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1
Q

What has been suggested or proposed as a predisposing factor for LLT?

A

Deep-chested dogs (more room wihtin their thoracic cavity)

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2
Q

According to this paper:

MRI features of CNS lymphoma in dogs and cats Palus 2012 VRU, what is the predominance of CNS lymphoma in cats vs dogs?

A

cats: is the most common tumor affecting the spinal cord and the second most common intracranial tumor
dogs: third most common secondry intracranial tumor and approx 4% of all primary intracranial tumors

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3
Q

The utility of VD and DV has been compared in patients with pneumothorax and pleural effusion. Which view is prefereble for the just mentioned clinical problem?

Detection of pneumothorax and pleural effusion with horizontal beam radiography Lynch 2012 VRU

A

VD: pleural effusion

DV: pneumothorax

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4
Q

What is Histiocytic Sarcoma prognosis, metastatic rate, forms?

Imaging charcateristics of intrathoracic histiocytic sarcoma in dogs Tsai 2012 VRU

A

Round cell neoplasia arising from dendriticantigen presenting cells or cells of the monocyte-macrophage line

Localized(bone, subcutis, joints, liver, spleen, GI, lung, brain, spinal cord, eye, nasal cavity) vs multiorgan (lung, spleen, liver, bone marrow, lymph nodes)

highly aggressive, poor prognosis, highly metastatic (91% met rate)

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5
Q

How were the BA ratios obtained on the study:

High resolution CT bronchial lumen to pulmonary artery ratio diameter ratio in anesthetized ventilated cats with normal lungs Reid 2012 VRU

A

The BA ratios were obtained at the level of the middle portion of the 9th rib, Luminal diameters were measured approximately 5-15 mm from the main stem bronchus in the image that depicted as much of the length of the bronchus as with corresponding artery and vein as possible

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6
Q

What was the major finding in this paper:

High resolution CT bronchial lumen to pulmonary artery ratio diameter ratio in anesthetized ventilated cats with normal lungs Reid 2012 VRU

A

no significant difference in mean BA ratio between lung lobes, gender, and weight. A mean BA ratio for these normal cats was 0.71 ± 0.1, which suggests an upper cut-off normal value > 0.91 (mean ± 2 standard deviations)

When evaluating BA ratios, other factors, such as altitude, pulmonary arterial disease (heartworms), and hypoxic-induced vasoconstriction, may also alter the ratio. Therefore, as in people, the BA ratio should not be used as the sole criterion

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7
Q

Normal HU for liver is

A

40-70 HU

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8
Q

Disease involving the pulmonary acini commonly are described using what terms?

Scrivani 2012

A

ground-glass opacity, consolidation, atelectasis, collapse and nodules.

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9
Q

Ddx for the MRI findings with CNS lymphoma:

MRI features of CNS lymphoma in dogs and cats Palus 2012 VRU

A

Metastatic

histiocytic sarcoma (in dogs)

primitive neuroectodermal tumors

non infectious inflammatory

infectious

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10
Q

What were the 3 most important findings in this study:

Effect of acquisition time and chemical fta suppression on meninngel enhancement on MRI imaging in dogs D’anjou 2012 VRU

A

Meningeal enhancement was more diffuse and leptomeningeal in animals with inflammatory disease vs neoplasia

meningeal thickness and contrast ratio were higher with neoplasia

images with fat suppression were the most useful for characterization of meningeal enhancement [agreement on meningeal enhancement was globally substantial (κ = 0.61) and the likelihood of obtaining a definite diagnosis was significantly increased with the use of fat suppression (P ≤ 0.004)]

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11
Q

What are some causes of pneumothorax mentioned in the intro of this paper:

Detection of pneumothorax and pleural effusion with horizontal beam radiography Lynch 2012 VRU

A

traumatic

iatrogenic : thoracocentesis, thoracotomy, overinflation of lungs in aneshesia, extension of pneumomediastinum

non traumatic: spontaneous rupture of bulla, cavitary lung masses, gas producing bacteria in pleural space

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12
Q

What are the types and distribution of meningeal enhancement used in this study:

Effect of acquisition time and chemical fta suppression on meninngel enhancement on MRI imaging in dogs D’anjou 2012 VRU

A

Leptomeningeal

pachymeningeal

focal and regional leptomeningeal

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13
Q

According to the introduction of this article:

Imaging charcateristics of intrathoracic histiocytic sarcoma in dogs Tsai 2012 VRU, which canine breeds are predisposed to develop histiocytic?

