Dogs Flashcards
Neoplastic diseases caused by spirocerosis is mainly?
1 = Osteosarcoma
Far less likely are…
Fibrosarcoma
Chondrosarcoma
Which is more contrast enhancing on post contrast CT images in dogs… Non-neoplastic nodules from spirocerosis or neoplastic nodules from spirocerosis?
Non-neoplastic - in all three phases
Opposite of what you think but this might be due to the fact that all these neoplastic diseases are sarcomas which have less angiogensis than carcinomas
Which has a hypoattenuating necrotic center on CT images in dogs… Non-neoplastic nodules from spirocerosis or neoplastic nodules from spirocerosis?
Non-neoplastic
Due to the worm being there.
Which is more likely to have mineralization on CT images in dogs… Non-neoplastic nodules from spirocerosis or neoplastic nodules from spirocerosis?
Neoplastic
Which had more contrast enhancement in the triple phase CT paper in dogs; neoplastic or non-neoplastic nodules from spirocerosis or the esophagus?
The esophagus and non-neoplastic masses had more contrast enhancement than the neoplastic nodules IN ALL THREE PHASES
What breed of dog had the most prevelance for dynamic pharyngeal collapse?
Yorkies
What are the major pharyngeal dilator muscles in the dog?
Sternohyoideus
Genohyoideus
Glenoglosius - pulls tongue cranially
What is the most common clinical sign for dynamic pharyngeal collapse?
Coughing
Pharyngeal collapse may happen more often in brachycephalic dogs… yes or no?
Yes
Does overweight dogs have more likelyhood to have pharyngeal collapse?
Yes
Is pharyngeal collapse likely to be a primary disease process?
No.. A manifestation of airway pathology that increases negative intrathoracic pressure.
Subarticular cleft is a degenerative process of what joint?
sacroiliac
What is the sensitivity and specificity for subarticular cleft and subchondral cysts on CT in the sarcoiliac joint?
100% sensitivity for both
56% - specific for subarticular cleft
22% - specific for subchondral cysts
Are there degenerative changes in the sacroiliac joints of dogs that are similar to that of humans and if so what are they?
Yes Subchondral cysts Erosions Subchondral sclerosis Intra-articular ankylosis Subchondral cleft
Biggest down fall with the paper of CT and gross pathology are comparable methods for detecting some degenerative sarcoiliac joint lesions in dogs?
They used 1 cm cuts of the joint for pathology review and the pathologist only had pictures of each side.
CT was 0.5cm slices with volume averaging.
Multiple myeloma has a predilection for bone marrow of what bones?
Axial skeleton
What percentage of dogs have radiographic evidence of multiple myeloma?
25-75%
What other clincopathologic abnormalities are seen with multiple myeloma?
hypervisosity syndrome
hypercalcemia
renal insufficiency
What is the T2 and T1 intensity for multiple myeloma?
Hyperintense to iso intense on both when compared to the spinal cord.
Why was multiple myeloma lesions noted to be T1 hyperintense?
Hemorrhage within myelomatous lesions
or
Intracellular fat content of the bone marrow increases in humans in early disease - but it did not null on STIR so probably not.
What is a unique imaging finding that may distinguish multiple myeloma from other boney neoplasm?
T1 hyperintensity
What percentage of dogs in the study about MRI features of multiple myeloma had extradural material causing spinal cord compression?
100% all 12/12 dogs.
The “golf tee” sign indicates the lesion is where?
Intradural and extra-medullary
Differentials for intradural - extramedullary masses in the spinal cord?
Peripheral nerve shealth tumor
Meningiomas
Archinoid
An FCE will be predominantly seen in what type of matter in the spinal cord?
Grey matter
Do nerve shealth tumors contrast enhance
Yes… moderate to marked homogeneous enhancement
The length of your TR (turbo factor) is directly related to the what?
Number of images acquired
Number of echoes within one TR
Nephroblastomas are considered what location intramedullary, intradural extramedullary or extradural?
