facultad de Veterinaria. Universidad
Complutense de Madrid, Spain, 28040. [email protected]
Introduction/Purpose: The blood supply to the large colon (LC) is provided by two
main vessels, the colic branch and right colic artery. These two vessels course along
the medial aspect of the LC and should not be visible during transabdominal
ultrasonographic examination in the normal horse. Previous studies described the
visualization of LC mesenteric vessels in the right side of the abdomen as an indicator
of right dorsal displacement of the LC (RDDLC) or 180° LC volvulus (LCV), or both.
The purpose of this retrospective study was to describe the visualization of LC mesenteric vasculature during transabdominal ultrasonographic examination in horses
referred for acute abdominal pain.
Methods: A retrospective search of all horses referred for acute abdominal pain
between 2013 and 2015 at the Veterinary Teaching Hospital from the Universidad
Complutense de Madrid was performed. Transabdominal ultrasonographic examinations (General Electric Logiq 5 Expert) upon the admission were reviewed, and only
horses in which LC mesenteric vasculature was identified were selected. Thorough
abdomen was evaluated using the same protocol in all horses with a 2.5-5 MHz curvilinear transducer. Localization, length (described in number of intercostal spaces) and
course of the vessels was recorded for each horse. Treatment and final diagnosis
were also recorded.
Results: Twenty-six horses met the inclusion criteria. Age ranged from 5 months to 25
years (mean 9.8 years ± 4.7 years) and Andalusians were the most represented
(10 horses). Eighteen horses underwent exploratory laparotomy, 6 horses had
a positive outcome with medical treatment and 2 horses were euthanized and subsequent necropsy was performed. LC mesenteric vasculature was distinct from the
caecal vessels in all horses. These LC vessels were identified in both the right (12/26)
and left (14/26) sides of the abdomen. Diagnoses of horses with vessels in the right
side included RDDLC (7/12), 180º LCV (2/12), 540º LCV (1/12) and LC impaction
(2/12). When vessels were identified in the left side, diagnoses included left dorsal
displacement of the LC (LDDLC) (5/14), 180º LCV (5/14) and RDDLC (4/14).
Discussion/Conclusions: Equine LC has a wide range of mobility within the abdomen making it susceptible to several types of displacements and volvulus. Exact determination of the position of the LC in horses with acute abdominal before surgery is
essential for establishing a precise diagnosis and prognosis. Ultrasonographic
identification of the LC mesenteric vasculature is a helpful aid when its medial aspect
becomes situated against the body wall. As previously described, visualization of
these vessels in the right side of the abdomen can be a predictor of RDDLC or LCV.
However, to the author’s knowledge this is the first description of the ultrasonographic
evidence of the LC mesenteric vasculature along the left lateral abdomen and should
be considered as an indicator of LDDLC, RDDLC or 180º LCV.
91
THE EFFECT OF RADIOOPAQUE MARKERS TO DELINEATE THE DORSAL
HOOF WALL ON IMAGE QUALITY IN DIGITAL EQUINE RADIOGRAPHY.
C.Rowan, A. Puggioni, C. Kearney C. Skelly. UCD Dublin, School of Veterinary
Medicine, Ireland. [email protected]
Introduction/Purpose: Radiographic examination of the foot is one of the most frequently performed studies of the equine limbs. Most authors recommend using a highly
attenuating marker (metallic strip, piece of wire or barium paste), to delineate the surface of the hoof wall. Given the high adoption of digital radiography (DR) in equine
practice with its wide dynamic range, the benefit of using radiopaque markers in these
cases needs to be examined. The purpose of this study is to compare the quality of the
projections without a lead marker compared to those with and evaluate if they remain
a legitimate aid or a remnant of a bygone imaging era.
Methods: Twenty-two cadaver limbs sectioned at the carpus/tarsus were suspended
from a rig to mimic the normal standing position in vivo. Two standardised lateromedial
views were taken of each limb (100cm SID 66 kV 5 mAs, centred 1cm distal to coronet) using a portable X-ray machine and a DR plate. A reference image was obtained
with a lead strip placed along the dorsal midline aspect of the hoof wall and a comparative image without a lead marker. Three board-certified observers (2 radiologists;
1 equine surgeon) were asked to compare the quality of the projections by performing
a comparative visual grade analysis (VGA) based on 6 anatomic criteria. These were
scored as better visualised (+1), equal to (0), or poorer visualised (-1) than the reference image. The same observers repeated the scoring of the images, 4-6 weeks later.
A chi squared test was performed.
Results: A total of 792 scores were performed for the VGA. The total number in each
rating, for each evaluation set are summarized in the table below.
Anatomical
Criterion
Rating
Evaluation 1 n (%)
Evaluation 2 n (%)
Dorsal Hoof Wall
Coronary Band
+1/0/-1
+1/0/-1
30(45%)/34(52%)/2(3%)
25(38%)/38(58%)/3(4%)
22(33%)/38(58%)/6(9%)
23(35%)/42 (64%)/1(1%)
0.12
0.53
Extensor Process
Dorsal P3
+1/0/-1
+1/0/-1
8(12% )/57(86%)/1(2%)
23(35%)/43(65%)/0(0%)
9(14%)/55(83%)/2(3%)
22(33%)/44(67%)/0(0%)
0.80
0.85
30(45.5%)/34(51.5%)/2(3%)
28(42%)/36(55%)/2(3%)
0.35
0.59
Soft Tissue Junction +1/0/-1
Dorsodistal P3
+1/0/-1
8(12.1%)/57(86%)/1(1.5%) 9 (14%)/57(86%)/0 (0%)
p-value
Discussion/Conclusions: The study showed that there was no benefit gained
by using a lead marker on the dorsal hoof wall. The image quality was shown to be
equal or superior when the lead marker was not applied. There was no significant
difference between the two evaluation sets. Therefore the continued practice of using
lead markers along the dorsal hoof wall is no longer necessary.
92
EXPOSURE OF PERSONNEL ASSISTING IN EQUINE RADIOGRAPHY OF THE
STIFLE AND TARSUS. C. Bergamino1, L. Gray2, D. Maguire2, C. D’Helft1, C. Skelly1.
1 - Veterinary Teaching Hospital University College Dublin, Belfield, Ireland. 2 - St.
Vincent’s University Hospital, Medical Physics and Clinical Engineering Department,
Dublin, Ireland. [email protected]
Introduction
Several studies have recently demonstrated that the risk of developing ocular lens
opacities amongst people working with ionizing radiation is greater than previously
considered. As a consequence, new EU guidelines and lower threshold limits have
been established in order to prevent adverse effects. However, although protective
clothing for the body and hands are currently required for personnel assisting with
veterinary radiography, no protective eye devices are legally required from ionising
radiation. This study was designed to quantify the risks associated with ionising radiation for personnel assisting in equine radiography of the stifle and tarsus and to determine whether the need for protective eye wear is indicated.
The scatter radiation pattern that occurs in equine radiography of the stifle and tarsus
was reproduced in the large animal X-ray room at our institution. A suspended,
average sized equine cadaver was radiographed with an appropriately positioned
tissue equivalent anthropomorphic phantom holding the image receptor. The scattered radiation dose was measured at four different areas, with a source to image-detector distance (SID) of 100cm: the eye, the thryoid, above and underneath a 5mm lead
equivalent glove on the distal aspect of the fingers. Each area had both an Unfors
probe and a TLD attached. Ten exposures were made and doses recorded of each
of the following views: the latero-medial (LM) and caudo-cranial (CdCr) projections
of the stifle, with a manually held image receptor (IR); LM and dorso-plantar (DP)
projections of the tarsus, with the IR supported manually and with a cassette holder.
Results
Results indicate that repetitive low doses of ionising radiation in the order of 0.003mSv
were received to eye and thyroid. The CdCr view of the stifle recorded the greatest
exposure dose to eyes (mean 0.0047mSv ±0.0028) and thyroid (mean 0.0054mSv
±0.0026). The use of a cassette holder reduced the radiation dose compared to
manually held IR in the tarsal region by approximately 23%-43% (DP view: dose
reduced approx. 23.75% for the thyroid and 43.18% for the eye; LM view: dose
reduced approx. 40.36% for the thyroid and 39.25% for the eye).
Discussion
The highest radiation exposures where recorded on the unprotected extremities which
are protected by lead gloves as a legal requirement. However, this study shows that
although the dose to the eye lens and the thyroid was less that the one to the extremities, the dose received was still at a level for concern for the personnel assisting.
Based on the results of this study and the revised degree of radiosensitivity of these
two organs, protective devices are highly recommended for these regions and should
be considered as good practice, even if not legally required.
93
RADIATION PROTECTION IN EQUINE AMBULATORY PRACTICE IN NORWAY.
M.A. Mikkelsen1, B.H. Knutsen2, N. Ottesen1, Å. Søvik2. 1 - Norwegian University of
Life Sciences, Norway, 0033. 2 - Norwegian Radiation Protection Authority, Norway,
Portable radiographic units are increasingly used in equine field services in Norway.
The use of such equipment may potentially pose a radiation risk to both personnel and
the general public if appropriate radiation protection practices are not observed. The
aim of this study was to evaluate the veterinarians’ knowledge of and compliance with
Norwegian radiation protection regulations, and to investigate how they employed
radiation protection principles in their daily practice.
Methods
A questionnaire was developed and sent out as a formal inspection in cooperation with
the Norwegian Radiation Protection Authority (NRPA). The questions were designed
to retrieve information about regulatory compliance, quality assurance, and practical
radiation protection during off-site radiographic examinations. The questionnaire was
sent out to all Norwegian equine veterinarians/clinics with known or suspected access
to mobile radiographic units, 46 in total, of which 37 confirmed the use such
equipment. The feed-back was 100% due to the nature of the formal inspection.
Results
Regulatory compliance: 29.7% of respondents had notified NRPA of their use of
a radiographic unit and 43.2% had appointed a radiation protection officer. Quality
assurance: 37.8% of respondents performed internal control of the radiographic unit
on a regularly base. 37.8% had their unit serviced externally yearly or every other year.
Practical radiation protection: 83.7% of respondents always or often used members of
the general public (e.g. the horse owner or stable/farm staff) as helpers during radiographic examinations. Personal protective equipment: The person managing the
radiographic unit and the person holding the detector plate always used a protective
lead apron in 97.3% and 100% of the respondents, respectively. 43.2% of respondents
always or often used a stand for the radiography unit. 59.4% of respondents always or
often used a cassette holder. Monitoring of radiation doses: 16.2% of respondents
used personal dosimetry. Only 5.4% used active dosimetry during the radiographic
examinations
The low percentage of veterinarians who had notified NRPA of their radiography units
and the low number of establishments who had appointed a radiation protection officer
suggests lack of knowledge of the Norwegian radiation protection regulations. Personal protective equipment was frequently used for the person managing the radiographic unit and the detector plate, but cassette holders and stands for the radiography
unit were used relatively infrequently. Few respondents use personal dosimeters. The
study demonstrates a considerable room for improvement of radiation protection
practices in equine field services in Norway.
94
THE PHYSIOLOGICAL RADIOPHARMACEUTICAL UPTAKE PATTERN OF THE
SOUND EQUINE MAXILLARY CHEEK TEETH. M. Szulakowski, T. Steinberg, M. Mageed. Tierklinik Lüsche GmbH, Germany, 49456. [email protected]
Introduction
The current work aimed to provide reference values and ranges of radiopharmaceutical uptake of clinical healthy cheek teeth in horses.
Methods
Thirty-one right lateral scintigrams of healthy horses were used. Each scintigram was
overlapped over the radiograph of the same horse using equine fusion software. Oval
ROI’s were positioned over the ‘06-’11 alveoli and a reference oval ROI was positioned
in the dental space. The reference value was calculated as count per pixel of each
tooth divided by count per pixel of the reference ROI. One way analysis of variation
test was used to detect the differences between the teeth and the age groups as well.
The significance level was set at P<0.05.