A

Bernese mountain dogs (are 225 times more likely)

Rotties (26 time more likely)

Golden and Labradors

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14
Q

Reference upper limits intestinal wall thickenss in dogs and cats used in Citi et al 2013 study (micronodular u/s lesions in the colonic submucosa of 42 dogs and 14 cats)?

What about the upper reference for thickness of intra-abdominal lymph nodes in cats and dogs?

A

dogs: duodenum (6mm), jejunum (5 mm), ileum (4mm), colon (3mm)
cats: duodenum (2.5mm), jejunum (2.5 mm), ileum (3.2mm), colon (2.5mm), cecum (1mm)

upper reference for thickness of intra-abdominal lymph nodes in:

cats= jejunal (5mm), ileocecal (4.1 mm), caudal mesenteric (3.1mm)

dogs= jejunal (5mm)

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15
Q

Horizontal beam is commonly referred to as:

Detection of pneumothorax and pleural effusion with horizontal beam radiography Lynch 2012 VRU

A

the lateral decubitus view

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16
Q

What contrast did they use and what dose in this study:CEUS findings in three dogs with LLT, Caivano et al 2016 Journal of Vet Med Science

A

0.03-0.06 mL/kg of sulfur hexafluoride microbubbles stabilized by a phospholipid shell (SonoVue) IV

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17
Q

What was the major finding in this study regarding CEUS?

CEUS findings in three dogs with LLT, Caivano et al 2016 Journal of Vet Med Science

A

CEUS showed abscence or reduction of pulmonary vascularization secondary to twisting of the lung lobe around its bronchovascular pedicle. Moreover, CEUS distinguished partial pumonary atelectasis from a lung lobe torsion.

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18
Q

According to the intro of this paper:

Value of tracheal bifurcation angle measurement as a radiographic sign of left atrial enlargement in dogs Le Roux 2012 VRU, what is the tracheal bifurcation angle in healthy dogs?

A

60-90 degrees

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19
Q

In people pulmonary disease in CT are characterized as what?

Scrivani 2012

A

centrilobular- involving the bronchiovascular core (bronchiole, arteriole, lymphatics, connective tissue)

panlobular- invlving the entire lobule

perilobular - involving the interlobular speta, lymphatics, and venules

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20
Q

LLT is rare in cats. LLT has been associated with what diseases in cats according to the introduction of Lung Lobe Torsion in 35 dogs and 4 cats, Benavides et al Can Vet 2019.

A

chronic upper respiratory infection

asthma

diaphragmatic hernia

chylothorax

neoplasia

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21
Q

What was the most important findings in this paper:

Value of tracheal bifurcation angle measurement as a radiographic sign of left atrial enlargement in dogs Le Roux 2012 VRU

A

There were statistically significant differences in tracheal bifurcation angles between dogs with a normal vs enlarged lef atrium; however, all the angles were all within the previously published normal reference range.

Supposedly if using 85.1 and 76.6 degrees as normal angles, the specificity and sensitivity for indentifying left atrial enlargement was 92.6% and 88.9% respectively

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22
Q

What are some theories tha have been proposed to explain the presence of a vesicular pattern?

