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Small animal (fourth year) > Diagnostic imaging > Flashcards

Diagnostic imaging Flashcards

1
Q

what are the advantages of using radiography to image the abdomen?

A

gives a good overview and is better for assessing size/shape of structures

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2
Q

what are the advantages of using ultrasound to image the abdomen?

A

excellent assessment of internal architecture and luminal spaces (unless gas filled)

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3
Q

what technique should be used to radiograph the abdomen?

A

low kV - high mAs technique

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4
Q

why should a low kV - high mAs technique be used to image the abdomen?

A

avoid scatter radiation and improve contrast resolution

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5
Q

why is the contrast poor when radiographing the abdomen?

A

mostly soft tissue with some fat contrast

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6
Q

what is the issue with using high mAs to image the abdomen?

A

there is a longer exposure which increases the chances of motion artefacts

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7
Q

what phase of respiration should an abdominal radiograph be taken in?

A

expiratory phase (end of expiration)

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8
Q

what view is the best for imagine the abdomen?

A

ventrodorsal

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9
Q

why is ventrodorsal view used to image the abdomen?

A

spreads out the organs so reduces superimposition

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10
Q

what are the two views used to image the abdomen?

A

ventrodorsal and right lateral

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11
Q

what are the two types of positive contrast media?

A

iodine containing
barium

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12
Q

what are the two types of iodine containing positive contrast media?

A

ionic/non-ionic
high/low osmolarity

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13
Q

what are the two negative contrast medias?

A

air
carbon dioxide

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14
Q

when is the only time barium is used as a contrast media?

A

GI studies

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15
Q

why is barium only used as a contrast media for the GI tract?

A

if it gets into body cavities it causes severe granulomatous inflammation and possibly death

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16
Q

what can iodine containing positive contrast media be used for?

A

GI tract
urinary tract
IV
myelography

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17
Q

what is the safest type of iodine containing positive contrast media?

A

non-ionic and low osmolar iodinated media (draw the least amount of fluid towards them)

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18
Q

what is the side effect seen if iodinated contrast media gets into body cavities?

A

anaphylaxis

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19
Q

what is the only time air is used as a contrast?

A

bladder (pneumocystogram)

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20
Q

what steps should be taken to ensure you achieve the best abdominal ultrasound possible?

A

perform after radiography
sedate in a dark quiet room
clip widely
use plenty of gel

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21
Q

what are some blind spots or places that we struggle to imagine in the abdomen?

A

organs within the pelvic canal
vascular malformation
ectopic ureters

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22
Q

what are the radiological signs (rontgen signs)?

A

number
size
shape (margination)
opacity (gas, fat, soft tissue, bone/mineral, metal)
location

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23
Q

what is the mass effect?

A

look at what organs have been displaced to determine where and what size the mass is

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24
Q

what is dystrophic tissue damage always secondary to?

A

tissue damage

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25
Q

what is metastatic mineralisation always secondary to?

A

hypercalcaemia

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26
Q

how does the location of dystrophic and metastatic mineralisation compare?

A

dystrophic is generally very focal whereas metastasis is often widespread

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27
Q

why is the fat in the omentum so important to radiography?

A

key to abdominal contrast and serosal detail

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28
Q

what is the peritoneum?

A

space around organs lined by a serous membrane and containing a tiny amount of fluid

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29
Q

what are the six differential diagnoses for loss of serosal detail in the abdomen?

A

lack of fat (emaciation)
brown fat in young animals (higher water content so appears as soft tissue)
peritoneal fluid
peritonitis
carcinomatosis/sarcomatosis
visceral crowding (due to very large mass)

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30
Q

what are the three main differentials for pneumoperitoneum?

A

post surgery (up to 4 weeks)
rupture GIT
penetrating trauma

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31
Q

how will a pneumoperitoneum look a radiograph?

A

increased contrast between gas/soft tissue
organs serosal surfaces are highlighted (eg. intestinal walls)
gas bubbles that are confined to GI tract

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32
Q

what are the features of a normal liver on a radiograph?

A

most cranial organ of abdomen
acute ventrocaudal angle pokes just past costal arch
should be parallel to gastric axis

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33
Q

what are the general features seen on radiograph of animals with hepatomegaly?