Results and discussion
There was no significant difference between the right cheek teeth based on the radioactivity uptake between the age groups (Table 1). However, ’09 tends to have slightly
more intense uptake what could be due to the overstress during the mastication process. The ’09 shares the rostral and caudal wall of the alveoli with ’08 and ’10 that
could explain the relatively high reference value of these teeth.
Table 1 Reference ranges of the sound equine cheek teeth uptake.
The teeth were named based on Triadan System.
‘06
‘07
‘08
‘09
‘10
‘11
Mean
1.7
2.2
2.4
2.4
2.4
2.2
Range
1.1-3.1
1.5-4.7
1.7-3.5
1.6-4.0
1.6-3.7
1.6-3.4
95
DIAGNOSTIC IMAGING IN GIANT AFRICAN LAND SNAILS (Achatina fulica and
A. Albopicta). M. Gumpenberger1, S. Schmidt-Ukaj2, 1 - Diagnostic Imaging,
2 - Internal Medicine (Small Mammals; Service for Birds and Reptiles), vetmeduni
Vienna, Austria. [email protected]
Giant African Land Snails are kept as pets and have been increasingly used in “snail
assisted therapy” in preschools or retirement homes. Our university has recently
started with encountering them as regular patients. Unfortunately there is a lack of
profound literature on healthcare or diagnostic and therapeutic procedures suitable
for these animals. The aim of this study was to provide a description of the normal
anatomy of giant snails as a reference for radiographic, sonographic and CT examinations. Eventually the most useful imaging method should be determined.
Methods
Two snails were presented as patients to the clinic. Two author owned adult, clinically
healthy and agile snails acted as references. All animals received radiographic,
sonographic and multislice helical CT examinations. For further evaluation of the GIT
a mixture of grated vegetables and barium sulfate was offered to the author owned
molluscs. Follow up radiographs were taken 12 times until a complete defecation of
contrast media occurred. Two CT examinations took place after 6h and 14h.
The above described procedures were discussed and approved by the institutional
ethics and animal welfare committee in accordance with GSP guidelines and national
legislation.
Results
The best anatomical representation of the GIT in Giant African Land Snails could be
achieved by using contrast-enhanced radiographs. Eggs were already found on plain
radiographs, whereas CT examinations provided further information about the
respiratory tract and the contrast-enhanced GIT. The huge albumen gland was only
detectable in CT. Successful sonographic examination highly depended on a cooperative protrusion of the snails from their shell. Even assuming a more thorough
understanding of the snail’s anatomy, sonography turned out to be challenging. The
best views could be obtained of the oesophagus and crop, whereas the genital tract
could not be differentiated clearly.
Radiographs and CT examinations, including GIT contrast studies, provided sufficient
information for a better understanding of giant snail anatomy. For further evaluation of
the urinary tract an iodine contrast study will be considered. Sonography turned out to
be more cumbersome than expected, because the shell protects most organs.
The overall cooperation of the animals was astonishingly excellent due to their curious
behaviour.
96
97
SATURDAY / 03.09.2016
08:45 - 09:00
ANNOUCEMENTS
09:00 - 10:45
SESSION IX, Chairperson: TOM MADDOX
09:00 - 09:30
Masterclass Lecture - Abby Caine: MAGNETIC RESONANCE IMAGING OF BRAIN TRAUMA
09:30 - 09:42
A. Hartmann: COMPARISON OF BRAIN PERFUSION IN NORMAL DOGS AND DOGS
WITH IDIOPATHIC EPILEPSY
09:42 - 09:54
C. Sievert: SPIN ECHO 3 TESLA MAGNETIC RESONANCE IMAGING STUDY
OF THE NORMAL CANINE FEMORAL AND SCIATIC NERVES
09:54 - 10:06
K. Mylo: A RADIOGRAPHIC PILOT STUDY ON THE EFFECT OF HANGING TRACTION
ON THE INTERVERTEBRAL DISC SPACE WIDTH IN 17 DACHSHUNDS
10:06 - 10:18
E. Vandermeulen: NORMAL LIVER-TO-HEART TRANSIT TIME AFTER TRANSPLENIC
INJECTION OF 99M TC-PERTECHNETATE IN HEALTHY CATS
10:18 - 10:30
E. Stock: EVALUATION OF FELINE RENAL PERFUSION USING CONTRAST ENHANCED
ULTRASOUND AND SCINTIGRAPHY
10:30 - 10:42
M. Dennler: INFLUENCE OF INJECTION PROTOCOL AND MEASUREMENT TECHNIQUE
ON COMPUTED TOMOGRAPHIC ASSESSMENT OF GLOMERULAR FILTRATION RATE (GFR)
IN HEALTHY BEAGLE DOGS
10:45 - 11:15
COFFEE BREAK
11:15 - 13:15
SESSION X, Chairperson: KERSTIN HANSSON
11:15 - 12:00
Keynote Lecture - Randi Drees: WHAT DOES THE RADIATION ONCOLOGIST NEED TO KNOW FROM
THE RADIOLOGIST… AND VICE VERSA!?
12:00 - 12:12
I. D. Jones: THORACIC AND ABDOMINAL COMPUTED TOMOGRAPHIC FINDINGS IN ELEVEN DOGS
WITH STAGE FOUR MULTICENTRIC LYMPHOMA
12:12 - 12:24
M. Dolera: FRAMELESS STEREOTACTIC VOLUMETRIC MODULATED ARC RADIOTHERAPY OF
BRACHIAL PLEXUS TUMORS IN DOGS: 10 CASES
12:24 - 12:36
M. Paninarova: PREVALENCE AND DISTRIBUTION OF MUSCULAR METASTASES IN 55 DOGS
WITH HEMANGIOSARCOMA. A WHOLE BODY COMPUTED TOMOGRAPHIC STUDY
12:36 - 12:48
L. F. F. Gomes: ULTRASONOGRAPHIC EVALUATION OF DOGS WITH STIFLE PAIN
12:48-13:00
13:00 - 13:12
13:15 - 14:15
98
Opera House - Foyer
C. J. Ley: COMPUTED TOMOGRAPHY EVALUATION OF INTRA-ARTICULAR MINERALISATION
IN FELINE STIFLE JOINTS
A. Bruhschwein: CT BASED SEMIAUTOMATIC MEASUREMENT OF CANINE FEMORAL TORSION
USING A 3D COORDINATE SYSTEM
LUNCH
Opera House - Foyer
SATURDAY / 03.09.2016
14:15 - 16:15
SESSION XI, Chairperson: PETRA AGTHE
14:15 - 15:00
Keynote Lecture - Kathelijne Peremans: RADIATION PROTECTION AND SAFETY IN VETERINARY
MEDICINE: INTERNATIONAL BASIC SAFETY STANDARDS
15:00 - 15:12
N. Onderka: RADIOGRAPHY VERSUS COMPUTED TOMOGRAPHY OF CONGENITAL VERTEBRAL
MALFORMATIONS IN 58 BRACHYCEPHALIC DOGS
15:12 - 15:24
T. P. Dobak: COMPUTED TOMOGRAPHIC PELVIMETRIC ASSESSMENT OF ENGLISH BULLDOGS
15:24 - 15:36
T. Schwarz: COMPARISON OF SCAPULOHUMERAL JOINT COMPUTED TOMOGRAPHY, COMPUTED
TOMOGRAPHIC ARTHROGRAPHY AND ARTHROSCOPY IN DOGS WITH SHOULDER LAMENESS
15:36 - 15:48
J. Wennemuth: A COMPARISON OF RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC FINDINGS OF
THE MEDIAL CORONOID PROCESS IN DOG BREEDING APPEAL CASES
15:48 - 16:00
F. Willmitzer: DENTAL CHANGES IN CATS WITH NEWLY DIAGNOSED DIABETES MELLITUS
16:00 - 16:12
E. Ludewig: PERSISTENT GROWTH-ZONES OF THE ATLAS IN BRACHYCEPHALIC DOGS
16:15 - 16:45
COFFEE BREAK
16:45 - 18:15
SESSION XII, Chairperson: PANAGIOTIS MANTIS
Opera House - Foyer
16:45 - 17:15
Filmreading Session
17:15 - 17:27
E. Stock: CONTRAST-ENHANCED ULTRASOUND OF NORMAL CANINE MAMMARY GLANDS
DURING THE ESTRUS CYCLE
17:27 - 17:39
P. Pey: SONOGRAPHIC APPEARANCE OF THE URINARY TRACT IN CATS WITH URETERAL
OBSTRUCTION TREATED WITH SUBCUTANEOUS URETERAL BYPASS (SUB): A RETROSPECTIVE
STUDY OF 22 CASES (2010-2015)
17:39 - 17:51
E. Fauchon: ULTRASOUND-GUIDED REMOVAL OF LOWER EXTREMITIES VEGETAL FOREIGN BODY:
A RETROSPECTIVE STUDY OF 19 CASES
17:51 - 18:03
T. Rick: CONTRAST-ENHANCED ULTRASONOGRAPHY OF INTRATHORACIC MASS LESIONS IN 48
DOGS AND CATS
18:03 - 18:15
A. Belmudes: LUNG LOBE TORSION: PARTICULAR ULTRASOUND FEATURES AS BASED ON
COMPARATIVE CT AND PATHOPHYSIOLOGICAL INFERENCES IN 12 DOGS
18:15 - 20:00
20:00 - 00:00
FREETIME
FAREWELL PARTY
Centennial Hall
99
IX
SESSION IX
MASTERCLASS LECTURE
MAGNETIC RESONANCE IMAGING OF BRAIN TRAUMA
Abby Caine, Newmarket, UK
Increasingly, cross sectional imaging is used in patients with acute neurological
trauma in veterinary medicine; however there remains only a handful of publications
assessing the utility in our species, and very little specifically examining the imaging
of traumatic brain injury (TBI) in the cat. It is known that clinical examination and
some laboratory findings do have prognostic significance; with a reduced Modified
Glasgow Coma Score the strongest predictor of nonsurvival1.
Brain trauma can be divided into the primary injury due to the brain deforming against
the brain case leading to direct neural injury and neural injury from vascular trauma
(either intra or extra axial), and secondary injury. Two publications in veterinary
medicine have examined primary brain tissue injury in dogs. One2 compared grade
and area of primary parenchymal injury, and demonstrated that the greater the area
affected the worse the prognosis, and the greater likelihood of developing post
traumatic seizures. The other study3 looked at outcome associated with the location
of the lesions, and demonstrated an association with a poorer outcome (death or severe persistent ongoing deficits) with a caudal fossa location as opposed to a rostral
fossa location.
Cats are known to have differing clinical outcomes from dogs in many disease
processes, and it is thought likely that trauma will differ similarly. One paper4 looking
at post trauma seizuring in cats showed that, unlike dogs, none of the 56 cats developed post traumatic epilepsy, whereas approximately 10% of dogs might be expected
to. In a small preliminary retrospective study at our practice, it seems that the
appearance of trauma in cats may equally differ. A lower proportion of cats undergoing
MRI following trauma that had clinical neurological deficits had visible parenchymal
change than in dogs, and the location (rostral/caudal fossa) and area affected had less
impact on the outcome than in dogs.
Dogs frequently have extra axial haemorrhage as part of the pattern of primary brain
injury seen, with a lower proportion of cats having extra axial haemorrhage; and
where present this was a smaller volume than that seen in dogs.
Secondary injury following TBI is due to the oedema secondary to the injury leading to
brain swelling, with consequent further neurological deterioration. In dogs the location
and size of the shift affected the prognosis (a larger shift is more likely to have a poor
outcome or require intervention) however the same pattern again does not seem to be
true in cats.
Sharma, Holowaychuk: Retrospective evaluation of prognostic indicators of dogs with head trauma.
J Vet Emerg Crit. Care 25:5:631-9 (2015)
Beltran, Platt, McConnell, Dennis, Keys and De Risio: Prognostic value of early magnetic resonance
imaging in dogs after TBI. JVIM 28:1256-62 (2014)
Yanai, Tapia Nieto, Cherubini, Caine: results of MRI performed within 48hours of head trauma in dogs.