D’anjou 2005 Radiogaphic Dx of lung lobe torsion

A
  1. incomplete lobar consolidation following acute torsion associated with the presence of air trapped within the alveoli.
  2. bronchial tears can for emphysematous bullae and those bullae can rupture
  3. increase in alveolar pressure following a lung lobe torsion may lead to alveolar rupture and interstitial accumulation of trapped air
  4. gas forming infections
  5. can also be congenital related to bronchial cartilage hypoplasia, dysgenesis or dysplasia.
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23
Q

What lung lobe most commonly torses in large vs small breed dogs?

male or female are most commonly affected?

D’anjou 2005 Radiogaphic Dx of lung lobe torsion

A

Large breed= right middle

Small breed= left cranial

male

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24
Q

What are the most common CT findings with complete lung lobe torsions?

Computed tomographic features of lung lobe torsion Seiler 2008

A

Pleural effusion

abruptly ending bronchus

rotated lung lobes will not contrast enhance

vascular compression within the affected lobe

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25
Q

What are the most important findings in this study:

Imaging charcateristics of intrathoracic histiocytic sarcoma in dogs Tsai 2012 VRU

A

right middle lung lobe most common place and venrally distributed

intrathoracic lymphadenopathy (sternal and tracheobronchial)

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26
Q

In people the fundamental pulmonary interpretation is recognition of abnormalities relative to what anatomic unit of the lungs? What about in vetmed? Scrivani 2012

A

People= disease in secondary pulmonary lobule Vetmed= disease in pulmonary acinus

27
Q

According to the intro of this paper:

High resolution CT bronchial lumen to pulmonary artery ratio diameter ratio in anesthetized ventilated cats with normal lungs Reid 2012 VRU, what is the BA ratio in dogs that has been reported to be normal?

A

BA 0.80-2.0

28
Q

Bronchiectasis is uncommon in cats but predominantly affects what gender and breed according to:

High resolution CT bronchial lumen to pulmonary artery ratio diameter ratio in anesthetized ventilated cats with normal lungs Reid 2012 VRU

A

male cats

Siamese are overrepresented

*concurrent diseases associated include: chronic bronchitis, bronchiolitis, neoplasia, bronchopenumonia, miliary broncholithiasis, bronchial dysgenesis

29
Q

Describe the attenuation values of normal/adjacent vs rotated lung lones on the study: Computed tomographic features of lung lobe torsion Seiler 2008

A

Rotated lung lobes did not enhance whereas adjacent collapsed and aerated lung lobes did.

30
Q

What BA ratios in human vs dogs have been reported to be abnormal?

High resolution CT bronchial lumen to pulmonary artery ratio diameter ratio in anesthetized ventilated cats with normal lungs Reid 2012 VRU

A

humans: above 1.0
dogs: above 2.0

31
Q

What are some radiographic findings that have been reported with lung lobe torsion?

D’anjou 2005 Radiogaphic Dx of lung lobe torsion

A

Pleural effusion (100%)

increased lobar opacity (100%)

vesicular gas pattern (88%)

when lobar bronchi were visible focal narrowing or blunting can be seen

mediastinal shift, displaced trachea, axial rotation of the carina

32
Q

What could be a possible explanation for the discrepancy in vascular enhacement in these 3 cases?

CEUS findings in three dogs with LLT, Caivano et al 2016 Journal of Vet Med Science

A

Complete LLT will see lack of vascular enhancement (this was also seen on CT)

vs

Incomplete (inhomogeneous, patchy etc) vascular enhancement can see in incomplete LLT or partial LLT or at early stage of torsion or necrosis (this was also seen on CT)

33
Q

Briefly explain the fractal organization of the lungs included in the diagram below.

Scrivani 2012

A

principal bronchi

each lung lobe has a lobar bronchus arising from principal bronchi

lobar bronchi give rise to tertiary or segmental bronchi

Segmental bronchus ventilates a specific portion of the lung tissue (known as bronchopulmonary segment). A bronchopulmonary segment (bronchus, interstitium, blood vessels and lymphatics) may be called bronchovascular bundle

Each bronchopulmonary segment is composed of smaller anatomical units called secondary pulmonary lobule, pulmonary acinus, and primary pulmonary lobule.