Intradural, extramedullary
They can infiltrate the spine so also intramedullary
At what location due nephroblastomas usually occur?
T10-L2
Nephroblastomas occur in what age dogs?
Young (<3 years)
What breed is predisposed to nephroblastomas?
German shepherds
Types of pituitary neoplasia?
Microadenoma
Macroadenoma
Carcinoma
Who is more accurate in determining intra-axial vs intradural-extramedullary? MRI or myelogram
MRI
Invasion into the cord can cause the myelogram to look like intramedullary when it is not.
Abscene of widening of the subarachnoid space can be seen in some intradural-extramedullary lesions
Is there a sex predilect for spinal arachnoid diverticulum?
Yes - Males
Where do spinal arachnoid diverticulum likely live?
Cervical region - C2-3, C5-C6
TL region - T9-L1
Where are spinal arachnoid diverticulum usually located directionally?
Dorsal
Breed predilect for spinal arachnoid diverticulum?
Pugs
Rotties
Frenchies
What is the most common clinical signs for spinal arachnoid diverticulum?
Ataxia
Hypermetria
Can hyperesthesia be related to spinal arachnoid diverticulum?
Yes; 10-25%
What does HASTE stand for?
Half- fourier Acquisition Single Shot Turbo Spin-Echo
H A S T E
In humans the HASTE is used for what type of imaging?
Abdominal imaging - biliary tract
Besides compression of the CSF column, what else can cause attenuation of the CSF column on HASTE imaging?
High cellular content
Why might spinal arachnoid diverticulum be missed on normal T2 imaging?
CSF and epidural fat look the same.
Where have intracranial arachnoid diverticulum found?
Most common - quadrigeminal cistern
Others include: posterior fossa, fourth ventral
Is syringohydromyelia painful?
35% are, yes.
Can you get periventricular edema with obstructive ventriculomegaly?
Yes
Intracranial fourth ventricular arachnoid diverticulum can cause what?
Obstructive ventriculomegaly and syringohydromyelia
Quadrigeminal cistern diverticulum or cysts can cause?
CN deficits
Seizues
What neoplasms of the brain can be cystic?
Gliomas
Meningiomas
Mets
Spinal cord arachnoid diverticulum are normally how long?
2 vertebral bodies
Multiple subarachnoid diverticulum normal noted in which region of the spine?
Cervical
Classical MRI feature for spinal cord arachnoid diverticulum?
Tear drop shaped
Why does spinal cord arachnoid diverticulum cause hypermetria in dogs?
They are mostly dorsally and the spinocerebellar tracts run dorsally.
Three types of pituitary adenomas when thinking of biologic behavior?
Adenoma
Invasive adenoma
Carcinoma
Can pituitary adenomas invade the ventricles?
Yes - 3rd
How big does a pituitary macroadenoma have to be to be a macroadenoma?
> 10mm in dorsoventral height
Are pituitary macrotumors contrast enhancing?
Yes, marked homogeneously or heterogeneously
What is the pituitary glands dynamic image enchancement characteristics?
52-65 secs the stalk of the gland (pas tuberalis and neurohypophysis lights up)
100-140s there is uniform enhancement
Do you see all pituitary adenomas on imaging?
No…6% in one paper
Who is bigger pituitary adenomas or invasive pituitary adenomas?
Invasive
Mineralization of the pituitary tumor makes you think of what histopath?
Invasive adenoma - 36% in one study.
The only way to image a dog/cat and say that it is an adenocarcinoma vs invasive pituitary adenoma?
Metastasis - intracranial or abroad
What do invasive pituitary adenomas like to invade in dogs?
Brain parenchyma - not bone or sinuses but still could
What age should you suspect invasive pituitary adenoma?
<7.7 yo
At what height should you suspect invasive pituitary adenoma?
> 1.9cm
Are pituitary adenocarcinomas rare?
Yes they are uncommon.
What percentage of normal MRIs will have inflammatory CSF?
~25%
Do lesions on inflammatory disease have to contrast enhance?