JAVMA 246:11:1222-9 (2015)
Grohman, Schmidt, Moritz, KramerPrevalence of seizure in cats after head trauma. JAVMA 241:11:146770 (2012)
100
COMPARISON OF BRAIN PERFUSION IN NORMAL DOGS AND DOGS WITH
IDIOPATHIC EPILEPSY. A. Hartmann1#, A. Driesen1, C. von Klopmann1, I. Lautenschläger1, V. Scholz2, M. Schmidt1. 1 - Department of Vet. Clinical Sciences, Clinic
for Small Animals, JLU, Germany, 35392. 2 - Institute for Theoretical Physics,
ETH Zurich, Switzerland, 8093. # Current Address: Vetsuisse Faculty, University
of Bern, Switzerland, 3012
Introduction
Idiopathic epilepsy is one of the most common neurologic disorders in dogs with
refractory epilepsy occurring in up to 25% of the patients. As standard MRI is unremarkable in those patients, more invasive treatments, which require localisation of the
epileptogenic zone, cannot be carried out. Perfusion weighted imaging has been
proven useful in human patients when an invasive treatment is considered. The aim of
our study was to evaluate perfusion in the brain of normal dogs and dogs suffering
from idiopathic epilepsy.
Ten purpose-bred healthy Beagle dogs were enrolled in the group of normal dogs.
Twelve client-owned dogs of 10 different breeds met the inclusion criteria for the group
of idiopathic epileptic dogs. All dogs were examined interictally. MR examination was
performed using a 1.0 Tesla MR system. Perfusion-weighted images were acquired
using a dynamic multi shot fast field echo – echo planar imaging sequence in the
dorsal plane. The slices were oriented parallel to the base of the skull with one slice
going through the thickest part of the caudate nucleus. A total of 40 dynamic images
per slice were acquired. A dose of 0.2mmol/kg body weight gadoteric acid was injected
at a rate of 5ml/second at the 10th dynamic, followed by 20ml of isotone ringer
solution. Image analysis was performed at a dedicated Workstation using gamma-variate fitting. Statistical analysis was done using commercially available software
performing Pearson`s, Spearman’s and Chi-squared tests.
Result
T0 and CBF were significantly dependent on the status (p < 0.01). Dogs suffering from
idiopathic epilepsy showed a significantly longer T0 and lower CBF compared to
normal patients. The least reduction in CBF was found in the hippocampus.
Discussion
The longer T0 and lower CBF indicate an overall decreased brain perfusion interictally in dogs with idiopathic epilepsy. Difference in the CBF might also be related to the
size of the ROIs. T0 depends only on physiological parameters and the cross-sectional area of the capillaries to the different ROIs. Thus it can be speculated that in
diseased dogs the cross-sectional area of capillaries in the brain might be reduced.
In human patients, the hippocampus plays an important role in the pathogenesis of
temporal epilepsy. In veterinary medicine, a link between hippocampal changes and
epilepsy has also been described. In general the interictal phase is characterized by
hypoperfusion due to cell loss and gliosis. However, a minority of reports also describe
a hyperperfusion of the hippocampus interictally similar to our findings. The authors
postulate that this is the result of small hypermetabolic foci within a hypometabolic
zone.
101
SPIN ECHO 3 TESLA MAGNETIC RESONANCE IMAGING STUDY OF THE
NORMAL CANINE FEMORAL AND SCIATIC NERVES. C. Sievert1, H. Richter1,
D. Gascho2, P.R. Kircher 1, I. Carrera1. 1 – Clinic of Diagnostic Imaging, University of
Zurich, Switzerland, 8057, 2 – Institute of Forensic Medicine, Forensic Medicine &
Imaging, University of Zurich, Switzerland, 8057. [email protected]
Understanding the normal appearance and optimizing visualization of the canine
peripheral nerves of the lumbar plexus, in particular the sciatic and femoral nerve,
is essential in patients with suspected peripheral neuropathies such as inflammatory
or neoplastic conditions. The purpose of the study was to describe the MRI anatomy
of the normal femoral and sciatic nerve and to define the sequences in which these
nerves are best depicted.
Methods
Imaging was performed on a 3 Tesla system with a 32-channel volume coil. First the
MRI protocol was optimized using 6 cadaveric specimens, and secondly the optimized
protocol was implemented on 10 healthy Beagle dogs under general anesthesia.
The optimized protocol included unenhanced sequences: T1-weighted, T2-weighted,
T2-SPAIR (Spectral Attenuated Inversion Recovery) and post contrast (Gadolinium)
sequences: T1-weighted and T1-SPIR (Spectral Presaturation Inversion Recovery)
sequences. These sequences were performed in dorsal, transverse and sagittal
planes.
Results
All sequences had excellent signal to noise ratio and contrast resolution in all patients.
The sciatic and femoral nerves were well seen in all sequences. They were symmetric
and of homogeneous signal intensity, being iso- to mildly hyperintense to muscle on
T2-weighted, hyperintense in T2-SPAIR and iso- to mildly hypointense in T1-weighted
images. On T1-SPIR post contrast sequences they showed isointense signal
compared to the muscles, without contrast enhancement of the nerves. The femoral
nerve is readily identified within the iliopsoas muscle. It exits the abdominal cavity
at the muscular and vascular lacuna where the femoral vein and artery are seen
ventromedial to the nerve. Proximally to the lacuna the vessels are separated from
the femoral nerve by the iliopsoas muscle. The sciatic trunk is located dorsal to the
iliopsoas muscle at the level of the lumbosacral junction. Slightly caudal to this level,
the caudal gluteal artery and vein are seen medial to the sciatic nerve. Then the
sciatic nerve crosses the greater sciatic notch of the ilium to pass to the lateral aspect
of the hindlimb. In this region the caudal gluteal nerve and artery are seen dorsal to
the sciatic nerve. Further distal the nerve runs for a short distance on its own, between
the adductor and the biceps femoris muscle.
Knowing the anatomical course and normal MRI appearance of the aforementioned
nerves helps in identifying absence or presence of pathology. To our knowledge this is
the first study describing detailed depiction of the normal canine femoral and sciatic
nerves on 3 Tesla MRI.
102
A RADIOGRAPHIC PILOT STUDY ON THE EFFECT OF HANGING TRACTION ON
THE INTERVERTEBRAL DISC SPACE WIDTH IN 17 DACHSHUNDS.
K. Mylo1, SS. van den Berg1, A. Carstens2, 1 - Equine-Librium College, South Africa,
6600. 2 - University of Pretoria, South Africa, 0110. [email protected]
Hanging traction is a conservative technique used to treat intervertebral disc
herniation in chondrodystrophic dogs. This study was conducted using radiography to
determine whether this form of treatment does in fact increase the intervertebral
disc space (IVDS) width in Dachshunds. It was hypothesised that the IVDS width in
sitting dogs (Sit) would be equal to those in standing (Stand) positions and that those
dogs in hanging positions (Hang) would have larger IVDS widths than those of both
sitting and standing dogs.
Methods
Seventeen healthy Dachshunds underwent lateromedial radiographs in sitting,
standing and hanging positions. The most dorsal and most ventral aspects of the
IVDS widths of T12/T13, T13/L1, L1/L2 and L2/L3 were measured three times, by two
observers and intra-class correlation coefficients determined. The means of the
measurements of Sit vs Stand, Sit vs Hang and Stand vs Hang were analysed
separately using a repeated measures ANOVA. (P < 0.05). There was no conflict of
interest for any of the authors; all animals were treated according to the ethical
requirements of the Equine–Librium College.
Results
The measurements of the two observers correlated well, with 79% of the measurements having greater than 60% correlation. Dorsally the widest IVDSs were at L1/2
and L2/3 stand (respective means ± standard deviations (SD) 2.58mm± 0.44 and
0.46). Ventrally the widest IVDSs were at L2/3 Sit and L2/3 Stand (respectively 4.05mm
± 0.65 and 0.83). Dorsally the narrowest IVDS mean ± SD was at T12/13 Hang
(2.03mm ± 0.45). Ventrally the narrowest IVDS mean ± SD was at T12/13 Stand
(4.25mm ± 0.55). There were significant differences between the IVDS widths, at the
ventral aspect of T12/T13 in Sit vs Stand (respective means 4.54mm ± 0.59 and
4.25mm ± 0.55; P = 0.01) and at the dorsal aspects of T13/L1 in Sit-Hang (respective
means 2.35 ± 0.31 and 2.15mm ± 0.39; P = 0.030), L1/L2 in Stand-Hang (respective
means 2.58mm ± 0.44 and 2.35mm ± 0.43; P = 0.012), and L2/L3 in Stand-Hang
(respective means 2.58mm ± 0.46 and 2.33mm ± 0.46; P = 0.003).
The fact that hanging traction results in significantly narrower IVDSs at T13 to L3
brings into question the supposed effectiveness of this form of conservative treatment.
More research is warranted to investigate this further.
103
NORMAL LIVER-TO-HEART TRANSIT TIME AFTER TRANSPLENIC INJECTION
OF 99MTC-PERTECHNATE IN HEALTHY CATS E. Vandermeulen1, K. Peremans1,
E. Stock1, T. Bosmans2, M. Hesta3, J. Saunders1. 1 - Department of medical imaging
of domestic animals, 2 - Department of medicine and clinical biology of small animals,
3 - Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine,
Ghent University, Belgium, 9820, Merelbeke. [email protected]
Portosystemic shunts (PSS) are a rather infrequent vascular disease in cats in
comparison to the canine population. Transplenic portal scintigraphy (TSPS) can aid
in diagnosing PSS in cats, following the same protocol as described for dogs. Although
the actual performance of the scan remains the same between species, it is to be
questioned whether the generally accepted transit time of 7 seconds can be applied
to cats, possibly influencing shunt fraction calculation.
Methods
Eighteen adult, normal cats (mean age ± SD 4.4 ± 2.37 years (range 1.7-9.5), 10
castrated females, 8 castrated males) underwent a dynamic TSPS study, with injection
of 66.9 ± 10.7 MBq (in a volume of 0.21 ± 0,03 mL) of 99mTc-pertechnetate in the
splenic parenchyma under ultrasound guidance. Regions of interest (ROI) for the liver,
heart and background were manually placed on the summed images. The transit time
of 99mTc-pertechnetate from first arrival in the liver ROI to first appearance in the heart ROI was determined by 2 methods: 1) based on visual inspection of the images
and 2) based on the listed raw data for each cat. For the latter method, an increase of
100% of counts above the background counts was taken as arrival point in liver
or heart ROI. The mean transit times and difference between transit times as obtained
by the 2 abovementioned methods was calculated.
Results
Blood examination, including pre- and postprandial bile acid measurement, and
general abdominal ultrasound were negative for presence of PSS in all cats. All TSPS
scans revealed arrival of the injected activity in the liver ROI before arriving in the heart
ROI, indicating the absence of a macroscopic PSS. The mean ± SD transit time based
on visual inspection was 6.7 ± 1.5 seconds, the mean ± SD transit time based on the
listed raw data was 7.3 ± 1.7 seconds. The mean difference between both methods
was -0.65 ± 0,7 seconds, transit times based on the visual inspection were estimated
shorter in all cats. There was no significant difference between both methods of
transit time measurement (T-test, P=0.30).
The generally accepted transit time of 7 seconds used for shunt fraction calculation
after TSPS scans seems to be valid in cats, based on 2 methods of transit time
calculation in cats with normal abdominal vasculature.
104
EVALUATION OF FELINE RENAL PERFUSION USING CONTRAST ENHANCED
ULTRASOUND AND SCINTIGRAPHY. E. Stock1, K. Vanderperren1, T. Bosmans2,
L. Duchateau3, M. Hesta4, L. Lybaert5, E. Vandermeulen1, J.H. Saunders1. 1 - Department of medical imaging of domestic animals, 2 - Department of Medicine and Clinical
Biology of Small Animals, 3 - Department of Comparative Physiology and Biometry,
4 - Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine
Ghent University, Belgium, 9820 Merelbeke. 5 - Lab of Biopharmaceutical technology,
Faculty of Pharmaceutical Sciences, Ghent University, Belgium, 9000 Ghent.
