Liver and Lymph Nodes

Question 1

What is the opacity of the liver

Answer 1

soft tissue opacity
largest solid organ in the abdomen

Question 2

What is the normal position of the liver

Answer 2

caudal to diaphragm
cranial to stomach

Question 3

What is the margination of the liver

Answer 3

smooth and well defined especially on laterals - oblong or triangular shape

Question 4

what is abundant in cats and sits ventral to the liver

Answer 4

falciform fat

Question 5

What kinds of dogs and cats have larger liver compared to body size

Answer 5

Juvenile dogs and cats

Question 6

What is notable about the radiographic appearance of the liver in older dogs and cats

Answer 6

stretching or elongation of the triangular ligaments that attaches the liver to the diaphragm leading to sagging and caudal extension

Question 7

How does liver size determine the gastric axis

Answer 7

Hepatomegaly displaces it caudally
Microhepatia displaces it cranially

Question 8

What are the radiographic signs of hepatomegaly

Answer 8

1) Rounding or blunting of the caudoventral liver margins
2) Extension beyond the costal arch
3) Caudal and perhaps medial displacement of the gastric axis

Question 9

What does the visualization of focal hepatomegaly depend on

Answer 9

1) right sided vs left sided mass = displacement of adhacent viscera such as stomach
2) Usually best on VD
3) Pedunculate liver masses may extend caudally to the stomach (and not displace the stomach)

Question 10

What might cause focal hepatomegaly

Answer 10

Primary or Metastatic Neoplasia
Abscess
Granuloma
Cysts

Question 11

What might cause generalized hepatomegaly

Answer 11

Inflammation (acute hepatitis)
Endocrine Hepatopathy (Cushings, DM)
Drug Induced (steroids)
Hepatic Venous Congestion (R CHF)
Lipidosis
Infiltrative Disease
Primary or Metastatic Neoplasia

Question 12

What allows the stomach to be displaced more cranial than normal

Answer 12

Microhepatia

Question 13

What causes Microphepatia

Answer 13

1) Chronic Liver Disease
2) Cirrhosis
3) Portosystemic Shunts (PSS)
4) Deep Chested Breeds: appearance of small liver- liver lies within the costal arch

Question 14

What could result in increased liver opacity

Answer 14

1) Choleliths
2) Choledocholiths
3) Parenchymal mineralization (dystrophic mineralization of granulomas, neoplasia, abscesses)

Question 15

What could result in radiolucency of the liver

Answer 15

Intrahepatic gas
1) Biliary system- linear or branching
2) Portal Venous System- linear or branching
3) Hepatic parenchyma- often collection of small gas bubbles

Question 16

What does intrahepatic gas in the hepatic parenchyma look like

Answer 16

often collection of small gas bubbles
-concern for abscess or necrotic tumor, needs further investigation

Question 17

What does intrahepatic gas in the biliary system look like

Answer 17

linear or branching

Question 18

What does intrahepatic gas in the portal venous system look like

Answer 18

linear or branching

Question 19

What opacity are lymph nodes

Answer 19

soft tissue opacity

Question 20

Are radiographs or ultrasound more sensitive for abdominal lymph nodes

Answer 20

ultrasound

Question 21

Radiographs are most commonly used for evaluating what kind of lymph nodes

Answer 21

Sublumbar

Question 22

Where are the sublumbar lymph nodes on radiograph?

Answer 22

Ventral and Caudal to the Lumbar Vertebrae

Question 23

What can be seen as a mid-abdominal mass if really large

Answer 23

Mesenteric Lymph Nodes but hard to definitively ID mass as lymph node on radiographs

Question 24

Enlarged Sublumbar lymph nodes could indicate

Answer 24

Primary disease of
Prostate
Anal Sac
Bladder
Lymphoma
COlon
Prepuce
Pelvic Region
Hindlimbs

Question 25

what is the size and shape of lymph nodes

Answer 25

small, oblong to round