A

rounded margins
mass effect
gastric acid displaced caudally
ventrocaudal angle extends further past costal arch

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34
Q

how is the gastric axis displaced in micro-hepatica?

A

cranial

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35
Q

what are the differential diagnoses for microhepatica?

A

vascular (portosystemic shunt, primary portal vein hypoplasia…)
inflammatory (chronic hepatitis with cirrhosis…)

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36
Q

how is the normal spleen seen on a lateral radiograph?

A

tail - flat triangle caudal to ventral liver (mobile)
head - flat triangle on left that superimposes the right kidney (fixed)

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37
Q

what is the retroperitoneum?

A

dorsal to peritoneal cavity and most most organs
contains kidneys, adrenal glands, large vessels, lymph nodes…

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38
Q

should adrenal glands be visible on radiographs?

A

no (can see them on cats when they are mineralised - harmless)

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39
Q

are abdominal lymph nodes visible on a radiograph?

A

no (unless abnormal)

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40
Q

can the normal pancreas be seen on a plain radiograph?

A

no (ultrasound more useful)

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41
Q

what mass effect with an enlarged pancreas have?

A

lateral displacement of duodenum
caudal displacement of transverse colon

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42
Q

what structure is the oesophagus found in?

A

mediastinum

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43
Q

when can the oesophagus be visualised on a plain radiograph?

A

if it contains gas or a contrast media

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44
Q

what is marked dilation of the oesophagus known as?

A

megaoesophagus

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45
Q

what radiographic sign indicates there is gas in the oesophagus?

A

trachea-oesophageal stripe (summation of tracheal and oesophageal wall soft tissue)

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46
Q

what sites of the oesophagus are predisposed to foreign bodies?

A

thoracic inlet, heart base and cranial to diaphragm

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47
Q

if barium contrast studies indicated for foreign bodies in the oesophagus?

A

no - could be perforations or could aspirate

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48
Q

what can gas distribution/redistribution be used for?

A

to provide contrast and highlight structures within the abdomen (can reposition patient)

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49
Q

where does gas rise to in the stomach of a right lateral radiograph?

A

fundus (on the left)

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50
Q

where does gas rise to in the stomach of a left lateral radiograph?

A

pylorus (pyloric antrum)

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51
Q

where does gas rise to in the stomach of a ventrodorsal radiograph?

A

body of the stomach

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52
Q

where does gas rise to in the stomach of a dorsoventral radiograph?

A

fundus

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53
Q

what are the compartments of a stomach?

A

cardia, fundus, body, pyloric antrum

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54
Q

what are the five layers of the stomach seen on uiltrasound?

A

(outside)
serosa
muscularis
submucosa
mucosa
lumen
(inside)

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55
Q

what layers of the stomach are seen as hypoechoic? (dark)

A

muscularis and mucosa

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56
Q

what are the two causes of gastric dilation?

A

gas dilation - aerophagia, GDV…
fluid/gas dilation - outflow obstruction…

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57
Q

what can cause bizarre gas pattens in the stomach?

A

gas trapped in foreign bodies (eg. socks…)

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58
Q

what axis does the stomach rotate around in GDV cases?

A

longitudinal axis

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59
Q

where is the fundus displaced in GDV cases?

A

caudoventrally and right

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60
Q

where is the pyloric antrum displaced in GDV cases?

A

craniodorsally and left

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61
Q

how much gas is it normal to have in the small intestinal tract?

A

dogs - some homogenous gas filling is normal
cats - little to none

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62
Q

why may the small intestines look thickened on a radiograph? (wall thickness illusion)

A

wall can’t be reliably assessed because fluid and soft tissue are indistinguishable on radiographs

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63
Q

how does the mucosal layer of the wall in the stomach compare to the small intestines?

A

thickest layer in the small intestine

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64
Q

how does the submucosa of the small intestine appear on transverse ultrasound images?

A

flower/wheel like appearance

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65
Q

what are the two main causes of small intestinal dilation?

A

mechanical obstruction (foreign body, tumour…)
functional ileus (inflammation, toxic, stress…)

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66
Q

what is dilation with gas and fluid of the small intestine associated with?