[email protected]
Chronic kidney disease is a common feline pathology. Evaluation of renal perfusion
changes is important as they occur early in the disease process, but measuring renal
perfusion non-invasively is challenging. The objective of this study was to investigate
the ability of contrast-enhanced ultrasound (CEUS) and technetium-99m mercaptoacetyltriglycine (99mTc-MAG3) scintigraphy to detect experimentally induced changes
in renal perfusion in healthy cats. The hypothesis is that both techniques will be
capable of detecting a decreased perfusion after infusion of angiotensin II (ATII).
Methods
Eleven healthy experimental cats were included. All cats received a vasoconstrictor
(2 ng/kg/min ATII) and control treatment (sterile 0,9% NaCl), in a randomized order,
with a washout period of 14 days. On both days, renal CEUS and 99mTc-MAG3
scintigraphy were performed, starting 15 minutes after the intravenous infusion.
The same observer, which was not blinded for treatment, performed all analyses.
Statistical analysis (SAS version 9.3) was based on a mixed model with period and
treatment as categorical fixed effects and cat as random effect.
Results
With CEUS, the peak enhancement decreased from 3603 arbitrary units (a.u.)
(control) to 2664 a.u. with ATII (- 26%, P=0.04). Furthermore, wash-in perfusion index
decreased from 2207 a.u. to 1637 a.u. (P=0.04) and wash-out rate from 704 a.u.
to 501 a.u. (P=0.02), representing a slower inflow of microbubbles. No consistent
influence of ATII on the perfusion parameters obtained with 99mTc-MAG3 scintigraphy
was present.
AT II causes vasoconstricton of the afferent and efferent glomerular arterioles, thereby
decreasing total and cortical renal blood flow. This study demonstrates that CEUS is
a promising technique to detect changes in renal perfusion. These perfusion changes
were not depicted by renal scintigraphy. Global renal perfusion is assessed by
scintigraphy while regional perfusion up to a microvascular level is assessed by CEUS.
Further research is warranted to determine the value of CEUS for diagnosis of
naturally occurring diffuse renal pathology.
105
INFLUENCE OF INJECTION PROTOCOL AND MEASUREMENT TECHNIQUE
ON COMPUTED TOMOGRAPHIC ASSESSMENT OF GLOMERULAR
FILTRATION RATE (GFR) IN HEALTHY BEAGLE DOGS. M. Dennler1, M. Wallimann1, H. Richter1, S.D. Krämer2, T.C. Gent3, N. Sieber-Ruckstuhl4, P.R. Kircher1.
1 - Clinic of Diagnostic Imaging, 2 - Institute of Pharmaceutical Sciences, ETH Zurich,
8093 Zurich. 3 - Section of Anaesthesiology, 4 - Clinic of Small Animal Medicine,
Vetsuisse Faculty, University of Zurich, 8057 Zurich. [email protected]
Introduction
Computed tomography (CT) allows investigation of glomerular filtration rate (GFR)
by assessment of contrast clearance determined by applying Patlak Plots. In single
slice studies, choice of the imaging plane is limited since both kidneys have to be
included in the scans. Variable injection protocols are described with smaller contrast
dosages than currently used for clinical, contrast enhanced CT studies. Objectives
of the study were to examine the impact of injection protocol, administered dosage
and measurement technique on the results of GFR acquired with dynamic CT in
healthy Beagle dogs. Independence of GFR-determination from applied dosage,
injection protocol and measurement technique represents the hypothesis of the study.
Methods
Nine healthy Beagle dogs, four male and five female with a mean body weight of 13.2
± 1.6 kg underwent randomized cross-over, dynamic CT study. The mid-abdominal
volume including both kidneys was scanned before, 15, 30, 45, 60, 75, 90, and 150
seconds after start of contrast medium injection with a 16 slice CT in 1 mm slices.
Three different iohexol-injection protocols (700 mgI/kg at constant rate / 700 mgI/kg
following an exponential decay curve / 350 mgI/kg at constant rate-injection) were
administered during dynamic CT scans of the entire renal volume in each dog, with
a recovery time of one week between protocols. Patlak Plots of the data originating
from a single slice through both kidneys, optimized transverse slices in each kidney,
the entire renal volume and a dorsal reconstruction served for comparison of the
measurement technique. Mann-Whitney Tests evaluated statistical differences and
significance implied with a p value ≤ 0.05.
Results
Mean ± standard deviation of the measurements from the dorsal reconstruction
significantly undercut the values for GFR acquired with the volume technique (fixed
transverse: 2.49 ± 0.54 ml/kg/min, optimized transverse: 2.72 ± 0.52, volume: 3.00
± 0.6 ml/kg/min and dorsal: 2.48 ± 0.41 ml/kg/min). The lower iodine dosage resulted
in significantly higher GFR values (3.00 ± 0.65 ml/kg/min) compared to the two
techniques with the higher dosage (constant rate: 2.54 ± 0.45 ml/kg/min and
exponential decay: 2.47 ± 0.48 ml/kg/min).
The use of the full dosage normally used for contrast studies in computed tomography
reduced the glomerular filtration rate compared to dividing the dosage by half.
This finding is an important consideration when assessment of GFR is implemented
in routine diagnostic imaging and when contrast studies are planned in patients with
impaired renal function.
106
SESSION X
X
KEYNOTE LECTURE
WHAT DOES THE RADIATION ONCOLOGIST NEED TO KNOW FROM THE
RADIOLOGIST… AND VICE VERSA!?
Randi Drees, London, UK
Decision for and planning of radiation therapy treatment heavily relies on the disease
extent and staging for a given patient. Computed tomography (CT) exams, possibly
in combination with magnetic resonance imaging (MRI), nuclear medicine, radiographic and ultrasound studies are utilized to aid decision making in staging and treatment
planning. Substantial technological advances in radiation treatment planning and
delivery allow for precise three dimensional radiation dose delivery, conforming to the
tumor treatment volume while sparing normal tissues. With precision of dose delivery
to the targeted volume comes potential for missing tumor extent outside the treated
volume that was not known at time of planning or treatment.
Communication between the radiologist, medical oncologist and radiation oncologist
is essential in determining choice of imaging modality/modalities, setup of the patient
and parameters for study acquisition especially for CT exams and also regarding
detailed diagnostic imaging study interpretation and reporting.
107
THORACIC AND ABDOMINAL COMPUTED TOMOGRAPHIC FINDINGS
IN ELEVEN DOGS WITH STAGE FOUR MULTICENTRIC LYMPHOMA.
Ian David Jones, Adam David Daniels, Ana Lara, Panagiotis Mantis. Royal Veterinary
College, U.K., AL9 7TA. [email protected]
Multicentric lymphoma is a commonly diagnosed canine neoplasm with varied clinical
signs. Computed tomography (CT) may be used to aid clinical staging. The aim of
this study was to describe the CT findings in a population of dogs with stage four
multicentric lymphoma.
Methods
Dogs diagnosed with stage 4 multicentric lymphoma were identified by reviewing
clinical records between January 2008 and June 2015 at the Queen Mother Hospital
for Animals, Hertfordshire, U.K. A diagnosis of stage four multicentric lymphoma
was based upon cytological identification of neoplastic lymphocytes in cellular
samples harvested from a peripheral lymph node, the spleen, the liver and subsequent immunophenotyping. Immunophenotyping was performed in all samples from
peripheral lymph nodes, however not all abnormal lymph nodes were sampled.
Thoracic and abdominal CT examinations of patients were evaluated by a board
certified radiologist. Detailed evaluation was performed only for lymph nodes, liver
and spleen though all other abnormalities were recorded. Specifically, for lymph node
evaluation, short and long axis thickness, short axis to long axis ratio, shape,
pre-contrast and post-contrast attenuation and the appearance of peri-nodal fat were
recorded. A short axis to long axis ration greater than 0.5 was considered abnormal.
Results
Eleven dogs satisfied the inclusion criteria. A variety of breeds were included.
Body weight range was 4-56kg (median 38.5 kg). The sex distribution was: 5 male
neutered, 4 female neutered, 2 male entire. Age ranged from 5-11 years (median 8
years). The most frequently observed abnormalities included: lymph node short
axis:long axis ratio was abnormal in every lymph node evaluated, streaky peri-nodal
fat was identified in 39% of lymph nodes evaluated, most often (55%) surrounding
abdominal (hepatic and splenic) lymph nodes. Splenic nodules were identified in just
under half (45%) of the patients, typically appearing as isoattenuting prior to contrast
(80%) and hypoattenuating in the post contrast sequence (60%). Pulmonary parenchymal changes were identified in just over a fifth (27%) of the patients typically appearing as a poorly marginated, multifocal, peripheral, patchy hyperattenuation with ventral consolidation.
Limitations of the study include: Due to very strict inclusion criteria only twelve dogs
were included. Immunophenotyping was performed in every dog, however the lymph
node used to collect the sample was not always recorded and may not have been
included in the CT. Pulmonary cytology was not performed in any patient. Samples
from liver and spleen may not have been harvested from the nodules or mass lesions
described. Thoracic and abdominal CT examination of dogs with stage four multicentric lymphoma is likely to reveal rounded lymph nodes, with occasional splenic nodules
and pulmonary parenchymal abnormalities.
108
FRAMELESS STEREOTACTIC VOLUMETRIC MODULATED ARC RADIOTHERAPY OF BRACHIAL PLEXUS TUMORS IN DOGS: 10 CASES.
M. Dolera1, L. Malfassi1, C. Bianchi1, N. Carrara1, L. Corbetta1, S. Finesso1,
S. Marcarini1, G. Mazza1, S. Pavesi1, M. Sala1, G. Urso1,2.
1 - La Cittadina Fondazione Studi e Ricerche Veterinarie, Italy, 26014. 2 - Azienda
Socio Sanitaria Territoriale di Lodi, Italy, 26900. [email protected]
Canine peripheral nerve sheath tumors (PNSTs) can involve the brachial plexus, its
peripheral branches, proximal nerves, and roots. Treatment is challenging and
prognosis after surgical resection is guarded poor. The aim of this prospective single
institution clinical study was to evaluate the feasibility and the efficacy of stereotactic
radiotherapy of these tumors.
Methods
Dogs with clinical signs and MRI findings consistent with PNSTs of brachial plexus,
branches and nerve roots were treated with LINAC based Volumetric Modulated Arc
Radiotherapy (VMAT). Mean delivered dose was 35 Gy in 5 fractions. Regular clinical
and MRI follow-up examinations were planned every two months. Neurological
disfunction, volumetric response and radio toxicity were graded and recorded. Overall
and progression-free survival time were estimated.
Results
Ten dogs were enrolled. Progressive forelimb paresis, axillary pain and various
degrees of tetraparesis were the most frequent presenting complaints. Tumors involved the plexus and proximal nerves in 3 dogs, the plexus, proximal nerves and nerve
roots in 5 dogs, the nerve roots and proximal nerves in 2 dogs. Partial or complete
reduction of neurological deficits were observed in all treated dogs. Partial responses
were observed in 10/10 patients. Local recurrence was observed in 9/10 of treated
dogs. Mean overall survival of 371 days and mean progression-free survival of
240 days are comparable to surgical literature data regarding the plexus and
proximal nerves localization but are superior in comparison to nerve roots localization.
No radio toxic effects occurred regarding trachea, esophagus and spinal cord.
VMAT RT can be a safe and viable alternative to surgery in case of canine brachial
plexus PNSTs involving the proximal nerves and nerve roots.
109
PREVALENCE AND DISTRIBUTION OF MUSCULAR METASTASES IN 55 DOGS
WITH HEMANGIOSARCOMA. A WHOLE BODY COMPUTED TOMOGRAPHIC
STUDY. M. Paninarova1,3, R. Terragni1, A.M. Morselli-Labate2, M. Alberti3, A. Pelloni3,
G. Albarello4, F. Millanta5, M. Vignoli1,6. 1 - Veterinary Clinic Modena Sud, Italy, 41057.
2 - Department of Medical and Surgical Sciences, University of Bologna, Italy, 40138.
