Abdominal Radiology

Question 1

what are normal guidelines for dog liver (3)

Answer 1

1) extends just caudally to the costal arch
2) comes to a point
3) >2 intercostal spaces

Question 2

what are normal guidelines for a cat liver (2)

Answer 2

1) does not extend beyond costal arch
2) comes to a point

Question 3

what is the normal orientation of the gastric axis… what does a cranial shift and a caudal shift tell you

Answer 3

normally roughly parallel with the ribs; cranial shift = microhepatia; caudal shift = hepatomegaly

Question 4

where is the only attachment of the spleen

Answer 4

the gastrosplenic ligament that connects the dorsal extremity of the spleen to the stomach

Question 5

where is the spleen located

Answer 5

left

Question 6

the _______ extremity of the spleen is fixed whereas the _______ extremity of the spleen varies widely in the dog

Answer 6

dorsal; ventral

Question 7

what part of the spleen do you usually not see on the lateral view in the cat

Answer 7

ventral extremity (unlike dogs where we can normally see this)

Question 8

what are indicators of splenomegaly (3)

Answer 8

1) very obvious, large spleen
2) margins rounded
3) can occur secondary to GDV, so may see concurrent signs of GDV

Question 9

what are signs of splenic torsion (3)

Answer 9

1) splenomegaly
2) displacement caudally and dorsally
3) may see emphysema

Question 10

which kidney is more cranial

Answer 10

R more cranial than L (R is right on time, L lags behind…)

Question 11

to properly assess the size of the kidneys, the patient should be in what orientation and why

Answer 11

VD; kidneys fall beside the spine so we can properly compare kidney size to vertebrae

Question 12

what are the guidelines for kidney size in the dog

Answer 12

2.5-3.5x length of L2 on VD

Question 13

what are the guidelines for the kidney in the cat (2)

Answer 13

2-3x length of L2 on VD; may see central fat opacity

Question 14

how should the margins of the kidney appear

Answer 14

smooth and uniform

Question 15

______ (nephroliths) occur in the renal ______, whereas ________________ occurs in the renal __________

Answer 15

calculi; pelvis; dystrophic mineralization; parenchyma

Question 16

T/F you can differentiate calculi from dystrophic mineralization using RADs but not U/S

Answer 16

F; cannot differentiate with either of these imaging modalities

Question 17

what are the normal guidelines for the ureters in the dog and cat

Answer 17

they track through fat in the retroperitoneal space; you will not see normal ureters unless performing an excretory urogram

Question 18

when evaluating the ureters, what should you take caution of

Answer 18

the deep circumflex iliac a branches off the aorta at a 90 degree angle and can mimic a ureteral calculi

Question 19

what are the guidelines for the bladder in the dog

Answer 19

1) size varies
2) pear-shaped to ellipsoid
3) cranial to brim of pelvis, but may be intra-pelvic when empty

Question 20

what are the guidelines for the bladder in the cat

Answer 20

1) size varies
2) ellipsoid
3) always intra-abdominal, typically 2-3 cm cranial to pubis

Question 21

what types of lower urinary calculi will not appear on radiographs and what is the exception

Answer 21

“Dont C U”

Dried solidified blood
Cystine
Urate

Exception: mixed composition stone containing calcium oxalate will be seen

Question 22

what are the guidelines for the urethra (2)

Answer 22

1) will not see normally unless performing a urethrocystogram or vaginourethrocystogram
2) intra-pelvic always wider than intra-penile in males

Question 23

how do urethral calculi appear on radiographs performed with contrast medium

Answer 23

as filling defects

Question 24

what are the guidelines for the prostate

Answer 24

1) will not normally see
2) located in cranial portion of pelvic cavity

Question 25

what are the guidelines for an abnormal prostate

Answer 25

1) enlarged 2) displaces bladder cranially and rectum dorsally 3) may see mineralization or gas

Question 26

On evaluation of a radiograph of a male that was castrated at a young age, you notice a mass in the caudal-ventral abdomen, caudal to the bladder and cranial to the pelvis. The mass has mineralization. The bladder has been displaced cranially and the rectum displaced dorsally. What is the diagnosis?

Answer 26

prostatic neoplasia 1) dog castrated at young age 2) enlarged prostate 3) mineralized prostate

Question 27

at what stage of pregnancy do you notice fetal mineralization in the: dog cat

Answer 27

dog: 45 d cat: 36 d

Question 28

what are the guidelines for the normal uterus

Answer 28

typically not visible; if gravid, not evident until larger than the bowel

Question 29

what are the guidelines for the normal ovaries

Answer 29

typically not visible, enlarged by neoplasia

Question 30

what are diagnostic indicators of a pyometra

Answer 30

1) soft tissue/fluid opacity that takes a tubular shape 2) bowel displaced cranially, dorsally and centrally 3) enlarged uterine body located between the colon and bladder

Question 31

how do we typically image the testes

Answer 31

using ultrasound, not radiographs

Question 32

what is the best approach to identify the parts of the GI tract

Answer 32

1) identify the stomach 2) identify the colon and cecum 3) all remaining tubular organs are small intestine can perform a pneumocolonogram if needed to help improve visualization of the colon

Question 33

what is the typical location of the stomach

Answer 33

within the costal arch, but can vary

Question 34

if you suspect a GDV in a patient, what is the most important view to take and how would a GDV appear in this view

Answer 34

take RIGHT LATERAL; appears like Popeye's arm/Smurf hat

Question 35

when assessing the stomach, it is important to correlate ________ with __________