A

obstruction

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67
Q

what is the small intestine diameter compared to to determine dilation?

A

height of L5 (take with pinch of salt)

68
Q

what is the obstructive pattern seen in the small intestine?

A

creates two populations of intestine - dilation proximal to obstruction and normal diameter distal to obstruction

69
Q

how does intussusception of small intestine appear on ultrasound?

A

onion appearance

70
Q

what are some possible artefacts/limitations of radiographing the musculoskeletal system?

A

geometric distortion - not collimated well or not truly parallel to the cassette
poor soft tissue contrast

71
Q

when may serial radiographs be indicated for the musculoskeletal system?

A

monitor disease progression
assess dynamic component of disease
if diagnosis is uncertain

72
Q

what are the radiographic (rontgen) signs?

A

number
size
shape (including margins)
location
opacity

73
Q

what are the three main things to consider when assessing radiographs of the musculoskeletal system?

A

soft tissues (swelling/loss)
bones (shape, defects, growth plates…)
joints (swelling, effusion, suchondral bone…)

74
Q

what are the two main causes of reduced size of soft tissue in the musculoskeletal system?

A

atrophy (focal) - neurogenic, fibrosis, lameness
weight loss (general)

75
Q

what are some possible causes of focal increase in soft tissue of the musculoskeletal system?

A

trauma, abscess, granuloma, neoplasia

76
Q

what are some possible causes of diffuse increase of soft tissue of the musculoskeletal system?

A

oedema, cellulitis, diffuse neoplasia

77
Q

what are the anatomical regions of long bone?

A

epiphysis
metaphysis
diaphysis

78
Q

what are the layers of long bone?

A

(outside)
periosteum
cortex
endosperm
(inside)

79
Q

how long does mineral loss have to be going on to identify reduction in opacity of bones on a radiograph?

A

minimum 7 days

80
Q

what are the ways lysis of bone can be described?

A

geographical (unified focal area)
moth-eaten (many coalescing holes)
permeative (many tiny holes)

81
Q

how aggressive are the different types of radiographic bone loss?

A

(least)
geographical
moth-eaten
permeative
(most)

82
Q

what are the ways of describing the periosteal reaction (bone surface) seen on radiographs? (in order of aggression)

A

(least - inactive)
smooth
rough
brush border
palisading
spicular
sunburst
amorphous
(most - aggressive)

83
Q

how can the transition zone of a bone lesion on radiograph help determine how aggressive it is?

A

long transition - aggressive
short - less aggressive (well circumscribed)

84
Q

what does monostotic?

A

single bone involved

85
Q

how can the distribution of skeletal lesions be described on a radiograph?

A

monostotic
polystotic
focal
generalised
symmetrical
asymmetrical

86
Q

what is polystotic?

A

multiple bone involved

87
Q

what is it important to critically assess regarding the joints on a radiograph?

A

soft tissue swelling
joint space width
sunchondral bone opacity
osteophyte/enthesophytes
periarticular mineralisation

88
Q

what are enthesophytes?

A

new bone formation around tendons/ligament attachments

89
Q

what are osteophytes?

A

new bone formation around the joint capsule

90
Q

what joint can joint effusion be determined from radiograph?

A

stifle - infrapatellar fat pad gets squashed

91
Q

can cartilage be seen on radiographs?

A

no - needs contrast

92
Q

what are some possible defects seen of the subchondral bone?

A

osteochondrosis
septic arthritis
erosive arthrits
neoplasia
trauma

93
Q

what are some signs of osteoarthritis on radiographs?

A

soft tissue swelling
periarticular osteophytes (predilection sites)
subchondral sclerosis
narrowed joint space

94
Q

what are the predilection sites for osteosarcoma?

A

proximal humerus
distal radius/ulna
distal femur
proximal tibia

95
Q

what are the predilection sites for osteosarcoma?

A

proximal humerus
distal radius/ulna
distal femur
proximal tibia

95
Q

what are the predilection sites for osteosarcoma?

A

proximal humerus
distal radius/ulna
distal femur
proximal tibia

95
Q

what are the predilection sites for osteosarcoma?