No - only 36% did
Golf tee sign for spinal cord meningoma was see consistently on what view?
Dorsal T2
Is fibrotic small intestinal stricture another differentail for adenocarcinoma in a cat?
YES. Do an FNA to verify not lymphoma.
Retroversion of the epiglottis cause what clinical signs?
Dysnea due to blocking the rima glottidis
Permanent epiglottic trac causes what complication?
None! In people and cats it shows that epiglotticectomy does not increase risk of aspiration. Birds don’t have an epiglottis.
How many dogs get secondary hyeradrenocorticism?
80-85%
The pituitary gland is split into what two structures?
Adenohypophysis
Neurohypohysis
The adenohypophysis includes what three structures?
pars distalis
pars intermedia
pars tuberalis
Hyperintensity in the caudodorsal aspect of the pituitary gland noted on T1 is what?
Accumulations of vasopressin secretory granules in the pars distalis
Downfall of dynamic MRI aquisition?
Increased image noise due to small slices and one excitement to fill k-space
How does dynamic MRI help find pituitary microadenomas?
Microadenomas contrast later than peak contrast enhancement of normal tissues
Imaging protocol for dynamic MRI sequence - post contrast - in pituitary studies?
One image every 13 secs over 3-4 minutes
How many dogs are asymptomatic with gall bladder mucoceles?
23% - 44%
What was the #1 clinical sign in gall bladder mucoceles?
Vomiting
Dogs with Gall bladder mucoceles that were symptomatic had generally higher?
ALT
ALP
T-bili
Leukocytes
Sensitivity, specificity and accuracy for GB rupture on US?
Sensitivity - 79%
Specificity - 100%
Accuracy - 84%
In the “Ultrasonographic features of GB mucocele in Dogs” ruptures were noted in which types of the 6 types of GB mucoceles described?
All but type 6
The conclusion of “Ultrasonographic features of GB mucocele in Dogs” was that ultrasonographic patterns of GB mucoceles was a good indicator for which ones will rupture….TRUE OR FALSE?
False. Ultrasound should not be used to determine the risk of rupture.
Clinical signs should be used to determine treatment path (surgery or medical management)
Was the rate of rupture high or lower in dogs with symptomatic GB mucoceles vs asymptomatic?
Higher - 46% of all symptomatic dogs had ruptures
Signs of rupture Gall bladder?
Discontinuity of the gall bladder
Hyperechoic mesentery
Fluid
What is the most common salivary gland to get a sialocele?
Sublingual…by far.
Based off the study from VRU 2019 of phased contrast MRA in the abdomen, what was mean stroke volume and velocity of the aorta?
- 6 +/- 1.9 ml
- 11.1 +/- 1.1 cm/s
Based off the study from VRU 2019 of phased contrast MRA in the abdomen, what was mean stroke volume and velocity of the cranial mesenteric and celiac?
Cranial Mes: 2.1 mls and -6.6 +/- 1.9 cm/s
Celiac: 2.3 +/- 1.0 mls and -7.9 +/- 3.1 cm/s
Based off the study from VRU 2019 of phased contrast MRA in the abdomen, what was mean stroke volume and velocity of the caudal vena cava and portal vein?
Caudal vena cava: 6.7 +/- 1.3 ml and 4.0 cm/s
Portal vein: 2.6 +/- 1.0 ml and 3.2 +/- 1.2 cm/s
Is phased contrast MRA feasible for quantifying blood flow in canine major cranial abdominal vessels?
Yes
In the VRU 2016 paper describing the association between thoracic radiographic changes and severity of pulmonary hypertension what were the four radiographic signs that were significantly related to the severity of pulmonary hypertension?
1) Reverse “D”
2) 3/5 to 2/5 ratio
3) MPA enlargement
4) Caudal pulmonary arteries compared to the 3rd rib
In the VRU 2016 paper describing the association between thoracic radiographic changes and severity of pulmonary hypertension what was the sensitivity and specificity for differentiating severe pulmonary hypertension vs controls using 1 of the clinically significant radiographic signs? 2 of the radiographic signs? 3?