3 - Veterinry Hospital I Portoni Rossi, Italy, 40069. 4 - Veterinary Clinic Blucenter, Italy,
39100. 5 - Veterinary Science Department, University of Pisa, Italy, 56124. 6 Faculty
of Veterinary Medicine, University of Teramo, Italy, 64100. [email protected]
Hemangiosarcoma (HSA) is a neoplasm arising from vascular endothelium with a high
metastatic rate. The purpose of the study was to determine the prevalence, localization and clinical signs of muscular metastases (MM).
Methods
The records of 3 different veterinary centers were searched for dogs with a final
diagnosis of HSA, which underwent whole body CT within the time period from 2013
to 2016. In all cases the final diagnosis of primary tumor and muscular metastases
was reached by histology and/or cytology. The CT studies were reviewed by 2 of the
authors (MP, MV). Signalment, clinical signs, localisation of the primary lesion and
metastasis were retrieved. The chi-square and the Fisher exact tests were applied.
Results
Fifty-five dogs (35 males, 20 females; age: 10.3±2.2, range 4-15 years) met including
criteria. The primary tumor, diagnosed as HSA, was located in spleen (n=37, 67.3%),
liver (n=7, 12.7%), muscles (n=5, 9.1%) and peritoneum (n=3, 5.5%), as well as in
right atrium, kidney and mediastinum (n=1, 1.8%, respectively). MM with ring enhancement or heterogeneous contrast enhancement were detected in 15 dogs (27.3%),
with localization of the MM in epaxial/paraspinal muscles (n=10, 66.7%), in thoracic/
abdominal wall muscles (n=4, 26.7%), in muscles of appendicular skeleton (n=6,
40.0%) and in tongue muscles (n=1, 6.7 %). Presence of MM was significantly higher
in males (40.0% vs. 5.0%, P=0.005) while it was not significantly related with age
(P=0.227), localization of the primary lesion (P=0.612) and breed (P=0.422). Nine
(60.0%) out of the 15 dogs with MM showed signs of lameness or were reluctant to
movement vs. none out of the 40 dogs without MM (P<0.001). Dogs with MM also had
non-significantly higher frequency of signs of anorexia (20.0% vs. 2.5%, P=0.057) and
depression (46.7% vs. 30.0%, P=0.341), while they had no respiratory symptoms
vs. 12.5% of dogs without MM (P=0.308).
The prevalence of MM in dogs with HSA is higher in comparison with previously
published studies about MM in human and veterinary literature. The presence of MM
of HSA was significantly higher in males. The most common clinical signs in dogs with
presence of MM were lameness and reluctance to movement. These nonspecific
signs could be confused with different health condition or metastatic spread to other
organ systems. Whole body CT is recommended in dogs with HSA for staging of the
oncologic patient.
110
ULTRASONOGRAPHIC EVALUATION OF DOGS WITH STIFLE PAIN.
L.F.F. Gomes, S. Unruh, S.C.F. Hagen. University of São Paulo, Brazil. [email protected]
Introduction
Musculoskeletal ultrasonography (MUS) is a safe and low cost imaging modality.
The benefits and high quality images provided by modern US machines have led to
wide application of the technique in human medicine, with improving diagnosis and
follow-up of articular conditions such as arthritis and osteoarthritis. However, radiography is more commonly used for joint assessment in small animals. This study set
out to correlate the radiographic degree of intra-articular soft tissue radiopacity with
intra-articular sonographic changes in dogs.
Methods
Eighteen dogs presenting with stifle lameness, without consideration of sex, age,
breed, weight and clinical history were used in this study; 28 stifles were evaluated
independently (15 left and 13 right). Radiographic assessment was based on mediolateral and craniocaudal stifle views. Dogs were then submitted to MUS. Radiographic
and sonographic images were evaluated by two experienced veterinary diagnostic
imaging specialists. Parameters evaluated were the presence of homogeneous
intra-articular soft tissue radiopacity and the degree of joint effusion and synovial
membrane changes in the infrapatellar space by MUS. Radiographic and sonographic
changes were graded 0-to-3. Correlations were investigated using Spearman correlation coefficients; the level of significance was set at p≤0.05.
Results
Thorough scanning of the joint space and extensor pouch was required for proper
assessment due to irregular distribution of joint effusion. MUS differentiation of the
synovial membrane is difficult in normal joints; synovial membrane of variable hyperechogenicity and heterogeneity reflecting the degree of thickening was observed
in most joints studied (21/28). The presence of intra-articular soft tissue radiopacity
was strongly correlated with joint effusion (ρ=0.699, p<0.001) and weakly correlated
with synovial membrane changes (ρ=0.429, p=0.022). The degree of joint effusion
was moderately correlated (ρ=0.587, p=0.001) with synovial membrane changes.
Discussion and conclusions
Detection of intra-articular soft tissue radiopacity can be associated with synovial
membrane, tumor, blood or joint effusion, but differentiation is not possible. This study
demonstrated a high correlation of this radiographic finding with joint effusion observed
in MUS, but correlation with synovial changes was weak. Joint effusion and thickening
of the synovial membrane are common MUS findings in synovitis; correlations
between such findings and associations with pain intensity have been reported in
human patients. All dogs in this study were lame; however, lameness was not
quantified. Therefore, correlations between the degree of lameness and imaging
findings could not be investigated. Magnetic resonance imaging (MRI) is the gold
standard for musculoskeletal lesion assessment. However, MUS does not require
general anesthesia and is widely available. The development of standardized protocol
will improve MSU.
111
COMPUTED
TOMOGRAPHY
EVALUATION
OF
INTRA-ARTICULAR
MINERALISATION IN FELINE STIFLE JOINTS. A. Corin1, C. Ley2, A. Leijon2,
C.J. Ley1. 1 – Dept of Clinical Sciences, 2 – Dept of Biomedical Sciences and
Veterinary Public Health, Swedish University of Agricultural Sciences, Sweden,
SE-750 07. [email protected]
Intra-articular mineralisation (IAM) is a common radiographic finding in cat stifles. The
etiology of IAM remains unknown, although several studies have shown a correlation
with osteoarthritis (OA). The aims of this study were to (a) investigate correlations
between IAM and the parameters age, sex, cat size and sesamoid volumes, (b) investigate possible correlations between IAM and OA cartilage lesions, (c) compare the
size of IAM in computed tomography (CT) images and radiographs of the same stifles.
Methods
Right stifle joints from 28 cats (16 MN, 9 FN, 3 F), age 1-23 years (mean 9.9), weight
2.1-7.3 kg (mean 3.9) that died for reasons unrelated to the study were examined
post-mortem with CT and radiography, followed by macroscopic and microscopic
evaluation of joint tissues. Femur volume, IAM volume and sesamoid mineralised
tissue volumes were measured in CT images. IAM area was measured in mediolateral
projection radiographs and categorized according to a published study1. All measurements were done by one author (CJL). The articular cartilage was graded for presence
of OA lesions by two authors (CL, AL) using consensus and with light microscopy
histology. OA grades were compared with the presence and volume of IAM in CT
images. Regression analysis, T-tests and Fisher exact tests were used and values
of P<0.05 were considered significant
Results
In 13 of 28 joints IAM were detected and all except one were located within the medial
meniscus. When measured in radiographs 11 of 13 IAM were small (<2.25 mm2), two
were intermediate and no IAM were large (>6.25 mm2). OA was detected in 26 joints
and of these 13 had minimal OA, 11 had mild OA and two had moderate OA.
No significant correlation was found between IAM and grade of OA cartilage lesions,
femur volume, lateral fabella volume, popliteal sesamoid volume, patella volume, sex
or age of the cats. The medial fabella was mineralised in 16 cats, eight of which had
IAM. The medial fabella was significantly larger in cats with IAM. Area of IAM in
radiographs had significant correlations with CT volume measurements.
Intra-articular mineralisations were not a consistent finding in stifle joints with minimal,
mild and moderate OA cartilage lesions. Small mineralisations in the feline medial
meniscus may develop for reasons other than OA and small IAM are unlikely to be
a reliable indication of feline stifle OA. The reason for cats with IAM having larger
mineralised medial fabella is not clear. It seems reasonable to use measurements
from mediolateral projection radiographs to estimate IAM size in feline stifle joints.
1. Voss K, et al. J Feline Med Surg. 2015;Epub ahead of print.
112
CT BASED SEMIAUTOMATIC MEASUREMENT OF CANINE FEMORAL TORSION
USING A 3D COORDINATE SYSTEM. A. Brühschwein, B. Schmitz, S. Reese, A.
Meyer-Lindenberg. LMU Munich, Germany, 80539. [email protected]
Commonly used radiographic technique to measure femoral rotational deformity
is two-dimensional. Also in three-dimensional computed tomography (CT) -scans the
measurements and angles are commonly taken in single two-dimensional images.
Femoral neck and femoral condyle axes are skew lines that lie in different planes and
do not intersect. Measurements in two-dimensional images are lacking definition in
the third dimension. Goal of study was to redefine a truly 3D-measurement technique
for canine femoral torsion based on CT scans.
Methods
Anatomical reference points were placed into a CT scan of a canine femur using
imaging software Voxim® (IVS Technology GmbH, Germany). Both centers of the
femoral condyle surfaces defined the femoral condyle axis, at right angles with the
femoral long axis, and a third orthogonal axis introducing a three-dimensional
Cartesian coordinate system. The femoral head center was automatically defined
by setting femoral head surface markers. Manually the femoral neck base center was
defined at the level of the lesser trochanter. Proximal femoral neck axis and the distal
femoral condyle axis were projected into a transverse plane for calculation of the
femoral torsion angle. Measurements were tested using experimental CT scans of 13
single femoral bones and CT datasets of 34 patients. CT measurements of 13 canine
femora were scanned in 3 positions and independence of positioning was tested using
Bland-Altman plots and by calculating the coefficient of variation (COV) for inter- and
intraobserver agreement. A femoral plastic torsion model was created to compare
anatomical and CT measurements at various predefined rotational angles using
Bland-Altman plots and Passing-Bablock regression analysis. Intra-observer
agreement was calculated for 10 anatomical measurements. Intra- and inter-observer
agreement for two independent observers was calculated for CT-based measurements of femoral torsion angles using the coefficient of variation.
Results
There was very good agreement between anatomical and CT measurements that
were on average 2° higher than the manual anatomical measurements. Bland-Altman-Plots proved that the results of the CT measurements were not dependent on positioning. Passing-Bablok regression analysis showed very good agreement between
anatomical and CT measurements in all rotational angles. The coefficient of variation
(COV) for the macroscopic measurement was 2.9%, lower than the intra- and
inter-observer agreement using CT, for the 39 torsion angle measurements in three
positions COV was 1.5% and 5.5% for intra- and inter-observer agreement, which is
considered a high repeatability.
In conclusion, the CT-based semiautomatic technique is feasible and promising tool
for three-dimensional measurement of canine femoral torsion.
113
XI
SESSION XI
KEYNOTE LECTURE
UPDATE ON VETERINARY RAD PROTECTION LEGISLATION
Kathelijne Peremans, Ghent, Belgium
Report on the meeting at International Atomic Energy Agency (IAEA), Vienna, Nov 2015.
It is a well-known problem that regarding European legislation, no (or little) specific regulations exist for
veterinarians as opposed to the detailed regulations provided for human medicine radiologists. Also, the
animal is not (yet) considered a patient and therefore radioprotection is solely focused on the user, the
helper and the public. This lack of dedicated regulations leads to a wealth of local organized or
non-organized rules with regard to the application of ionizing radiation in veterinary medicine. At this
moment, everyone that may call him/herself a veterinarian can play around with X-ray generators and
CT units. The use of nuclear medicine and radiotherapy is more tightly regulated albeit here also with
local different approaches. In 2012 a radiation committee was created by the ECVDI. Its first task was
to draw up an inventory of the European situation with regard to radioprotection regulation in veterinary
medicine. The committee sent a questionnaire to 18 different European countries (16 responders) on
the national regulations concerning the application of radiation. The results demonstrated a lack of
harmonization in relation to legislation, licenses, training, and continuing education. The organization
Heads of the European Radiological protection Competent Authorities” (HERCA) was contacted and
the problem was discussed with them. This organization consists of over 50 radiation protection authorities from 31 European countries who bend over commonly identified issues in relation to radioprotection and propose practical solutions for these issues. They created a task force to look into the matter.
