Papers by KL Flashcards
Images of the same dog, 6 months apart. What caused the difference in their appearance? What other significant finding was described in this paper?
Dog with PDH treated with trilostane.
This study also showed a statistically significant increased in size of the adrenals after treatment.
What is the significance of these three patterns of enhancement of the canine adrenal gland?
All three patterns are associated with PDH. Common features include disorderly enhancement throughout the adrenal.
Dogs with PDH also had higher peak intensity than normal dogs.
What is the structure labeled LAG?
How is this image obtainted?
What is the range of thickness of this organ?
Left adrenal gland, obtained transrectally in a horse
Normal: 0.5 - 1.4 cm thick (range)
Mean thickness of caudal pole: 0.66 cm
Mean thickness of cranial pole: 0.9 cm
What is a cholesteatoma?
What are characteristic imaging features on CT?
Epidermoid cyst (keratin-filled)
CT: non-contrast enhancing, expansile, tympanic cavity mass, ~ 50-60 HU. Some dogs will have ring enhancement. Bony changes of the bulla (lysis, thickening, expansion), TMJ. Can cause lysis of the petrous temporal bone –> intra-cranial extension
What are the MRI features of a cholesteatoma?
T1w-iso to hypo
T2w- hyper
No CE
No T2* artifact
(Harran, JAAHA 2012)
What is the average range of attenuation for each of the following (in the context of peritoneal effusion)?
- Bile, urine, intestinal contents
- Clotted blood
- Unclotted blood
- Bile, urine, intestinal contents: 0-15 HU
- Clotted blood: 45-70 HU
- Unclotted blood: 30-45 HU
What is the sentinel clot?
The highest attenuating hematoma (sentinel clot) is expected to be close to the site of bleeding. Lower attenuating unclotted blood is located farther from the source.
What were the important factors in optimizing CT protocols for metallic gunshot head trauma in a seal? What factors did not result in improved image quality?
Minimized artifacts with: high frequency image reconstruction algorithm, proprietary extended CT scale raw data reconstruction (ECTS). All with WIDE window setting.
Increasing tube voltage and use of beam-hardening reduction (PFO) filter did not significantly reduce metal artifacts
What are the MRI features of acute distemper virus?
- T2W hyperintense, T1W hypointense lesions in the cerebellum and brainstem with loss of gray–white matter distinction (areas of demyelination)
- Large, ill-defined lesions affecting the cerebral gray matter that are T2W and T2-FLAIR hyperin- tense and T1W iso- or hypointense; the may be attributed to the acute, post-ictal brain edema.
What are the MRI features of chronic distemper virus?
- Bilaterally symmetric hyperintense T2W lesions of the white matter just deep to the gray–white matter junction of the parietal and frontal lobes.
- T2W hyperintensity of the arbor vitae of the cerebellum causing loss of cerebellar gray–white matter junction.
- Ill-defined hyperintense T2W lesion of the caudal brainstem.
- Pachymeningeal contrast enhancement.
What are some features of NME that are not commonly reported with GME?
Meningeal enhancement, mass effect, and ventricular dilation were features frequently seen in these cases of NME that are not commonly associated with GME.
In evaluating meningioma and histiocytic sarcoma, how do the following parameters compare?
- Intratumoral ADC and fractional anisotropy (FA)?
- Peritumoral ADC and FA?
- High T2 signal ADC and FA?
- Intratumoral ADC and fractional anisotropy (FA)?
- ADC: HiSA (0.76) < meningioma (1.1)
- Similar FA
- For both peritumoral and high T2 signal ADC and FA?
- ADC: HiSA > meningioma
- FA: HiSA < meningioma
What is the proposed significance of FA and ADC measurements in the peritumoral region?
Lower FA and higher ADC are associated with infiltrative tumor cells
What are the three general causes of bronchial dilation/bronchiectasis?
- Damage to bronchial wall (e.g., chronic bronchitis, chronic pneumonia)
- Obstruction of the bronchial lumen
- Traction from fibrotic tissue (e.g., IPF)
What is the significant feature present in this image that helps you identify the type of bronchiectasis present?
- No bronchial wall thickening to indicate chronic inflammation/damage
- Too diffusely affected to be secondary to obstruction of the lumen
- Diffuse ground glass opacity may indicate pulmonary fibrosis –> therefore this is traction bronchiectasis.
Fitzgerald, et al. VRU 2017
What are the differential diagnoses for contrast medium superimposed with the spinal cord during myelography (6)
- Epidural contrast deposition (focal CM accumulation at the nerve roots may mimic intramedullary contrast – check the VD, should be lateralized)
- Subarachnoid cyst
- Central canalogram (incidental vs. trauma to the cord vs. neoplasia)
- Syringohydromyelia
- Myelomalacia
- Severed spinal cord
Lu, D., Lamb, C.R. & Targett, M.P. (2002) Results of myelography in seven dogs with myelomalacia. Veterinary Radiology and Ultrasound 43, 326–330
Where is the contrast accumulating?