Several primary pulmonary lobules combine to form a pulmonary acinues and several pulmonary acinus combine to form the secondary pulmonary lobule.

34
Q

What were the most important findings in this study:

MRI features of CNS lymphoma in dogs and cats Palus 2012 VRU

A

intracranial lesions affected the rostrotentorial structures in 6 dogs and caudotentorial structures in 2 cats

all lesions were T2 hyperintense (when compared to the white matter), T1 hypointense, hyperintense in FLAIR

lesions had indisctinct margins, perilesional edema, had a mass effect and abnormal meningeal enhancement

CNS lymphoma strongly enhance after contrast administration

are highly cellular tumors in which water diffusion is often restricted making them appear hyperintense on DW images and hypointense on ADC

35
Q

Micronodular u/s lesions within the colonic submucosa in dogs and cats have been reported. How do these lesions look like and what was it proposed to present based on their study?

Citi 2013

(micronodular u/s lesions in the colonic submucosa of 42 dogs and 14 cats)

A

Rounded/oval in shape, 1-3 mm in size, were hypo/anechoic on u/s

authors propose that micronodular colonic lesions may represent reactive lymphoid follicles and may indicators of colonic inflammatory diseases in dogs and cats.

36
Q

According to Caivano et al ( CEUS findings in three dogs with LLT, Caivano et al 2016 Journal of Vet Med Science) what were the U/S findings in dogs with LLT?

A

Hypoechoic, enlarged, hepatized lung lobe

pleural effusion

portions of the lung lobe were filled with scattered reverberating foci (gas)

lack or decreased of vascular enhancement (in CEUS): may depend if there is a complete torsion vs partial.

color Doppler was not helpful due to motion artifact

37
Q

On the study by Citi et al in 2013 (micronodular u/s lesions in the colonic submucosa of 42 dogs and 14 cats), what other concurrent findings were seen other than the micronodules.

A

caudal mesenteric lymphadenopathy (46%)

small bowel wall thickening, altered layering, and/or hyperechoic mucosa (45%)

abdominal effusion (29%)

mesenteric lymphadenopathy (27%)

increased colon wall thickness (12.5%)

pericolic peritoneal fat reactivity (9%)

50 out of 56 presented with diarrhea.

38
Q

According to some articles (Caivano 2016, D’anjou 2005, Seiler 2008) what diseases can mimic a lung lobe torsion?

A

peumonia

thromboembolism/coagulopathy

contusion

atelectasis

neoplasia

39
Q

True or false: Lung lobe torsion has been documented in both small and large breed dogs with Pugs and Afghan Hounds being over-represented.

Lung Lobe Torsion in 35 dogs and 4 cats, Benavides et al Can Vet 2019.

A

True

40
Q

Normal HU for lungs is

A

-900 to -700 HU

41
Q

Which canine breed has been reported to be overrepresented?

MRI features of CNS lymphoma in dogs and cats Palus 2012 VRU

A

Rotties

42
Q

What were the most important findings in this study:

Detection of pneumothorax and pleural effusion with horizontal beam radiography Lynch 2012 VRU

A

Subjective assessment for the presence and degree of pneumothorax and pleural effusion was made more confidently with HB projections.

Right and left lateral HB VD projections and the standard VB left lateral projection were significantly more likely to detect and grade pneumothorax severely than the VB VD/DV views. The right lateral HB projection had the highest rate of detection and gradation of severity for pneumothorax compared with other views.

No significant difference in diagnosis and grade of pleural effusion were seen between views

43
Q

In the study performed by Scrivani et al in 2012, the increased lung attenuation noted in CT was due to what?

What were the final diagnoses of the four cases included?

A

In this study, increased lung attenuation during CT due to disease localized to the pulmonary acini was due to the displacement of air from the lungs and not to the microscopic distribution of lesions within the pulmonary acinus.

Final diagnoses were hemorrhagic pneumonia, bronchiolar carcinoma, metastatic mammary adenocarcinoma, and pulmonary edema.

