BackgroundThis study describes the feasibility of Contrast Enhanced Ultrasonography (CEUS) in the diagnostic work-up of non-cardiac thoracic disorders of small animals. The second aim is to assess the usefulness of CEUS as a direct guide for sample procedures.ResultsForty animals, 28 dogs and 12 cats, were included in the study. Thoracic disorders included 23 pulmonary lesions [primary carcinoma (14), lymphoma (1), sarcoma (1), histiocytic sarcoma (1), abscess (1) and pneumonia (5)] and 17 mediastinal lesions [lymphoma (8), thymoma (3), mesothelioma (1), melanoma (1), carcinomatous lymphadenopathy (1), mixsosarcoma (1), lipoma (1), and abscess (1)]. The majority of neoplastic pulmonary lesions showed an inhomogeneous distribution of contrast medium, whereas inflammatory lesions had a homogenous distribution with typical pulmonary vessels ramification. The majority of mediastinal malignant lesions showed an inhomogeneous distribution pattern. The lung and mediastinal abscesses had peripheral enhancement of the wall with an avascular center. All cytological and biopsy samples obtained after CEUS were diagnostic. Quantitative analysis, performed in 19/23 pulmonary lesions, showed a statistically significant difference (P < 0.0001) between the arrival time of the malignant (7.27 s - range 4.46–13.52 s) and benign (4.52 s - range 2.87–6.06 s) pulmonary lesions.ConclusionsCEUS may be a useful tool for the evaluation of non-cardiac thoracic lesions. The contrast medium allows for the precise definition of lesion edges, the presence of necrotic areas, and the distribution of pulmonary vessels.Based on our preliminary results, the use of ultrasonographic contrast medium can be recommended for improving the diagnostic usefulness of cytology and biopsy sampling, because CEUS may help to define necrotic areas from viable tissue.
Computed tomography (CT) is increasingly available to evaluate dogs with suspected adrenal disease, however, published studies describing the reproducibility of CT methods for quantifying adrenal gland (AG) measurements are lacking. This prospective, pilot, observer agreement study aimed to evaluate reproducibility and repeatability of two different methods of measurement of AGs on CT to establish a usable technique and define standard reference ranges. Multiplanar reformatted (MPR) CT images of both AGs of six large breed dogs were obtained with the MPR axis parallel to the spine and parallel to the long axis of the AG. Ten measurements were performed: maximal length and diameter at cranial and caudal poles on dorsal, sagittal, and transverse images; and minimal diameter of cranial and caudal poles on transverse images. Three observers with different levels of experience repeated these measurements three times for each dog. Intra‐ and interobserver variability were calculated through intraclass correlation coefficient (ICC). The differences in time to perform measurements between the two methods were tested with Student's t‐test. Regardless of the measurement method used, length of AGs on dorsal and sagittal MPR images had the lowest intra‐ and inter‐observer variability (ICC = 0.93‐0.99), diameter of caudal pole on transverse plane showed low intra‐ and interobserver variability (ICC = 0.77‐0.80) and diameter of cranial pole had the highest variability (ICC = 0.12‐0.61). Although length was the less variable measurement, its use may be unrealistic in daily practice. Interestingly measurement of caudal pole on transverse plane was characterized by low intra‐ and interobserver variability. No difference in time performing the measurements was noted between the two methods.