Answer 35

opacity; history (ex. dog hasn't eaten or drank in 2 days but the stomach contains fluid and soft tissue... abnormal)

Question 36

if you suspect a gastric outflow obstruction in the pyloric region of the stomach, what is the most important view to take

Answer 36

LEFT LATERAL

Question 37

when evaluating for FB, it is important to take how many views and why

Answer 37

take 3! redistributes gas and fluid to help visualize the FB

Question 38

what are normal SI guidelines in the dog

Answer 38

<1.6x the central height of L5

Question 39

what are normal SI guidelines in the cat

Answer 39

<2x the end plate height of L2

Question 40

what do normal intestines look like

Answer 40

smooth contours with focal narrowing of peristalsis and commonly gas opacity

Question 41

you should never rely on RADs to determine _____________, with the exception being

Answer 41

intestinal thickness; exception is when markedly thick and lumen is non-uniformly distended

Question 42

what is a good view to determine if there is a small intestinal FB

Answer 42

left lateral

Question 43

compare and contrast the cecum of the dog to the cecum of the cat (3 for each)

Answer 43

Dog: semicircular; compartmentalized; normally gas opacity Cat: cone; non-compartmentalized; rarely gas opacity

Question 44

what are normal guidelines for the colon in the dog

Answer 44

< length of L7

Question 45

what are normal guidelines for the colon in the cat

Answer 45

< 1.3x length of L5; >1.5x indicates megacolon

Question 46

what abdominal organs can normally be seen on radiographs

Answer 46

1) liver +/- gallbladder 2) spleen 3) kidney 4) stomach 5) SI 6) cecum 7) LI 8) bladder

Question 47

what abdominal organs cannot normally be seen on radiographs

Answer 47

1) pancreas 2) uterus 3) ovaries 4) mesentery/omentum 5) lymph nodes 6) ureters 7) urethra 8) adrenal gland

Question 48

how many zones do we split the lateral view in the dog and cat into

Answer 48

5

Question 49

how many zones do we split the ventral view in the dog and cat into

Answer 49

4

Question 50

lateral zone 1 contains:

Answer 50

- stomach - liver - dorsal spleen - adrenal glands

Question 51

lateral zone 2 contains

Answer 51

- liver - gallbladder - descending duodenum - pancreas - ventral spleen

Question 52

lateral zone 3 contains

Answer 52

- SI - cecum - colon - kidneys - adrenal glands - spleen - uterus - ovaries - mesentery - mesenteric LN

Question 53

lateral zone 4 contains

Answer 53

- colon - lumbar LN (medial iliac LN)

Question 54

lateral zone 5 contains

Answer 54

- bladder - prostate - uterus

Question 55

VD zone 1 contains

Answer 55

- pancreas - liver +/- gallbladder - duodenum - R kidney - R adrenal

Question 56

VD zone 2 contains

Answer 56

- stomach - liver - dorsal spleen - pancreas - L adrenal

Question 57

VD zone 3 contains

Answer 57

- spleen - SI - LI - L kidney - cecum - R kidney - L adrenal - pancreas - uterus - ovaries - LNs

Question 58

VD zone 4 contains

Answer 58

- bladder - prostate - uterus - medial iliac LN

Question 59

the opacity of abdominal masses may be (4):

Answer 59

- soft tissue - gas - mineral - fluid

Question 60

what is serosal contrast

Answer 60

the ability to see serosal surfaces of abdominal viscera

Question 61

pneumoperitoneum (increases/decreases) serosal contrast whereas peritoneal effusion (increases/decreases) serosal contrast

Answer 61

increases; decreases

Question 62

what causes an artificial decrease in serosal contrast (3)

Answer 62

1) young animal 2) underexposed image 3) reduced fat

Question 63

thinner patients require (more/less) effusion to lose serosal detail

Answer 63

less

Question 64

what are 3 reasons why young animals have an artifactual decrease in serosal contrast

Answer 64

1) they tend to have a small amount of peritoneal effusion 2) more brown fat (soft tissue opacity) 3) reduced fat in general

Question 65

what are 3 indicators of peritoneal effusion

Answer 65

1) distended abdomen (sometimes) 2) loss of serosal contrast (ranges from moderate to complete) 3) gas still present in stomach/SI/colon but you can no longer see the walls Fluid FALLS

Question 66

how would you distinguish moderate from marked peritoneal effusion

Answer 66

moderate: focal/partial loss of serosal contrast severe: complete loss of serosal contrast

Question 67

what are the causes of pneumoperitoneum (4)

Answer 67

1) can occur post-operatively 2) rupture of a gas-filled abdominal organ 3) penetration of body wall 4) gas-producing bacteria present

Question 68

what are signs of pneumoperitoneum (3)

Answer 68

1) increased serosal contrast 2) gas penetrating the liver lobes 3) obvious stomach wall Gas RISES

Question 69

what space makes up the retroperitoneum

Answer 69

the space ventral to the vertebrae and dorsal to the peritoneum that connects with the mediastinum and extends from the diaphragm to the perineum

Question 70

what structures are contained within the retroperitoneum (4)

Answer 70

1) kidneys 2) ureters 3) adrenal glands 4) medial iliac LN

Question 71

what are 4 things to look for to diagnose a retroperitoneal pathology

Answer 71

1) irregular structures OR you can see all other abdominal organs except kidneys 2) wispy pattern of fat and fluid in the retroperitoneal space 3) hammock hugging the kidneys 4) patterns of lines in the retroperitoneal space that silhouette with kidneys