Quantitation of portosystemic shunting in dogs by ultrasound-guided injection of 99MTc-macroaggregates into a splenic vein

Meyer, H.; Rothuizen, J.; Brom, W. E. van den; Voorhout, George; Sluijs, F.J. van; How, K.L.; Pollak, Y.W.E.A.

doi:10.1016/0034-5288(94)90082-5

Cited by 29 publications

(22 citation statements)

References 13 publications

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“…To the authors' knowledge, this technique has not been described in dogs. There is one report that described ultrasound‐guided injection of 99m Tc‐MAA into the splenic vein of dogs to quantify portosystemic shunting; however, this did not allow for morphologic evaluation of the portal circulation 13 …”

Section: Discussionmentioning

confidence: 99%

Trans‐splenic Portal Scintigraphy in Normal Dogs

Cole

Morandi

Avenell

et al. 2005

Vet Radiology Ultrasound

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The purpose of this study was to (1) establish a technique for ultrasound-guided trans-splenic portal scintigraphy (TSPS) using 99mTcO4(-), (2) evaluate portal vein morphology, (3) compare the radiation exposures for TSPS vs. per-rectal portal scintigraphy (PRPS), and (4) compare the quality of numerical data from the TSPS vs. PRPS. Eight juvenile dogs underwent PRPS and TSPS (minimum of 48h between studies) after initial screening tests. PRPS was done according to established protocol using 425 +/- 36MBq (mean +/- SD) of 99mTcO4(-). TSPS was done with the dogs in right lateral recumbency over the gamma camera. 99mTcO4(-) (57 +/- 13.9 MBq) was injected into the spleen 1-2s following initiation of the dynamic acquisition. The frame rate was 4 frames/s for 5 min. There was significantly lower radioactivity of 99mTcO4(-) given and significantly higher total counts recorded in the liver and heart during the TSPS compared with PRPS. The total counts for the TSPS and PRPS were 7120 +/- 4386 and 830 +/- 523, respectively. Percent absorption from the spleen was 52.5 +/- 19.1% compared with 9.2 +/- 5.7% for the colon. Calculated transit time for the TSPS studies was 7 +/- 2.3s. In TSPS studies, the splenic and portal veins were clearly identified. Radiation exposure levels of the dogs were significantly lower following TSPS than after PRPS. TSPS appears superior to PRPS as a method to image the portal venous system representing a valid alternative diagnostic test for animals with suspected portosystemic shunts.

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Section: Discussionmentioning

confidence: 99%

Trans‐splenic Portal Scintigraphy in Normal Dogs

Cole

Morandi

Avenell

et al. 2005

Vet Radiology Ultrasound

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“…20 This technique quantified the portosystemic collateral circulation and the fraction of portal blood bypassing the liver was expressed as the shunt index (SI). Clinical recurrence or persistence was defined as the presence of clinical signs with confirmation of portosystemic shunting by abnormal ammonia metabolism or positive SI.…”

Section: Study Populationmentioning

confidence: 99%

Prognostic Implications of the Degree of Shunt Narrowing and of the Portal Vein Diameter in Dogs with Congenital Portosystemic Shunts

2003

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“…Diagnostic tools and examinations used to confirm the presence of portosystemic shunting were the rectal ammonia tolerance test, laparotomy, postmortem examination, calculation of the degree of shunting by scintigraphy with 99m Tc-labeled macroaggregates, histology of 16-gauge (G) needle-biopsies of the liver (only in parenchymal liver diseases resulting in hypertension and the formation of collateral circulation), and Doppler ultrasonography (only in arteriovenous fistulae). [23][24][25][26][27][28][29] The rectal ammonia tolerance test, laparotomy, calculation of the degree of shunting by scintigraphy with 99m Tc-labeled macroaggregates, and postmortem examination were used to exclude portosystemic shunting.…”

Section: Diagnostic Testsmentioning

confidence: 99%

Diagnostic Value of Fasting Plasma Ammonia and Bile Acid Concentrations in the Identification of Portosystemic Shunting in Dogs

2006

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Portosystemic shunting occurs frequently either as congenital anomalies of the portal vein (PVA) or as acquired shunting (AS) due to portal hypertension secondary to parenchymal liver disease or portal vein thrombosis. The 2 most commonly used screening tests for portosystemic shunting are bile acid and plasma ammonia concentrations. The purpose of this study was to compare the 12-hour fasting plasma ammonia (AMM) and bile acid concentration (BA) as tests for diagnosing portosystemic shunting. Medical records of 337 dogs were used in which AMM and BA were measured simultaneously and in which portosystemic shunting was confirmed or excluded. These dogs were divided into 2 groups (group 1: portosystemic shunting present, n 5 153, and group 2: portosystemic shunting absent, n 5 184). Group 1 was subdivided into 2 subgroups (group 1a: PVA, n 5 132 and group 1b: AS, n 5 21). The sensitivity of AMM in detecting PVA was 100% and of BA was 92.2%. For portosystemic shunting in general (PVA or AS), the sensitivity of AMM was 98% and that of BA was 88.9%. The specificity in the total population of AMM was 89.1% and that of BA was 67.9%. If only dogs with liver diseases were included with (n 5 153) or without (n 5 28) shunting, the specificity of AMM to detect shunting was 89.3% and that of BA was 17.9%. In conclusion, AMM is a highly sensitive and specific parameter to detect PVA and portosystemic shunting in a general population and in dogs with liver disease, whereas BA is somewhat less sensitive and considerably less specific.

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Quantitation of portosystemic shunting in dogs by ultrasound-guided injection of 99MTc-macroaggregates into a splenic vein

Cited by 29 publications

References 13 publications

Trans‐splenic Portal Scintigraphy in Normal Dogs

Trans‐splenic Portal Scintigraphy in Normal Dogs

Prognostic Implications of the Degree of Shunt Narrowing and of the Portal Vein Diameter in Dogs with Congenital Portosystemic Shunts

Diagnostic Value of Fasting Plasma Ammonia and Bile Acid Concentrations in the Identification of Portosystemic Shunting in Dogs

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