This task force repeated the questionnaire (2013, 24 responders) and came to similar results. In the
aftermath of this study, HERCA published in 2015 recommendations for both veterinarians as well as
assistants regarding education and training (knowledge, skills and competence) depending on the type
and use of radiation.
The next step became the involvement of the International Atomic Energy Association (IAEA), an
organization that provides the fundamental safety objectives and principles of protection and safety
under the form of International Basic Safety Standards (BSS). These BSS are international guidelines,
however they are not binding for all countries. The IAEA became interested in this issue and decided to
create a separate BSS for veterinary use of ionizing radiation.
The guidelines should encompass all forms of use and modalities currently applied in veterinary
medicine: radiology, nuclear medicine and radiotherapy. For this purpose 5 external persons (3 veterinary (imaging and oncology) experts, 2 radiation protection experts familiar with veterinary medicine)
were invited to create these guidelines each with a specific target, depending on the person’s qualifications/current activities. Topics were: 1. radioprotection safety fundamentals (with additional emphasis
on safety aspects in relation to animal handling), 2. outline of responsibilities of the different players
involved in the use of radiation (government, regulatory body, veterinarians, helpers, suppliers of cameras and radiation generating equipment.....), 3. general and specific (also related to more advanced
techniques such as nuclear medicine, radiotherapy) training requirements (based on the HERCA
guidelines), 4. requirements of infrastructure, radiation generating equipment, cameras and ancillary
tools and equipment, 5. general procedures (ALARA based) for use of ionizing radiation and specific
protocols for more advanced techniques with there own specific issues. At the end of the document, the
message is given that advances in veterinary medicine follow, with a lag time, those of human medicine
and that therefore future specific radioprotection issues may need to be addressed. The BSS presented
during this meeting is at this moment in the editing stage and the next step will be that the document
will be send to IAEA member states for feedback before officially distributed.
114
RADIOGRAPHY VERSUS COMPUTED TOMOGRAPHY OF CONGENITAL
VERTEBRAL MALFORMATIONS IN 58 BRACHYCEPHALIC DOGS. N. Ondreka1,
S. Michiels-Corsten1, K. Failing2, M.J. Schmidt1. 1 - Department of Veterinary Clinical
Sciences, University of Giessen, Germany. 2 - Department of Biomathematics,
University of Giessen, Germany, 35392. [email protected]
Introduction
The scope of radiographic screening for inherited vertebral malformations in phenotypic breeding schemes is unclear. The aim of this study was to compare radiographic
with computed tomographic (CT) findings of the thoracic (T) and lumbar (L) spine in
brachycephalic dogs to evaluate the diagnostic accuracy of radiography in diagnosing
congenital vertebral malformations.
CT scans of the spine of brachycephalic dogs and radiographs including the T and L
spine of the same animals were retrieved from the patient archive. The anonymized
radiographs were assessed independently by one observer and compared with the
CT as reference method with an 8-week interval. Number, position and type of
vertebral malformation were recorded using the following classification: hemivertebra
with lateral, ventral and ventrolateral aplasia; ventral, lateral and dorsal wedge
vertebra; butterfly vertebra; short vertebra; block vertebra; spina bifida; kissing spines;
fused spines; transitional vertebra. Sensitivity and specificity were calculated. Significance was tested using Fisher’s exact test with the significance level set at p < 0.05.
Results
58 dogs matched the inclusion criteria: 54 were French Bulldogs, 3 Pugs and
1 English Bulldog. 13 dogs had full sets of orthogonal (ORT) views of the T and lumbar
L spine available. 25 had ORT views of the T and lateral (LAT) views only of the L
spine. 6 had LAT views only of the T and ORT views of the L spine. 14 had LAT views
of the T and L spine only. 266 of 1160 (23 %) total vertebrae revealed malformations.
The most common malformation 102/266 (38 %) was a butterfly vertebra. 29/266
(11 %) dorsal wedge, 27/266 (10 %) lateral wedge, 27/266 (10 %) short and 26/266
(10 %) ventral wedge vertebrae were found as well as 15/266 (6 %) hemivertebrae
with ventrolateral aplasia and 2/266 (< 1 %) block vertebrae. There were 44 cases
of kissing spines and 26 cases of fused spinous processes. 12 (5 %) thoracolumbar
and 1 (< 1 %) lumbosacral transitional vertebrae were recorded. A single case of
a spina bifida occulta was recorded. 247/266 (93 %) of the vertebral malformations
were located between T4 and L1, 142/266 (53 %) between T6 and T9. Sensitivity and
specificity of radiographs to diagnose vertebral malformations correctly regarding
their number and position along the spine were 78 % and 97 % for ORT views and
85 % and 96 % for LAT views (p < 0.0001) respectively.
Discussion
Based on the reasonably high diagnostic accuracy radiography is a suitable screening
tool for congenital vertebral malformations. Lateral views of the thoracic and lumbar
spine appear to be sufficient. The orthogonal view may be resigned for the purpose
of screening as it does not add to the diagnostic value.
115
COMPUTED TOMOGRAPHIC PELVIMETRIC ASSESSMENT OF ENGLISH
BULLDOGS. T. P.Dobak1, G.Voorhout1, J.C.M.Vernooij2, S.A.E.B.Boroffka3.
1 - Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University,
The Netherlands, 3584 CM Utrecht. 2 - Department of Farm Animal Health, Faculty of
Veterinary Medicine, Utrecht University, The Netherlands, 3584 CL Utrecht. 3 - Boroffka Diagnostic Imaging, The Netherlands, 3543 AR Utrecht. [email protected]
English bulldogs (EBD) have been reported to have a very high incidence of dystocia
and fetopelvic disproportion is considered one of the main underlying causes. A radiographic pelvimetry study in two terrier breeds found a direct relation of narrow pelvic
size and obstructive dystocia due to fetopelvic disproportion. In this study CT was
used as an optimal high-resolution imaging modality for three-dimensional assessment
of bony structures, performing pelvimetry of healthy EBD and control dogs. The hypothesis was that the pelvis of EBD is significantly narrower and shorter than the pelvis of other breeds not highly predisposed for dystocia.
Methods
Forty clinically healthy EBD were recruited for prospective study purposes and CT
examinations of the pelvises were performed. A control group of mesaticephalic and
dolichocephalic dogs was retrospectively collected from the patient archive system
and consisted of 30 dogs of other breeds with comparable body weight to the EBD
group that underwent CT of the pelvis for reasons that would not influence the size and
shape of the pelvis. Individual measurements of the pelvic inlet, outlet, length and
width were obtained from multi planar reconstructions (MPR). These measurements
were compared between EBD and controls using a univariate analysis of variance
(ANOVA). A P-value of <0.05 was considered significant.
Results
A significant difference (P= 0.00) between the EBD and control group was found for
the pelvic length and caudal pelvic aperture: Mean length between tuber coxae and
ischial tuberosity was 105 mm (± 6 SD) for EBD and 130 mm (± 9 SD) for the control
group, mean length at the level of the left 73 mm (± 4 SD) and right 72 mm (± 4 SD)
sacrotuberous ligament for EBD and mean length at the level of the left and right 83
mm (± 7 SD) sacrotuberous ligament for the control group.
The findings in our CT pelvimetric study prove that the pelvises of EBD are significantly narrower and shorter when compared with the control group. This may be directly
related to the high rate of dystocia reported in this breed. We suggest that our
measurements may serve as a baseline for the pelvic size of EBD and can be useful
for future studies on dystocia in this breed.
116
COMPARISON OF SCAPULOHUMERAL JOINT COMPUTED TOMOGRAPHY,
COMPUTED TOMOGRAPHIC ARTHROGRAPHY AND ARTHROSCOPY IN DOGS
WITH SHOULDER LAMENESS. N. Corzo-Menendez1, S.H. Austwick2, D.G. Thomson1, T. Schwarz3. 1 - Davies Veterinary Specialists, UK MK43 0US. 2 - Austwick
Veterinary Services Ltd. UK, LU4 8FE. 3 - Royal (Dick) School of Veterinary Studies
UK, EH25 9RG. [email protected]
Introduction
Shoulder pathology is a common cause of canine forelimb lameness. Computed
Tomography (CT) and arthroscopy (A) are frequently used for diagnosis. A post-mortem canine shoulder Computed Tomographic Arthrography (CTA) study showed
excellent anatomic detail. Studies about the clinical use of CTA in shoulder lame
dogs are lacking. The objective of this retrospective study was to compare lesion
detection of scapulohumeral CT, CTA and A in clinical dogs with shoulder lameness.
Methods
Inclusion criteria were a diagnostic quality shoulder CT, CTA and videotaped A within
one month in dogs with shoulder lameness. All procedures used standardised
equipment and published techniques. Scoring was performed blinded to outcome by
an experienced radiologist (CT/CTA) and surgeon (A) recording presence or absence
of anomalies of deep and superficial muscle, tendon, ligament, bone, cartilage and
synovium structures. A was only scored and compared for superficial lesions visualisable with A.
Results
Included were 36 shoulder joints of 35 dogs. The most represented breed was Labrador Retriever (11 dogs). Comparison of lesion detection revealed (number of cases
in brackets): musculature (CTA(7)>CT(6)), tendons (CTA(18)>CT(10)>A(8)),
ligaments (CTA(10)>A(8)>CT(0)), bone (CT(28)>CTA(26)>A(15)), cartilage
(A=CTA(10)>CT(3)) and synovium (A(22)>CTA(11)>CT(6)).
Discussion
CTA and A provided increased lesion detection of tendons, ligaments and cartilage
compared to CT in diseased canine shoulder joints. Deep lesions cannot be assessed
with A whereas CT and CTA do not provide colour and fine detail of surface articular
structures. A combined CTA & A work-up is recommended.
117
A COMPARISON OF RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC
FINDINGS OF THE MEDIAL CORONOID PROCESS IN DOG BREEDING
APPEAL CASES. J. Wennemuth, B. Tellhelm, N. Ondreka, M. Kramer, K. von Pückler.
Justus-Liebig-Universität Giessen, Germany, 35390.
Introduction
Elbow dysplasia (ED) commonly affects young large breed dogs and leads to osteoarthritis of the elbow joint. Medial coronoid disease is the most common cause (85%
of cases) of early osteoarthritis of the elbow joint. The success of radiographic screening
methods in excluding affected animals from breeding is limited by the sensitivity of
those methods. In cases of equivocal findings using radiography, owners are allowed
to present their animals for an official second opinion. In the current study, a comparison of the radiographic and computed tomographic (CT) findings of the medial coronoid process (MCP) was carried out. The purpose was to provide decision criteria
under which CT of the elbow could complete the radiographic assessment.
Methods
One hundred and forty dogs presenting for official second opinion radiographs and CT
of the elbow joints were included in the study. The data were blinded and reviewed by
three board certified observers following defined criteria regarding MCP conformation
and elbow dysplasia. Subsequently, a consensus assessment was achieved about
radiographic and CT results. Grading of the joints was based on the International
Elbow Working Group (IEWG) guidelines.
Results
Dogs from seven different breeds (predominantly retrievers and German shepherd
dogs) were included in the study. Gender distribution was equal, with 51% of the dogs
being male. The median age was 14.4 months. The imaging results obtained were
as follows: 52 radiographed and 34 CT-scanned elbows were graded as IEWG 0;
16 radiographed and 21 CT-scanned elbows were graded as borderline; 8 radiographed and 24 CT-scanned elbows were graded as IEWG 1; 58 radiographed and 23
CT-scanned elbows were graded as IEWG 2; and 6 radiographed and 38 CT-scanned
elbows were graded as IEWG 3. Forty-three percent of elbows received the same
grade by both modalities. In 41% of the cases, the presence or absence of a primary
lesion was confirmed on both radiographs and CT scans. In 16% of the examined
elbows, radiographic and CT findings did not match.
