Anomalies involving arterial branches in the lungs are one of the causes of hemoptysis in humans and dogs. Congenital and acquired patterns of bronchoesophageal artery hypertrophy have been reported in humans based on CT characteristics. The purpose of this retrospective study was to describe clinical, echocardiographic, and multidetector computed tomography features of bronchoesophageal artery hypertrophy and systemic-to-pulmonary arterial communications in a sample of 14 dogs. Two main vascular patterns were identified in dogs that resembled congenital and acquired conditions reported in humans. Pattern 1 appeared as an aberrant origin of the right bronchoesophageal artery, normal origin of the left one, and enlargement of both the bronchial and esophageal branches that formed a dense network terminating in a pulmonary artery through an orifice. Pattern 2 appeared as a normal origin of both right and left bronchoesophageal arteries, with an enlarged and tortuous course along the bronchi to the periphery of the lung, where they communicated with subsegmental pulmonary arteries. Dogs having Pattern 1 also had paraesophageal and esophageal varices, with the latter being confirmed by videoendoscopy examination. Authors conclude that dogs with Pattern 1 should be differentiated from dogs with other congenital vascular systemic-to-pulmonary connections. Dogs having Pattern 2 should be evaluated for underlying pleural or pulmonary diseases. Bronchoesophageal artery hypertrophy can be accompanied by esophageal venous engorgement and should be included in the differential diagnosis for esophageal and paraesophageal varices in dogs.
In humans, the process of development of collateral vessels with hepatopetal flow around the portal vein in order to bypass an obstruction is called "cavernous transformation of the portal vein." The purpose of this retrospective, cross-sectional, multicentric study was to describe presumed cavernous transformation of the portal vein in small animals with portal vein obstruction using ultrasound and multidetector-row computed tomography (MDCT). Databases from three different institutions were searched for patients with an imaging diagnosis of cavernous transformation of the portal vein secondary to portal vein obstruction of any cause. Images were retrieved and reanalyzed. With MDCT-angiography, two main portoportal collateral pathways were identified: short tortuous portoportal veins around/inside the thrombus and long portoportal collaterals bypassing the site of portal obstruction. Three subtypes of the long collaterals, often coexisting, were identified. Branches of the hepatic artery where involved in collateral circulation in nine cases. Concomitant acquired portosystemic shunts were identified in six patients. With ultrasound, cavernous transformation of the portal vein was suspected in three dogs and one cat based on visualization of multiple and tortuous vascular structures corresponding to periportal collaterals. In conclusion, the current study provided descriptive MDCT and ultrasonographic characteristics of presumed cavernous transformation of the portal vein in a sample of small animals. Cavernous transformation of the portal vein could occur as a single condition or could be concurrent with acquired portosystemic shunts.
A 6-year-old 40-kg castrated male Samoyed dog was presented for evaluation of chronic remittent lameness of the right forelimb. The dog had a history of polyuria-polydipsia (PU/PD) and lethargy over the previous year. Physical examination was unremarkable except for a grade II systolic murmur at the apex of the heart on the left side. A 6-lead ECG was within normal limits. Arterial blood gas analysis indicated mild respiratory alkalosis (pH, 7.457, reference range, 7.370-7.450 Thoracic radiographs disclosed a generalized increase in the size of the cardiac silhouette and pulmonary vascular enlargement, suggesting pulmonary overcirculation. An ELISA for Dirofilaria immitis antigen was negative. Two-dimensional, M-mode echocardiography a (transducer frequency, 2.0-3.0 MHz) revealed left atrial enlargement, left ventricular eccentric hypertrophy, and impaired systolic function (end-diastolic dimension, 65.7 mm; end-systolic dimension, 44.2 mm; shortening fraction, 32.7%) with normal valves. Spectral and colorflow Doppler examination disclosed mild mitral, aortic, and pulmonic valve insufficiency. Both the tricuspid and the telediastolic pulmonic valvular peak regurgitant jet velocities were increased as follows: 3.26 m/s (normal, #2.5 m/s) and 2.44 m/s (normal, #2.0 m/s), respectively. According to the Bernoulli's equation modification, the systolic pulmonary artery pressure was estimated to be 42.5 mm Hg and the