A

proximal humerus
distal radius/ulna
distal femur
proximal tibia

96
Q

what modes of imaging can be used for the urogenital tract?

A

plain radiograph
contrast radiograph
ultrasound

97
Q

can the uterus and ovaries be visualised on plain radiograph?

A

no - unless markedly enlarged

98
Q

why is it difficult to ultrasound the uterus and ovaries?

A

located between the bladder (ventrally) and descending colon (dorsally)

99
Q

what are the signs of a pyometra on radiography?

A

dilated soft tissue opacity loops between the bladder and colon
intestines displaced cranially and dorsally (mass effect)

100
Q

what are the signs of pyometra on ultrasound?

A

fluid filled uterine horns/body
thin/thick/cystic walls

101
Q

where is the prostate located?

A

caudal to bladder and partly within the pelvic canal

102
Q

what shape is the prostate?

A

symmetrical and ovoid/round

103
Q

what opacity is the prostate?

A

soft tissue

104
Q

what does the size of the prostate depend on?

A

age and neutering status

105
Q

how big should the prostate of an entire male be in comparison to the pelvic inlet?

A

no more than 70%

106
Q

what can cause prostatomegaly?

A

benign prostatic hyperplasia
prostatic neoplasia
prostatitis

107
Q

what opacity is seen with prostatitis on radiograph?

A

soft tissue with some mineralisation

108
Q

what causes of prostatomegaly are only seen in entire males?

A

bengin prostatic hyperplasia
prostatitis

109
Q

what signs of prostatic neoplasia will be seen on radiography?

A

mineralisation
irregular shape (only one lobe effected)
metastasis (lumbar vertebrae)

110
Q

what is the most likely diagnosis of mineralisation of the prostate in neutered dogs?

A

prostatic neoplasia

111
Q

where do prostatic neoplasias metastasise to?

A

medial iliac lymph nodes
lumbar vertebrae (periostea reaction)
lungs

112
Q

what are the categories of contrast radiographic studies for the urogenital tract?

A

positive/negative cystography
iodinated retrograde urethrography
iodinated intravenous urography

113
Q

what positive contrast media can be used for cystography?

A

iodinated contrast

114
Q

what negative contrast media can be used for cystography?

A

usually air

115
Q

what is the process of cystography?

A

catheterise and empty bladder
instil contrast medium until distended

116
Q

what contrast is best for looking at mucosal detail on cystography?

A

double contrast

117
Q

how is a double contrast cystogram carried out?

A

catheterise and empty bladder
instil positive contrast and massage to coat mucosa
instil negative contrast (air)

118
Q

how do calculi appear in a double contrast cystogram?

A

central defects in the contrast pool

119
Q

how do blood clots appear in double contrast cystography?

A

can adhere to the wall and be irregular, can be scattered around bladder

120
Q

how is a retrograde urethrogram carried out?

A

catheterise and empty bladder then slightly inflate with air to create some back pressure (allow urethral dilation)
place catheter at tip of urethra and clamp
inject iodine based contrast

121
Q

why do retrograde urethrograms need to be done under GA?

A

clamping penis/vulva is very painful

122
Q

what is needed for an IV urogram to be diagnostic?

A

adequate renal function/hydration
GA
lot of time (>2 hours)
multiple radiographs

123
Q

what are the indications for cystography?

A

radiolucent calculi
bladder mass
bladder rupture
chronic cystitis

124
Q

what are the indications for retrograde urethrogram?

A

stranguria (uroliths, stenosis, neoplasia…)
ectopic ureter
bladder rupture/integrity

125
Q

what are the indications for an intravenous urogram?

A

suspected Coptic ureter
ureteroliths
ureteral stenosis
renomegaly

126
Q

what mode of imaging is needed to visualise cystitis?

A

double contrast cystography
ultrasound

127
Q

what bladder calculi can be visualised on plain radiography?

A

struvite, oxalate, calcium phosphate

128
Q

what bladder calculi can’t be visualised on plain radiography?

A

cystine and urate

129
Q

why can’t masses in the bladder be diagnosed on plain radiography?

A

soft tissue and fluid have the same opacity

130
Q

what mode of imaging is used to diagnose a bladder rupture?