Discussion
The results of the present study were in line with those of previous studies that showed
that, in special cases, MCP assessment using radiography alone can prove difficult.
The relatively high number of inconsistent assessments was likely due to the preselection of the cases and the high prevalence of unclear radiographic findings in the
population of appeal cases. Decision criteria under which CT of the elbow could
complete the radiographic assessment possibly include blurred MCP and reduced
opacity.
118
DENTAL CHANGES IN CATS WITH NEWLY DIAGNOSED DIABETES MELLITUS.
F. Willmitzer, A. Riederer, S. Grundmann, P. Kircher, E. Salesov, C. Reusch. University of Zurich, Vetsuisse-Faculty, Switzerland, 8057. [email protected]
Periodontal disease is the most common oral complication of diabetes in humans,
referred as the “sixth complication of diabetes”. The dental and periodontal status in
a group of newly diagnosed diabetic cats was evaluated using computed tomography
(CT) as part of a concurrent study.
Methods
In this prospective study CT examinations of the heads of 26 diabetic cats with newly
diagnosed diabetes, were acquired (1024x1024 matrix, reconstructed to 0,6mm
slice thickness) and reviewed using the bone algorithm series. Every tooth was
assessed according to a list of 10 possible findings. Descriptive statistic of the
collected data was compiled using a commercial software program (SPSS Statistics©
v.23).
Results
The median age of the cats was 10.0 (2.6 - 12.8) years and the median weight was
4.9 (2.7 – 12.8) kg, mainly European Shorthair cats (69.2%), 53.8% female neutered,
42.3% male neutered and 3.8% male intact. 755 teeth have been evaluated, 25 (3.2%)
were missing. 709 (90.9%) were of normal CT appearance. 27 (3.5%) had type
1 resorptive lesions (RL), 10 (1.3%) tooth root fractures, 4 (0.5%) vertical bone loss,
3 (0.4%) periapical lucencies, one (0.1%) horizontal bone loss and one (0.1%) a type
2 resorptive lesion. 7/26 (26.9%) cats had no lesions, 7/26 (26.9%) cats had a single
lesion, 9/26 (34.6%) cats had two to five lesions and 3/26 (11.5%) cats had nine to
thirteen lesions. Premolars were the most frequently lost teeth (48.0%). Type 1 RL
occurred more frequently in the upper jaw compared to the lower jaw (4.6% versus
2.2%). Overall RL occur more often in incisor and canine teeth. Tooth root fractures
had a low frequency (1.3%) and never occurred in premolars and molars. Periapical
lucencies occurred very rarely (0.4%) and in canine teeth only.
Type 1 RL was the most common dental lesion in the group of cats with newly diagnosed diabetes. RL were more common in incisors and canine teeth, together
accounting for 63.0% of these lesions. Most of the cats with dental abnormalities had
two to five lesions. RL are reported to affect 20% to 67% of all cats and a positive
relationship between the occurrence and increasing age is described. The amount
of lesions in the present group of diabetic cats is slightly higher than the one published
for a healthy feline population with a mean age of 4.92 years. Long-term studies taking
the therapy of diabetes and its responsiveness into account, would provide valuable
information in cats on the two-way relationship between diabetes and dental and
periodontal lesions described in human medicine.
119
PERSISTENT GROWTH-ZONES OF THE ATLAS IN BRACHYCEPHALIC DOGS.
E. Ludewig1,2, M. Kind1, G. Oechtering1. 1 - Department of Small Animals, Veterinary
Faculty, University of Leipzig, Germany. 2 - Diagnostic Imaging, Department of
Companion Animals and Horses, Veterinary University Vienna, Austria.
Introduction: The atlas develops from several ossification centers. In Beagle dogs at
birth the atlas is composed of three separate bony elements: a bilateral pair of neural
arch elements dorsolaterally and the body of the atlas formed from an intercentrum
ventromedially. Fusion is completed at about 120 days post partum (Watson et al.
1986). Intermittently, in computed tomography (CT) we observed persistent growth-zones (PGZ) of the atlas in brachycephalic dogs. Therefore, the purpose of the study
was to assess the prevalence of PGZ of the atlas in adult brachycephalic breed dogs
(pug, French bulldog (FBD), English bulldog (EBD)) and to describe CT-features of
this malformation.
Animals, Materials and Methods: The sample population for this retrospective study
consisted of adult (≥ 12 months) dogs presented with clinical signs of brachycephalic
airway syndrome (November 2005 - December 2015). CT was performed with a 6-slice helical scanner. For all dogs a pre-de¬fined optimized protocol was applied.
CT-studies of 196 pugs, 201 FBDs and 68 EBDs were eva¬lu¬ated retrospectively
for the presence and the characteristics of PGZs of the atlas. Image evaluation was
performed initially by a final-year veterinary student following specific training. This
was followed by a consensus review with a board-certified radiologist. Criteria were
(1) presence of one or more PGZ (yes, no), (2) position of PGZ(s) relative to the transverse section, (3) percentage of the lucent band relative to the transverse diameter of
the bone (100%, > 75%, > 50%, > 25%, < 25%), and (4) presence of reactive new
bone formation (not present, mild, moderate, severe).
Results: PGZs were seen in 10.9% (22/201) of the FBDs and 35.3% (24/68) of the
EBDs. In pugs no PGZ was found. Within the affected breeds neither an influence of
gender, nor if the dogs were intact or neutered could be demonstrated (p ≤ 0.05,
Mann-Whitney U-test). In FBDs and EBDs the defect was localized mid-dorsally (3/22
= 13.6%, 1/24 = 4.2%), mid-ventrally (16/22 = 72.7%, 18/24 = 75.0%) or in both locations (3/22 = 13.6%, 5/24 = 20.8%), respectively. In the majority of cases - in 77.3%
(17/22) of FBDs and in 75.0% (18/24) of EBDs - the lucent band crossed the bone
completely or almost completely. Mostly, reactive new bone formation was absent
or mild. If present mainly it was seen on the outer surface of the bone. In none of the
affected dogs neurologic deficits were observed.
Discussion: Interestingly, PGZs were found in mid-ventrally. This is surprising because
in Beagle dogs no growth zone was described here. Instead, growth zones lie ventrolateral at the junctions of the intercentrum and the lateral bony arches (Watson et al.
1986). Further, in this ventrolateral position PGZs are described in normocephalic
dogs (Warren-Smith et al. 2009). In our population no PGZ was seen ventrolaterally.
Summary and Conclusions: PGZs are a frequent finding in both, FBDs and EBDs.
It was not seen in pugs. Investigations in skeletally immature dogs can aid to answer
the question if ossification of the atlas in brachycephalic dogs differs from the
development in normocephalic dogs.
References: Warren-Smith CMR, Kneissl S, Benigni S, et al. Incomplete ossification
of the atlas in dogs with cervical signs. Vet Radiol Ultrasound 2009;50:635-638.
Watson AG, Evans HE, de Lahunta A. Ossification of the atlas-axis-complex in the
dog. Ana Histol Embryol 1986;15:122-138.
120
SESSION XII
XII
CONTRAST-ENHANCED ULTRASOUND OF NORMAL CANINE MAMMARY
GLANDS DURING THE ESTRUS CYCLE. K. Vanderperren1, E. Stock1, E. Van der
Vekens1, H. de Rooster2, L. Duchateau3, J.H. Saunders1. 1 - Department of Medical
Imaging of Domestic Animals, 2 - Department of Medicine and Clinical Biology
of Small Animals, 3 - Department of Comparative Physiology and Biometry,
Faculty
of
Veterinary
Medicine,
Ghent
University,
Belgium,
9820.
[email protected]
Abnormalities of the canine mammary gland are very common and include neoplasia,
cysts, inflammation and infection. Different contrast enhancement and flow patterns
were observed between benign and malignant lesions with contrast-enhanced ultrasound (CEUS). However, no literature is available about the normal CEUS pattern of
canine mammary glands. Therefore, the purpose was to determine if CEUS could
characterize variations in mammary gland vascularization during the estrus cycle and
to select parameters that were stable despite cyclic changes.
Methods
The study included 6 intact female research beagles (mean age of 1.5 y). The dogs
were not used for breeding. CEUS of the first, third and fifth mammary glands were
performed (2 operators for scanning, 1 operator for CEUS analysis) at 5 time points
during their reproductive cycle (proestrus, estrus, metestrus (early and late) and anestrus). All dogs were sedated (butorphanol (0.4mg/kg)). Parameters derived from the
time-intensity curves (peak enhancement, wash-in area under the curve, rise time,
mean transit time, time to peak, wash-in rate, wash-out area under the curve, total
area under the curve) were compared between the different stadia of the estrus cycle
using a mixed model with dog as random effect and stadia of the estrus cycle as fixed
effects. Stadia were compared pairwise by a t-test adjusting the global 5% significance level by Tukey’s multiple comparisons technique (SAS Version 9.3).
Results
It was difficult to obtain good quality images for quantitative analysis of the first mammary glands due to its small size (< 1 mm). For the third mammary glands, significant
differences were found for the wash-in area, wash-out area and total area under the
curve with a significant increase between estrus and late metestrus and a significant
decrease between late metestrus and anestrus. Similarly, the mean transit time was
significantly increased between the estrus and metestrus and decreased between the
early metestrus and anestrus. For the fifth mammary gland, only the time to peak was
significantly longer during the anestrus compared to the estrus whereas all the other
contrast parameters did not change during the cycle.
Differences were observed in contrast parameters during the estrus cycle in dogs and
should be taken into account when performing CEUS in dogs suspected of mammary
gland disorders.
121
SONOGRAPHIC APPEARANCE OF THE URINARY TRACT IN CATS WITH
URETERAL OBSTRUCTION TREATED WITH SUBCUTANEOUS URETERAL
BYPASS (SUB): A RETROSPECTIVE STUDY OF 22 CASES (2010-2015).
J. Fages1, M. Dunn1, S. Specchi2,3, P. Pey3. 1 - Department of Clinical Sciences,
Faculté de médecine vétérinaire, Université de Montréal, Canada, QC J2S 2M2.
2 - Diagnostic Imaging Service of the Istituto Veterinario di Novara, Italy, 28060.
3 -Antech Imaging Services, USA, 92614 CA. [email protected]
Introduction
Reported complications related to Subcutaneous Ureteral Bypass (SUB) placement
include urine leakage around the nephrostomy or cystotomy catheters or port,
occlusion of the SUB device by a blood clot, urolith or kinking of the catheter, recurrent
urinary tract infection or inflammatory cystitis. To the authors’ knowledge, the sonographic appearance of the urinary tract following SUB placement has yet to be reported. The objective of the present study was to describe short and long-term sonographic appearance of the urinary tract in cats with ureteral obstruction treated with SUB
and identify relevant sonographic parameters for monitoring.
Twenty-two cats with unilateral (n=18) or bilateral (n=4) ureteral obstruction treated
by placement of a SUB device were recruited in this retrospective case study.
Appearance and measurement of the width of the renal pelvis along with several
qualitative sonographic parameters were recorded for each patient prior to SUB placement (pre-T0) and during the short ( T0 > and < 3 months) and long term ( >3 months)
follow-ups. For both intervals, the most recent review available was used for the
qualitative criteria while the average quantitative values were recorded. The complications observed during follow-up were classified as obstructive or non-obstructive.
A McNemar test was used to compare the binary coded quantitative parameters
of each group with each other. A linear model with repeated values over time was
used to assess the pelvis dilation and its analysis of variance followed by Tukey post
hoc analysis was used to compare the three groups (pre-T0, short term and long
term). A p-value <0.05 was considered as significant.
Results
No qualitative sonographic parameter showed statistically significant changes.