44
Q

According to this article: Lung Lobe Torsion in 35 dogs and 4 cats, Benavides et al Can Vet 2019, what were the most commonly affected lung lobes according to the breeds?

A

small breeds left cranial (80% left cranial)

large breeds right middle (78%)

45
Q

According to this study: Imaging diagnosis: a case of spontaneous hepatic portal vein and hepatic parenchymal gas in a 11 month old westie Cartwright 2016 VRU, what were the ddx for pneumatosis coli and portal vein gas?

A

pneumatosis coli: marked inflammatory bowel disease resulting in ulcerative colitis, infectious process such as E. coli and neoplastic process.

portal vein and hepatic parenchymal gas: migrating gas from ulcerated colon or less likely pneumobilia.

46
Q

What were the most important points stated in this case report:

Imaging diagnosis: a case of spontaneous hepatic portal vein and hepatic parenchymal gas in a 11 month old westie Cartwright 2016 VRU

A

1) colonic gas most likely due to severe pyogranulomatou colitis
2) portal and hepatic parenchymal gas most likely translocation of gas through colonic vessels into the portal vein. This finding resolved on the recheck u/s so the clinical significance of this finding is unknown.
3) It was initially thought that portal gas was associated with high mortality rate but now it may represet benign/incidental finding or a significant finding.
4) When a patient has severe gastrointestinal disease it may be posible that they could have transient portal vein gas so pay attention to that.

47
Q

What are some possible causes for pneumatosis coli in dogs mentioned in the introduction of:

Ultrasonographic findings of pneumatosis intestinalis in a dog Song 2013 Jet Vet Clin

A

ulcers, intestinal neoplasia,mucosal injury, FB, enema administration, bacterial overgrowth.

48
Q

What are the most common bacteria we need to think about when we see pneumatosis intestinalis?

Ultrasonographic findings of pneumatosis intestinalis in a dog Song 2013 Jet Vet Clin

A

Clostridium perfringes

E. coli

49
Q

What has been proposed to be the pathophys of pneumatosis intestinalis?

Ultrasonographic findings of pneumatosis intestinalis in a dog Song 2013 Jet Vet Clin

A

bowel necrosis from vascular compromise from infarction, ischemia, bacterial colonization. Gas woul dissect through the lumen due to increased pressure (bowel obstruction, chronic respiratory disease.

50
Q

What were the distinctive u/s findings of pneumatosis intestinalis?

Ultrasonographic findings of pneumatosis intestinalis in a dog Song 2013 Jet Vet Clin

A

echogenic gas bubbles or spotty high echoes within the circumferene of bowel walls.

51
Q

What was the bacteria isolated from the small intestines in this cat?

Radiography and u/s of pneumatosis intestinalis in a cat 2017 VRU Walczak

A

Clostridium difficile

52
Q

Important points mentioned in this article

Radiography and u/s of pneumatosis intestinalis in a cat 2017 VRU Walczak

A

1) sometimes you may see the mural gas on radiographs
2) mortality rates for portal venous gas have been reported to range from 27-47% , while in one human study the association of pneumatosis intestinalis and portal vein gas correlated to 100% fatality rate

53
Q

What was said to be the main limitation of radiography over MR in detecting discopondylitis?

MRI features of discospondylitis in doga Carrera VRU 2011

A

the delay of up to a few weeks between the onset of clinical signs and detection of radiographic findings as well as the discrepancy between clinical signs and radiographic signs during recovery.

54
Q

what was the most common bacterial isolate found in the study population in:

MRI features of discospondylitis in doga Carrera VRU 2011

A

Staphylococcus spp

* Brucella canis can also cause disco

55
Q

What canine breeds are predisposed in getting disco?

MRI features of discospondylitis in doga Carrera VRU 2011

A

young to middle aged medium to large breed dogs

Great Danes, boxers,rotties,english bull dogs, GSD, Doberman pinschers, Rhodesian ridgebacks

56
Q

According to the introduction in this article, what does the term Modic changes mean?