- 84% sensitive and 91% specific for using only one of the signs
- 56% sensitive and 100% specific for using a combo of two signs
- 24% sensitive and 100% specific for using a combo of three of the signs
In the VRU 2016 paper describing the association between thoracic radiographic changes and severity of pulmonary hypertension what was the only sign that did not show up in the normals?
Reverse D
In the VRU 2016 paper describing the association between thoracic radiographic changes and severity of pulmonary hypertension it was determined that radiographs are good for determining the severity of pulmonary hypertension. T/F
False. They are not.
What is the sensitivity for detecting PSS on CTA vs US?
96% CTA
68% US
Kim 2013 VRU
What is the specificity for detecting PSS on CTA vs US?
89% CTA
84% US
Kim 2013 VRU
Which modality correctly detected the origin and insertion of a cogential PSS….CTA or US?
CTA - 15/16 origin and insertion
US - 24/30 origin and 20/33 insertion
Kim 2013 VRU
Which modality correctly detected multiple acquired shunts a cogential PSS….CTA or US?
CTA - 4/5
US - 1/6
Kim 2013 VRU
How many more times was CTA more likely to correctly ascertain the presence or absence of a PSS when compared to US?
5.5 times
Kim 2013 VRU
In, Kim 2013 VRU, what was the most common intrahepatic shunt?
Left divisional 5/6
In, Kim 2013 VRU, what was the most common origin of extrahepatic PSS?
Splenic 42/44
In, Kim 2013 VRU, what was the most common insertion of extrahepatic PSS?
Caval 23/44
Azygous 19/44
When comparing CE-CT, CE-US, radiographs and B-mode US which modality was the best for accurately differentiating surgical from non-surgical abdomens?
All modalities were high accuracy
CT - 100%
US - 94%
Rads - 94%
When comparing CT, US and rads which modality is not good at looking for pneumoperitoneum?
US
What is fat stranding on CT?
Abnormal increased attenuation of fat caused by edema or engorged lymphatics
- may look hazy/ground glass/reticular
When comparing CE-CT, CE-US, radiographs and B-mode US which modality was the best for accurately assessing hypoperfusion in the pancreas and small bowel?
CEUS
- Due to better spatial and temporal resolution
- Microbubble contrast sensitivity for perfusion deficiency
Are broncho-arterial ratios the same when using positive pressure ventilation technique vs end expiration in dogs?
No.
PP = 1.24
End expiration = 1.11
However, There was overlap
Are broncho-arterial ratios the same between large bronchi vs small bronchi in dogs?
No
Large = 1.39 with PPV Small = 1.08 with PPV
However, there was overlap
Pancreaticoduodenal lymph node is always what direction from the pancreas or duodenum?
Ventral
Are microchips affected by MRI?
No
Are microchips affected by MRI?
No
How much difference is there between 2 view chest rads and 3 view chest rads in identifying mets?
12%
The bigger the injection site sarcoma is, the more likely it is to have mineralization. T/F
True
With injection site sarcomas, infiltrative margins were more prevalent in cases that had excisional biopsy compared to incisional biopsy. T/F
True
100% in excisional
40% in incisional
With injection site sarcomas, on MRI a T2W hyperintense zone was more prevalent in cases that had excisional biopsy compared to incisional biopsy. T/F
True
90% in excisional
30% in incisional
Injection site sarcomas in cats have very similar MRI characteristics. T/F
False… it varies alot
What were common MRI characteristics in injection site sarcomas?
T1 and T2 hyperintensity
Mineralization
Cavitation
Moderate to marked contrast enhancement
With injection site sarcomas, cavitation was more prevalent in cases that had excisional biopsy compared to incisional biopsy. T/F
False
Incisional biopsy was more likely to be cavitated.
How many times more likely are bernese mountain dogs and rotties gonna get histiocytic sarcoma?
225x - BMD
26x - Rotties
What are the grades for chronic hypertrophic pyloric gastropathy?