diastolic pulmonary artery pressure was estimated to be 23.9 mm Hg, values consistent with mild pulmonary hypertension.The dog was anesthetized and subjected to radiography of the right forelimb and total body multidetector computed tomography b (MDCT). The radiographs were negative for abnormalities, and synovial fluid examination of the shoulder and stifle joints did not indicate evidence of any inflammatory pathology. MDCT scans of the brain, thorax, and abdomen were obtained. For the thoracic and abdominal scans, the dog was positioned in dorsal recumbency, and we employed the following parameters: helical modality, 120 kV, 200 mA, 0.7-second rotation tube, 0.526 pitch, and 1.2-mm slice thickness. For the brain scan, the dog was positioned in sternal recumbency and the scanner parameters were as follows: axial modality, 120 kV, 310 mA, 2-second rotation tube, 0.625 slice thickness, and 10-mm intervals. For an enhanced series, 2-mL/kg iodixanol c 320 mg I/mL was injected via a 22-gauge catheter into the right cephalic vein at a 3 mL/second infusion rate, through a computed tomography injector system. d The brain and abdominal MDCT scans were normal. However, MDCT of the neck and chest revealed 12 pairs of ribs, an enlarged heart, and enlarged pulmonary vessels. Both of the bronchoesophageal arteries were enlarged and connected with an enormous network of homogeneously enhancing serpentine structures involving the thoracic esophagus (esophageal and paraesophageal varices). The bronchoesophageal vein was extremely dilated (Figs 1, 2). The right azygous and hemizygous veins were normal. The cranial vena ca...
A 6-year-old 40-kg castrated male Samoyed dog was presented for evaluation of chronic remittent lameness of the right forelimb. The dog had a history of polyuria-polydipsia (PU/PD) and lethargy over the previous year. Physical examination was unremarkable except for a grade II systolic murmur at the apex of the heart on the left side. A 6-lead ECG was within normal limits. Arterial blood gas analysis indicated mild respiratory alkalosis (pH, 7.457, reference range, 7.370-7.450 Thoracic radiographs disclosed a generalized increase in the size of the cardiac silhouette and pulmonary vascular enlargement, suggesting pulmonary overcirculation. An ELISA for Dirofilaria immitis antigen was negative. Two-dimensional, M-mode echocardiography a (transducer frequency, 2.0-3.0 MHz) revealed left atrial enlargement, left ventricular eccentric hypertrophy, and impaired systolic function (end-diastolic dimension, 65.7 mm; end-systolic dimension, 44.2 mm; shortening fraction, 32.7%) with normal valves. Spectral and colorflow Doppler examination disclosed mild mitral, aortic, and pulmonic valve insufficiency. Both the tricuspid and the telediastolic pulmonic valvular peak regurgitant jet velocities were increased as follows: 3.26 m/s (normal, #2.5 m/s) and 2.44 m/s (normal, #2.0 m/s), respectively. According to the Bernoulli's equation modification, the systolic pulmonary artery pressure was estimated to be 42.5 mm Hg and the diastolic pulmonary artery pressure was estimated to be 23.9 mm Hg, values consistent with mild pulmonary hypertension.The dog was anesthetized and subjected to radiography of the right forelimb and total body multidetector computed tomography b (MDCT). The radiographs were negative for abnormalities, and synovial fluid examination of the shoulder and stifle joints did not indicate evidence of any inflammatory pathology. MDCT scans of the brain, thorax, and abdomen were obtained. For the thoracic and abdominal scans, the dog was positioned in dorsal recumbency, and we employed the following parameters: helical modality, 120 kV, 200 mA, 0.7-second rotation tube, 0.526 pitch, and 1.2-mm slice thickness. For the brain scan, the dog was positioned in sternal recumbency and the scanner parameters were as follows: axial modality, 120 kV, 310 mA, 2-second rotation tube, 0.625 slice thickness, and 10-mm intervals. For an enhanced series, 2-mL/kg iodixanol c 320 mg I/mL was injected via a 22-gauge catheter into the right cephalic vein at a 3 mL/second infusion rate, through a computed tomography injector system. d The brain and abdominal MDCT scans were normal. However, MDCT of the neck and chest revealed 12 pairs of ribs, an enlarged heart, and enlarged pulmonary vessels. Both of the bronchoesophageal arteries were enlarged and connected with an enormous network of homogeneously enhancing serpentine structures involving the thoracic esophagus (esophageal and paraesophageal varices). The bronchoesophageal vein was extremely dilated (Figs 1, 2). The right azygous and hemizygous veins were normal. The cranial vena ca...
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