Objectives The aim of this study was to evaluate the relationship between the ultra sonographic (US) diffuse honeycomb pattern (HCP) of the spleen and a pathological diagnosis in cats, and to assess the influence of transducer type on HCP visualisation. Methods Abdominal ultrasounds of cats with an HCP were reviewed and splenic size, shape, margination, other parenchymal alterations and splenic hilar lymphadenopathy were recorded. When applicable, images acquired with high-frequency linear and curvilinear transducers were compared to determine if an HCP was more frequently demonstrated on high-resolution images. A retrospective review of the corresponding splenic cyto histopathological samples was also performed. Results Thirty-three cats met the inclusion criteria. Five cases were diagnosed by histology and 28 by cytology, confirmed by PCR for antigen receptor rearrangements (PARR) in uncertain cases. There were 15 cases of lymphoid hyperplasia, eight cases of lymphoma (four B cell, three T cell and one large granular lymphocytes), six cats with splenitis, three with extramedullary haematopoiesis and one with histiocytic sarcoma. The prevalence of lymphoma in cats with an HCP of the spleen was 24%. Splenomegaly was the most frequent US feature associated with an HCP and was observed in all lymphoma cases. In the images obtained from both high-frequency linear and micro-convex transducers the visualisation of an HCP was enabled in all cases (24/24) and in 62.5% (15/24), respectively. Conclusions and relevance: Based on our findings, an US HCP of the spleen in cats can be associated with benign and malignant disorders and is infrequently associated with lymphoma in comparison with dogs. Cytological or histological examination, possibly supplemented by PARR, should always be performed for diagnostic support. Use of high-frequency linear transducers is recommended to properly recognise an HCP or subtle changes in splenic parenchyma.
A 4-year-old 4.7-kg (10.4-lb) intact female domestic short-haired cat with a history of left forelimb amputation due to periarticular histiocytic sarcoma (HS) was referred to the Oncology Unit at the University of Bologna. Seven months prior to referral, the cat had been evaluated by the referring veterinarian for a 1-month history of a Grade 3 left forelimb lameness. Initially, the cat had been treated with oral meloxicam (Metacam, Boehringer Ingelheim Pharma, Ingelheim am Rhein, Germany) at 0.05 mg/kg (0.02 mg/lb) q 24 h for 1 week with exercise restriction. Despite initial clinical improvement, lameness recurred, and a mild soft tissue swelling of the left distal radioulnar joint developed within a few weeks. Regrettably, the travel restrictions due to the Coronavirus pandemic delayed the consultation with an oncologist. The cat was re-evaluated by the referring veterinarian only 5 months after the first presentation. At that time, initial diagnostic tests included a left forelimb radiograph (latero-medial view), three-view thoracic radiographs, abdominal ultrasound, and routine blood analysis (complete blood count, serum biochemistry, and clotting profile). Forelimb radiography revealed severe permeative lysis of the carpal bones extending across the joint space to the distal radial and ulnar epiphyses and diaphyses, as well as to the first metacarpal bone. Destruction of both medullary and cortical bone was evidenced at these sites with an ill-defined transition zone, along with moderate adjacent soft tissue swelling.The rest of the diagnostic procedures were unremarkable. Due to suspected neoplastic disease, a core biopsy of the bone lesion was submitted for histopathologic evaluation. Microscopic examination
OBJECTIVE To determine the sensitivity, specificity, and interobserver variability of survey thoracic radiography (STR) for the detection of heart base masses (HBMs) in dogs. DESIGN Retrospective case-control study. ANIMALS 30 dogs with an HBM and 120 breed-matched control dogs (60 healthy dogs and 60 dogs with heart disease and no HBM). PROCEDURES In a blinded manner, 2 observers (designated as A and B) evaluated STR views from each dog for a mass-like opacity cranial to the heart, tracheal deviation, cardiomegaly, findings suggestive of pericardial effusion or right-sided congestive heart failure, and soft tissue opacities suggestive of pulmonary metastases. Investigators subsequently provided a final interpretation of each dog's HBM status (definitely affected, equivocal, or definitely not affected). RESULTS Considering equivocal interpretation as negative or positive for an HBM, the sensitivity of STR for diagnosis of an HBM was 40.0% (95% confidence interval [CI], 22.5% to 57.5%) and 56.7% (95% CI, 38.9% to 74.4%), respectively, for observer A and 63% (95% CI, 46.1% to 80.6%) and 80.0% (95% CI, 65.7% to 94.3%), respectively, for observer B. The corresponding specificity was 96.7% (95% CI, 93.5% to 99.9%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer A and 99.2% (95% CI, 97.5% to 100%) and 92.5% (95% CI, 87.8% to 97.2%), respectively, for observer B. The presence of a mass-like opacity cranial to the heart or tracheal deviation, or both, was significantly associated with a true diagnosis of HBM. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that STR is a highly specific but not a highly sensitive predictor of HBM in dogs.
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