OBJECTIVE To determine clinical relevance for quantitative and qualitative features of canine hepatic masses evaluated by use of triphasic CT and B-mode, color flow, power, and pulsed-wave Doppler ultrasonography and to compare diagnostic accuracy of these modalities for predicting mass type on the basis of histopathologic classification. ANIMALS 44 client-owned dogs. PROCEDURES Dogs with histopathologic confirmation (needle core, punch, or excisional biopsy) of a hepatic mass were enrolled. Triphasic CT and B-mode, color flow, power, and pulsed-wave Doppler ultrasonography of each hepatic mass were performed. Seventy quantitative and qualitative variables of each hepatic mass were recorded by 5 separate observers and statistically evaluated with discriminant and stepwise analyses. Significant variables were entered in equation-based predictions for the histopathologic diagnosis. RESULTS An equation that included the lowest delayed-phase absolute enhancement of the mass and the highest venous-phase mass conspicuity was used to correctly classify 43 of 46 (93.5%) hepatic masses as benign or malignant. An equation that included only the lowest delayed-phase absolute enhancement of the mass could be used to correctly classify 42 of 46 (91.3%) masses (with expectation of malignancy if this value was < 37 Hounsfield units). For ultrasonography, categorization of the masses with cavitations as malignant achieved a diagnostic accuracy of 80.4%. CONCLUSIONS AND CLINICAL RELEVANCE Triphasic CT had a higher accuracy than ultrasonography for use in predicting hepatic lesion classification. The lowest delayed-phase absolute enhancement of the mass was a simple calculation that required 2 measurements and aided in the differentiation of benign versus malignant hepatic masses.
BackgroundIntra-synovial tendon injuries display poor healing, which often results in reduced functionality and pain. A lack of effective therapeutic options has led to experimental approaches to augment natural tendon repair with autologous mesenchymal stem cells (MSCs) although the effects of the intra-synovial environment on the distribution, engraftment and functionality of implanted MSCs is not known. This study utilised a novel sheep model which, although in an anatomically different location, more accurately mimics the mechanical and synovial environment of the human rotator cuff, to determine the effects of intra-synovial implantation of MSCs.MethodsA lesion was made in the lateral border of the lateral branch of the ovine deep digital flexor tendon within the digital sheath and 2 weeks later 5 million autologous bone marrow MSCs were injected under ultrasound guidance into the digital sheath. Tendons were recovered post mortem at 1 day, and 1–2, 4, 12 and 24 weeks after MSC injection. For the 1-day and 1–2-week groups, MSCs labelled with fluorescent-conjugated magnetic iron-oxide nanoparticles (MIONs) were tracked with MRI, histology and flow cytometry. The 4, 12 and 24-week groups were implanted with non-labelled cells and compared with saline-injected controls for healing.ResultsThe MSCs displayed no reduced viability in vitro to an uptake of 20.0 ± 4.6 pg MIONs per cell, which was detectable by MRI at minimal density of ~ 3 × 104 cells. Treated limbs indicated cellular distribution throughout the tendon synovial sheath but restricted to the synovial tissues, with no MSCs detected in the tendon or surgical lesion.The lesion was associated with negligible morbidity with minimal inflammation post surgery. Evaluation of both treated and control lesions showed no evidence of healing of the lesion at 4, 12 and 24 weeks on gross and histological examination.ConclusionsUnlike other laboratory animal models of tendon injury, this novel model mimics the failed tendon healing seen clinically intra-synovially. Importantly, however, implanted stem cells exhibited homing to synovium niches where they survived for at least 14 days. This phenomenon could be utilised in the development of novel physical or biological approaches to enhance localisation of cells in augmenting intra-synovial tendon repair.
The ratio between maximal small intestinal (SI) diameter and the height of the body of the fifth lumbar vertebra (L5) in radiographs has been reported as a diagnostic test in dogs with suspected intestinal obstruction. In order to assess the effect of the SI/L5 ratio on the accuracy of radiographic diagnosis of intestinal obstruction, lateral abdominal radiographs of 37 dogs with small intestinal obstruction and 48 nonobstructed dogs were mixed and examined independently by six observers who were unaware of the final diagnosis and who represented a range of experience. Observers first examined radiographs subjectively and stated the likelihood of obstruction (definitely not, probably not, equivocal, probably, definitely). Observers subsequently reexamined the radiographs, determined the SI/L5 ratio, and again stated the likelihood of obstruction. The most frequent cause of obstruction was foreign body (29/37, 78%). Dogs with SI obstruction had a significantly larger median SI/L5 ratio than nonobstructed dogs (P = 0.0002). Using an SI/L5 ratio of 1.7 for diagnosis of intestinal obstruction, sensitivity and specificity were 66%. Use of the SI/L5 ratio was not associated with increased accuracy of diagnosis for any observer, regardless of experience, hence this test may have no diagnostic impact. C 2013 Veterinary Radiology & Ultrasound.
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