The presence of retroperitoneal or peritoneal effusion was rare. Hyperechogenicity
of the perirenal adipose tissue decreased in the long term. A statistically significant
decrease in the width of the renal pelvis was noted in the short (3.1 mm) (p<0.0001)
and long term (1.5 mm) (p<0.0001) follow-up, as compared to the preoperative value
T0 (12.2 mm). Three months following SUB placement, each patient without an
obstructive complication had a pelvis width ≤ 3 mm.
Conclusions
Renal pelvic distension is reversible when ureteral obstruction is treated by placement
of a SUB device. Ultrasound monitoring is an essential tool to detect obstructive
complications. A renal pelvis measuring 4mm and > is suggestive of occlusion of the
SUB device.
122
ULTRASOUND-GUIDED REMOVAL OF LOWER EXTREMITIES VEGETAL
FOREIGN BODY: A RETROSPECTIVE STUDY OF 19 CASES.
E.Fauchon, C.Lassaigne, D.Rossetti, G.Ragetly, E.Gomes. CHV Frégis, France,
Subcutnaneous abscesses or granulomas in lower extremities are a common condition in dogs. Vegetal foreign body penetration and migration is one of the most common causes of this type of lesion. An ultrasonographic examination can be performed
to search for a vegetal foreign body. Its appearance has already been described, allowing its identification before removal. The aim of this study was to describe ultrasound-guided retrieval of grass awns in lower extremities of dogs and particularly emphasize the usefulness of this procedure and its immediate and long-term effectiveness
and prognosis.
Methods
Our ultrasonographic database was searched over the years 2012–2015 for dogs with
a confirmed plant awn abscess of the lower extremities, including carpal, tarsal, metacarpal, metatarsal and phalangeal regions; and that underwent ultrasound-guided minimally invasive foreign body retrieval. Information obtained from the records included
signalment, whether exploratory surgery and treatment had been done before presentation to our hospital, clinical examination at presentation, abscess size and location,
presence of a draining tract, ultrasonographic features of the lesion and foreign body,
technique employed, and follow-up and outcome. Nineteen dogs meet the inclusion
criteria and 22 vegetal foreign bodies were identified in these cases. In all dogs, ultrasonographic examination was performed using a 5-8 MHz multifrequency sector and
a 15 MHz linear transducer. The ultrasound field included the entire area of soft tissue
swelling plus 2-3 cm of normal tissue around. If present, draining tracts were followed
from the skin surface to its termination or until it could no longer be visualized. In all
dogs a grass awn was detected.
Results
When presenting to our hospital, 18 dogs had a good general condition and one had
an altered general condition. On presentation, all dogs had a focal swelling of the affected lower extremity, 10 dogs had an associated fistulous tract, 8 dogs had lameness of the affected limb, and 3 dogs showed pain response on palpation. Lesions
were interdigital in 14 dogs, metacarpal in 1 dog, metatarsal in 1 dog, carpal in 2 dogs
and tarsal in 1 dog. In all dogs, linear spindle-shape structures with two ore more reflecting interface were identified, associated with an acoustic shadowing in only 1 dog.
The median length was 11 mm (range to 2,7 to 36 mm) and the median width was 2,3
(0,1 to 11 mm). All retrieval procedures were performed in the sonography suite. A
resolution of clinical signs was observed in less than 5 days in 14 dogs, in 5 to 10 days
in 3 dogs and in more than 10 days in 2 dogs. The long-term follow-up varied between
3 to 45 months with a median of 15 months, and no dog had recurrence of the abscess. Four dogs had another episode of lower extremity foreign body but the localisation was different.
Ultrasonographic examination does have limitations for foreign body detection in the
lower extremities of the dog including operator experience and the familiarity with the
region being examined. But it should be the first tool for a suspicion of abscess or granuloma of the lower extremities in dogs. In our retrospective study, all foreign bodies
identified and retrieved with ultrasonographic guidance had a successful long-term
follow-up.
123
CONTRAST-ENHANCED ULTRASONOGRAPHY OF INTRATHORACIC MASS
LESIONS IN 48 DOGS AND CATS. T. Rick, M. Kleiter, I. Schwendenwein,
M. Reifinger, K.M. Hittmair. University of Veterinary Medicine, 1210 Vienna, Austria.
[email protected]
The use of contrast-enhanced ultrasonography (CEUS) to characterize abdominal
organ pathology in dogs and cats has been reported. There are no reports on the use
of CEUS for intrathoracic mass lesions in veterinary medicine. The purpose of this
study was to characterize pulmonary and mediastinal masses in dogs and cats and to
determine whether CEUS could be valuable for differentiation between benign and
malignant intrathoracic mass lesions.
Methods
Forty-eight patients (29 dogs and 19 cats) showed intrathoracic mass lesions on
thoracic radiographs and were included in this prospective study. The masses were
defined as pulmonary or mediastinal in origin with the help of ultrasonography. CEUS
was performed with a low mechanical index setting (MI) of 0.10 – 0.12 following injection of SonoVue®. Each patient received a bolus injection of 1-2 ml contrast medium
and 3-5 ml saline flush. Using region-of-interest (ROI) generated signal intensity (SI)
time curves, intrathoracic masses were characterized by time to enhancement (TTE),
signal intensity (SI), and time to peak (TTP). Additionally, the spleen, representing
a parenchymal, systemically perfused organ, was examined with CEUS in every
patient using the same setting. The results were statistically evaluated using a t-test
and Fisher-exact tests. Ultrasound guided FNA was performed in 34 animals and
tissue core biopsies in 7 patients. More than one diagnostic procedure was applied
in some patients.
Results
Of the 48 patients, 7 patients were excluded due to unclear biopsy results. In the
remaining 41 cases, ultrasonography determined 30 (73%) pulmonary masses and
11 (27%) mediastinal masses. Comparison of TTE values of intrathoracic masses
and those of the spleen were able to determine pulmonary arterial and bronchial
arterial vascularization. There was a highly significant difference in TTE (p=0,001)
between pulmonary arterial and bronchial arterial vascularization. All pulmonary
sarcomas were supplied by bronchial arteries, which shows a significant difference
to carcinomas (p=0,018) and benign lesions (p=0,033). In contrast benign lesions
were commonly vascularized by pulmonary arteries. Of the pulmonary masses 11/30
(36%) were adenocarcinomas, 4/30 (13%) undifferentiated carcinomas, 1/30 (3%)
adenosquamous carcinoma, 1/30 (3%) squamous cell carcinoma, 7/30 (23) sarcomas
and 6/30 (20%) benign lesions. 6/11 (54%) mediastinal masses were thymomas and
5/11 (45%) lymphoma. There was no significant difference in TTE for mediastinal
masses.
CEUS provides useful information to characterize pulmonary and mediastinal mass
lesions as well as vascularization of these masses.
124
LUNG LOBE TORSION: PARTICULAR ULTRASOUND FEATURES AS BASED
ON COMPARATIVE CT AND PATHOPHYSIOLOGICAL INFERENCES IN 12 DOGS.
A. Belmudes1, G. Gory2, D. N. Rault 1, A. Combes3, H. Gallois-Brides2, L. Couturier1,
E. Cauvin1. 1 - Azurvet, France, 06800. 2 - Olliolis, France, 83190. 3 - Alliance,
France, 33300. [email protected]
The radiological, computed tomographic (CT) and bronchoscopic features of lung
lobe torsion (LLT) have been well described in dogs. Conversely, ultrasonography
(US) has received less interest. Some authors have described a hypoechoic peripheral band surrounding an irregular hyperechoic interface within the lobe. In our
experience, this finding may be highly suggestive of LLT. The aim of this study is to
assess the significance of this particular US feature by correlating it to CT and
histological findings.
Methods
12 dogs, including 3 pugs and 6 deep-chested dogs, with confirmed LLT were
included. All had received US and CT thoracic assessments. Histopathological
examination was performed in 9 dogs.
Results
In all cases CT revealed pleural effusion, hilar soft tissue attenuation, central
emphysema surrounded by a peripheral, hyperattenuating band or line. This coursed
along the entire lobe in 6/12 cases. In the remaining 6 cases, only the ventral
two-thirds of the lobe were affected, the dorsolateral portion being systematically
spared. In all cases, US showed pleural effusion and a lateral or ventrolateral,
hypoechoic band or line capping spiculated, hyperreflecting interfaces (emphysema),
and absence of blood flow by using color Doppler. Histopathological examination
revealed ischemic or hemorrhagic parenchymal necrosis and thickening of the
visceral pleura in the area of the above described band.
LLT appears to highlight specificities of pulmonary ischemia. CT spatial distribution
of lesions within the twisted lobe (‘ring like’ necrotic band around central emphysema)
suggests that gravity is not a major factor in lobar ventilation and perfusion, unlike
previous hypotheses. Recent studies have demonstrated that the fractal organisation
of airways and blood vessels plays a more important role, which could explain the
susceptibility to ischemia of peripheral areas. The visceral pleura is perfused by
pulmonary arteries, which explains the combined peripheral lung necrosis and
pleural remodelling. CT and pathophysiological inferences thus help to understand
the origin of the peripheral band surrounding emphysema, as observed in the
ventrolateral part of the twisted lobe on US. This finding is therefore highly suggestive
of LLT. US may consequently be a valuable tool to distinguish LLT from other pulmonary lesions.
125
SUNDAY / 04.09.2016
10:15 - 17:30
CONTINUING PROFESSIONAL DEVELOPMENT COURSE
10:15 - 13:30
Livia Benigni
Hotel Monopol
- Feline thoracic ultrasound
- Ultrasound of feline gastrointestinal, hepatic and pancreatic disorders
- Imaging of feline urinary tract
13:30 - 14:30
LUNCH
Hotel Monopol
14:30 - 17:30
Lorrie Gaschen
Hotel Monopol
- Making sense of lung patterns. How to develop an action plan
- The coughing dog - how to get a radiographic diagnosis
- Diagnosing intestinal obstructions. Tips you need to know
EXHIBITORS:
OR Technology
126
wa
le
Po
ws
t
ań
có
w
Po
d
h
kic
Ślą
s
Pla
c
w
Po
sta
ńc
ó
ar
wW
- GALA DINNER
w
sza
- RESIDENTS’ DINNER
Dinette Bistro
Address: Plac Teatralny 2, 50-051 Wrocław
Phone: +48 502 575 145
Opera House
Address: Świdnicka 35, 50-066 Wrocław
Phone: +48 71 370 88 00
MAIN VENUE:
- SESSIONS
- COFFEE BREAKS
- LUNCH BREAKS
rza
Kazimie
lkiego
W ie
MA RKE T S Q UA RE
TOWN HA LL
zyńsiego
Wys
y
OVO Hotel – Ballroom
Address: Podwale 84, 50-414 Wrocław
Phone: +48 71 777 00 00
w ic z a
Cu
rie
-Sk
łod
ow
ski
ej
- FAREWELL PARTY
Centennial Hall – Pergola Restaurant
Address: Wystawowa 1, 51-618 Wrocław
Phone: +48 713475022
ró
ble
WRO CŁAW ZO O
W
y
W
S ie n k ie
wa
wo
sta
Hotel Monopol
Address: Modrzejewskiej 2, 50-071 Wrocław
Phone: +48 71 77 23 777
- WELCOME RECEPTION
- ECVDI BOARD DINNER
a
utt
ug
Tra
127
ws
kie
go
MAIN SPONSOR
GOLDEN SPONSOR
SILVER SPONSOR
RESIDENT SPONSORSHIP
HONORARY PATRONAGE
BRONZE SPONSOR
MEDIA PATRONAGE
BRONZE SPONSOR

EVDI2016 BOOK.indd - evdi 2016 wroclaw poland

Transcription

Similar documents

Nothing to do - Rabbit Welfare Association

Coleus canina

Startin pric fro $2,050.00

Canine Pemphigus Foliaceus

Helping Guide Dogs PDF

and spend the afternoon enjoying: And so much more!

Shampoo A7 Quick Guide

Skooby`s Hot Dogs 6654 Hollywood Blvd. Hollywood, CA 90028

Gary Rolfe – Hanwag footwear

Fall 2009