A

positive contrast cystogram

131
Q

what is the only mode of imaging that can be used for assessment of the urethra?

A

retrograde urethrogram

132
Q

which kidney is more cranial?

A

right (left is left behind)

133
Q

what do you compare the kidneys to to determine if they are the correct size?

A

L2

134
Q

what mass effect will an enlarged kidney cause?

A

ventrally displace colon

135
Q

what diseases could be suspected if there is irregular (focal) renomegaly?

A

unilateral - neoplasia, cysts. abscess
bilateral - neoplasia, FIP,

136
Q

what diseases could be suspected if there is a smooth (generalised) renomegaly?

A

unilateral - neoplasia, hydronephrosis
bilateral - AKI, FIP, pyelonephritis, lymphoma

137
Q

what is pyelectasia?

A

mild/moderate dilation of the renal pelvis secondary to diuresis or inflammation

138
Q

what is hydronephrosis?

A

moderate to seere pelvic dilation often due to secondary obstruction

139
Q

what are the three main causes of microrenale (small kidneys)?

A

CKD
atrophy
dysplasia (congenital)

140
Q

what breed is predisposed to polycystic kidney disease?

A

Persians

141
Q

what is needed to visualise the ureters in diagnostic imaging?

A

intravenous urography

142
Q

what shape to the ureters form when they enter the trigonal region?

A

a J shape

143
Q

what are some indications for neurological imaging?

A

confirm diagnosis with expected changes
rule out differentials

144
Q

what are the indications for an aural radiograph?

A

chronic otitis
peripheral vestibular syndrome
facial nerve paralysis
Horners syndrome
(all caused by middle ear disease)

145
Q

what imaging modality is the best for imaging middle ear disease?

A

CT

146
Q

what is an open mouth rostrocaudal radiograph useful for?

A

highlight tympanic bulla

147
Q

what are some considerations for taking spinal radiographs?

A

straight positioning (sand bags…)
exposure in expiratory pause (no motion artefacts)
take multiple sections (avoid geometric distortion)

148
Q

why is a ventrodorsal view of the spine used instead of dorsoventral?

A

spine is closer to the cassette in ventrodorsal so there is less distortion

149
Q

why are multiple sections needed to radiograph the entire spine?

A

to avoid geometric distortion by not having parallel rays to the area of interest

150
Q

what are horses heads when discussing radiographs of the spine?

A

intervertebral foramina

151
Q

what dog breed is predisposed to having mineralised intervertebral discs?

A

dachshund

152
Q

what causes atlanto-axial subluxation?

A

congenital malformation of dens or excessive ligament laxity
(less common through trauma)

153
Q

what is the major cause of luxation/subluxation of vertebra?

A

trauma

154
Q

what is the most important radiographic view if laxation of the spine is suggested?

A

lateral - if confirmed don’t take orthogonal and could damage further

155
Q

what is discospondylitits?

A

infection of an intervertebral disc that extended to cause osteomyelitis of adjacent endplates

156
Q

what radiographic changes are seen with discospondylitis?

A

no changes in disc apparent
irregular shaped endplates with new bone formation appear after 3 weeks

157
Q

what are the possible locations of soft tissue lesions within the vertebral canal?

A

extradural
intradural
intramedullary

158
Q

what mode of imaging is used to asses for soft tissue injury to the vertebral canal?

A

myelography

159
Q

how is myelography carried out?

A

injecting iodinated positive contrast into subarachnoid space followed by orthogonal radiography

160
Q

what are the indications for CT as neurological imaging?

A

suspected bone trauma/anatomy abnormality
otitis media
intracranial tumours
peripheral nerve tumours

161
Q

what lesions of the neurological system is MRI not good at imaging?

A

anything to do with bone

162
Q

what can degenerative intervertebral disc disease predispose to?

A

disc herniation
infections (discospondylitis)

163
Q

what is spondylosis deformans?

A

briding/spur formation of new bone arising from the ventral aspect of endplates
not clinically significant

164
Q

what breeds are predisposed to vertebral anomalies?

A

brachycephalic (usually not clinical significant but can predispose to neurological disease)

Small animal (fourth year) (26 decks)

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