B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Dogs

Abstract

Canine gastric disorders are common in veterinary clinical practice and among these neoplasms require rapid identification and characterization. Standard ultrasound (US) is the imaging modality of choice for gastric wall assessment. The aim of this prospective study is to describe the specific B-mode and contrast enhanced US (CEUS) features of normal, inflammatory, and neoplastic gastric wall in dogs. B-mode US and CEUS of the stomach were performed in anesthetized dogs with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 41 dogs were included: 6 healthy (HEA) as the control group; 9 gastritis (INF); 8 adenocarcinoma (AC); 8 alimentary lymphoma (AL); 4 leiomyosarcoma (LEIS); 2 gastrointestinal stromal tumor (GIST); 2 leiomyoma; 1 undifferentiated sarcoma; 1 metastatic gastric hemangiosarcoma. Gastric tumors appear as a marked wall thickness with absent layers definition and possible regional lymphadenopathy (AC and AL) and steatitis (AC) while gastritis generally shows no/mild thickening and no other alterations on B-mode US. On CEUS, neoplasm shows a higher and faster wash in if compared to that of gastritis. B-mode and CEUS assessment may be useful in the evaluation of canine gastric disorders in the distinction between gastritis and gastric neoplasms, even if there are no specific features able to discriminate between the different tumor histotypes.

Diagnostic imaging appearance of canine gastric leiomyomas: Four cases

“…1,6,9,14 Simeoni et al in a recent study, comparing B-mode and contrast-enhanced ultrasonography, did not find specific features to discriminate between the different gastric tumours. 22 Regarding the appearance of GL on CT, there are similarities with human patients and other veterinary reports, where GLs are well-defined lesions, isoattenuating and homogeneous (dogs: 51 ± 3 HU; humans: 69.4 ± 12 HU) with low-tointermediate post-contrast enhancement, similar to that seen in the cases presented here, taken from the nonmineralised areas in our patients. 15 Tanaka et al in 2019 reported the presence of two GL, which showed heterogeneous enhancement, due to what they believed was the presence of mineralisation.…”

“…Simeoni et al. in a recent study, comparing B‐mode and contrast‐enhanced ultrasonography, did not find specific features to discriminate between the different gastric tumours 22 …”

Use of New Ultrasonography Methods for Detecting Neoplasms in Dogs and Cats: A Review

“…Other authors mentioned that focal gastric wall thickness with loss of the normal wall layering may suggest gastric neoplasms [63]. Those features (to a much lesser extent) can be observed in cases of inflammatory conditions, with the exception of the involvement of lymph nodes and steatites [62].…”

“…Gastric neoplasia in dogs can be characterized using B-mode ultrasonography as severe gastric wall thickening (exceeding 1.2 cm), marked loss of the wall layering, and involvement of adjacent structures (i.e., regional lymphadenomegaly and steatites) [62]. Other authors mentioned that focal gastric wall thickness with loss of the normal wall layering may suggest gastric neoplasms [63].…”

“…Malignant gastric tumors presented faster wash in compared to gastritis. B-mode ultrasound and CEUS were able to distinguish between malignant and benign gastric disorders, but the differentiation among several tumor histotypes still relies upon cytological or histopathological exams [62].…”