Grade 1: Thickening of the muscularis layer
Grade 2: Thickening of the muscularis and mucosal layer
Grade 3: Thickening of muscularis and mucosal layer + granular cystic appearance and submucosal inflammation
What was the minimum thickeness of the muscularis of the plyorus of the dogs in Biller 1994 paper about chronic plyoric gastropathy?
4mm - hypoechoic
What are the two types of histiocytic sarcoma?
Disseminated
Localized
Skeletal histiocytic was most seen in what age and breeds of dogs?
Golden and Rotties over 5 years of age
In the 2007 study by shultz, all of the appendicular lesion noted with histiocytic sarcoma were by what?
A joint! Most involved multiple bones of the joint. This is because the histiocytic cells likely come from the synovium and therefore look like synovial cell sarcoma
What are the 3 top skeletal locations for histiocytic sarcoma?
Periarticular
Vertebral
Humeral
What are the two characteristics of histiocytic sarcoma that would make you think disseminated?
Rottie - all of them had disseminated disease
Bone involvement.
The most common place for histiocytic sarcoma?
1…Spleen* known*
Liver
Bone marrow
Lymph nodes
Common sequeal of histiocytic sarcoma?
Anemia
Most common US abnormality in the abdomen with histiocytic sarcoma?
Well defined HYPOechoic nodules in the spleen
2nd - Hepatomegaly with hyper and hypoechoic nodules
Pure hypoechoic, well defined nodule in the kidney think what neoplastic disease?
Histiocytic sarcoma
What is the difference in contrast enhancement between necrotizing pancreatitis vs edematous pancreatitis?
Necrotizing panc - heterogeneous contrast enhancement
Edematous - Homogeneous contrast enhancement
When is the pancreas best delineated from the liver on a contrast CT?
Delayed phase
What is the best CTA to use to find the location of a insulinoma? Single, double or triple?
Triple because there are less huge location errors 17% vs 50% in the others.
What is a common sequeal for acute pancreatitis?
Portal thrombus
What is the expected difference in US-CE between adneocarcinomas and insulinomas in humans? Has this been proven in dogs?
Hypoechoic contrast enhancement with adeno
Hyperechoic CE with insulinomas
There is more variation with dogs
Why is it important to do a triple phase CT when looking for an insulinoma?
Insulinomas can be more conspiquous in different phases
When thinking of metabolic tumors where would you see on MRI?
Bilateral lesions - metabolic, toxic
What are differentials for bilateral signal changes in the basal ganglion?
Hepatic encephalopathy
Hypoxia
Hypoglycemia
What is the contrast enhancement difference between insulinomas and adenocarcinomas in a dog with CEUS?
Adenocarcinomas - hypoechoic
Insulinoma - hyperechoic
What modality is best for finding portal thrombi secondary to pancreatitis?
CT
How many dogs with histopathologically diagnosed pancreatitis that showed US signs of pancreatitis?
68%
What are the two imaging findings that are correlated with a worse prognosis and longer hospital times?
Heterogeneous contrast enhancement - necrosis
Portal thrombus.
What is the esophageal diameter to the height of T12 used for on fluroscopy?
Determining megaesophagus.
Is there a difference between the esophageal diamter: height of T12 in dogs with megaesophagus that have or do not have lower esophageal schinter achalasia?
No difference
What are two imaging findings that were seen in the majority of dogs with megaesophagus and LES achlasia that are not seen in dogs with megaesophagus and no LES achalasia?
Bird Beak sign at the LES
Esophageal fluid line after fasting.
What is the key pathologic component of LES achalasia?
Failure for the LES to open in response to a pharyngeal swallow
Does LES achalasia have to be concurrent with megaesophagus?
No
Lateral recumbancy inhibits what phase of swallowing on fluroscopic studies?
Esophageal transient time
Amount of primary peristaltic waves
The degree of compression of HT 1 disc compression in the TL spine was not associated with what?
Severity of neurologic signs or prognostic indicator.