MRI characterization of vertebral endplate changes in the dog Gendro 2012 VRU

A

It is a term used in human medicine to describe signal intensity changes seen within the vertebral endplates due to degenerative disc disease with associated endplate edema.

Although the significance of these changes remains debatable, they are associated with back pain

57
Q

What are Schmorl’s nodes?

MRI characterization of vertebral endplate changes in the dog Gendro 2012 VRU

A

Intraosseous disc herniations due to degenerative changes and it is usually asymptomatic.

58
Q

What were the different categories/groups made according to the lesions seen on MRI

MRI characterization of vertebral endplate changes in the dog Gendro 2012 VRU

A

discospondylitis: paravertebral STIR hyperintensity or contrast enhancement, T2/STIR hyperintense endplates, T1 hypointense (endplate), endplate erosion, collapse of intervertebral space.

Reactive endplates: T2/STIR hyperintensity (endplates), T1 hypointensity (endplates), with or without endplace enhancement

Fatty infiltration: T1/T2 hyperintensity nuled on STIR

osteochondrosis: defect on dorsal edge, disc isointense material filling the gap

Schmorl’s nodes: well marginated focal endplate defect contiguous w/ a disc filled with disc isointense material.

Sclerosis of endplates:T1/T2 hypointense

59
Q

Which joint was the most commonly affected in this study?

MRI characterization of vertebral endplate changes in the dog Gendro 2012 VRU

A

LS joint.

60
Q

What was the most important findings in this study (3):

MRI characterization of vertebral endplate changes in the dog Gendro 2012 VRU

A

1) That there is an overlap of MR characteristics of nonfatty end plate changes and you should be cautious when evaluating these structures. Differentiation between these various disease may not be possible with MR alone.
2) The following features were observed in discospondylitis as well as in other nonfatty endplate pathologies: irregular endplates, endplate hyperintensity in T2w or STIR images, reduced endplate signal intensity in T1w SE, variable T1w GRE signal intensity, and endplate contrast enhancement. A T1 sagittal should be included or would be beneficial.
3) paravertebral contrast enhancement was only seen in discospondylitis in this study population

61
Q

According to the following paper, what are the two techniques that have been developed to detect the biology of the articular cartilage and how do they work?

The use of delayed gadolinium enhanced MRI of cartilage and T2 mapping to evaluate articular surface in the normal canine elbow Wucherer VRU 2012

A

1) Delayed gadolinium enhanced MR imaging of cartilage (dGEMRIC): used to estimate GAG (glycosaminoglycans) content within the cartilage matrix. GAG carries a negative charge, gadolinium carries a negative charge so using the law of electrostatic repulsion, in an area with low GAG content, there would be more gadolinium accumulation hence it will have a low T1 value.
2) T2 mapping: sensitive to water content and thus tissue dehydration. In damaged cartilage, there is an increase in H2O content so there would be more T2 hyperintense.

62
Q

What were the mean dGEMRIC index (T1 value) and mean T2 value in the following study: The use of delayed gadolinium enhanced MRI of cartilage and T2 mapping to evaluate articular surface in the normal canine elbow Wucherer VRU 2012

A

Mean dGEMRIC index (T1 value) was 400±47 ms and mean T2 value was 56± 8 ms.

63
Q

What was the main difference regarding the cause of the compressive lesion in large breed vs giant breed found in this study and what they had in common:

Computed Tomography myelographic findings in dogs with cervical spondylomyelopathy Da Costa VRU 2012

A

The main site of compression was C5-C6 and C6-C7 for large and giant breeds

Giant breed: often had multiple compressions usually caused by osseous changes and laterally localized.

Large breed: most compressions were disc associated and ventrally localized.

Given that in this study most of the giant breed dogs had lesions within the cranial thoracic vertebrae (C7-T1, T1-T2), it is important to include the cranial thoracic region when imaging dogs with suspected cervical spondylomyelopathy.

64
Q
A

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