Subdural space
Subdural injection commonly causes contrast to accumulate in the dorsal subdural space of the cranial cervical area. This results in a radiopaque line of contrast with a very sharp dural border, a sharp bevel- or knife tip-like caudal end on lateral radiographs, and a wave-like ventral/axial border on lateral/ventrodorsal radiographs, respectively (also known as the dural drape sign).
Llabres-Diaz, F.J. (2005) Practical contrast radiography 4. Myelography. In Practice 27, 502–510
Where is the contrast accumulating?
Epidural space
The presence of marked undulations in the contrast over the disc spaces, contrast medium around the nerve roots outside the vertebral canal and also in the caudal lumbar area, away from the caudal end of the subarachnoid space, and/or the presence of patchy pooling of contrast in the dependent portions of the vertebral canal can help to identify this artefact.
Where is this lesion located? (Epidural, intradural extramedullary, or intramedullary)
Intramedullary (nephroblastoma)
Intramedullary lesions result in a widening of the spinal cord, together with narrowing and abaxial deviation of the subarachnoid contrast columns on all
projections
Which of the following statements is incorrect regarding normal findings in myelography:
- Focal thinning of the ventral subarachnoid space at the intervertebral disc spaces is common in larger breeds.
- Contrast accumulation in the dural sace can be used to confirm subarachnoid injection of contrast medium.
- There is normal, focal widening of the spinal cord at the level of C5-7 and L3-4.
- The subarachnoid space terminates at the level of C1 and does not cross into the foramen magnum.
Which of the following statements is incorrect regarding normal findings in myelography:
- Focal thinning of the ventral subarachnoid space at the intervertebral disc spaces is common in SMALLER breeds.
- Contrast accumulation in the dural sace can be used to confirm subarachnoid injection of contrast medium.
- There is normal, focal widening of the spinal cord at the level of C5-7 and L3-4.
- The subarachnoid space terminates at the level of C1 and does not cross into the foramen magnum.
Give some examples of diseases that can produce a normal myelogram (4-6 examples)
- Myelitis
- Meningitis
- Degenerative myelopathy
- Ischemic myelopathy
- +/- trauma
- +/- GME
Where is this lesion located?
Intradural extramedullary
What is a typical dose of contrast for equine myelography?
25-50 ml (following removal of 10-40 ml CSF)
What are considered normal results of flexion and extension on the contrast columns in equine myelography?
Flexion:
- dorsal contrast column is unchanged
- ventral contrast column will narrow at the IVDS
Extension:
- dorsal contrast column is unchanged
- ventral contrast column will become wider at C5
What are the three most common methods for assessing spinal cord compression in horses on myelographic examination?
- Reduction of the dorsal contrast column
- 50% commonly used, but likely to have false positives
- 70% reduction is more specific
- >60% recommended for C7-T1
- Reduction in total dural diameter
- >20% commonly used
- >30% recommended for C7-T1
- The 2-mm rule – NOT RECOMMENDED
What are the two types of cervical vertebral myelopathy in horses?
What is the typical signalment for each type?
Type 1 CVM: developmental disease of young TB and WBs
Type 2 CVM: secondary to degenerative disease of caudal cervical articular process joints; older horses, no breed predilection
What risk factors have been identified for the incidence of seizures after myelography using iohexol?
- Larger dogs
- Larger total volume of contrast (authors propose max dose of 8ml iohexol)
- Cerebromedullary cistern injection
- Cervical lesion
Based on a study of ECG-gated CTA of dogs with and without pulmonic stenosis, what are the two cut-off values suggested to determine the presence of pulmonic stenosis?
- PV:AoVT > 1.2
- Pulmonic valve : aortic valve in transverse plane
- PV:AoAs < 0.8
- Pulmonic valve to the aortic annulus in a sagittal plane
In a study of ultrasonographic contrast enhancement of intra-thoracic masses, how was pulmonary arterial vs. bronchial arterial supply distinguished?
Vascularization type was considered relative to enhancement of the spleen (systemic arterial supply).
rTTE (lesion) = TTE lesion / TTE spleen
If rTTE > 1 –> likely systemic circulation (bronchial artery)
If rTTE < 1 –> likely pulmonary arterial supply
In a study of CEUS of intra-thoracic masses, what was the general sensitivity and specificity of vascular supply in differentiating the different types of masses?
rTTE had an approximately 63% sensitivity and 78% specificity for differentiating types of pulmonary neoplasia
https://doi.org/10.1111/vru.12691
In a study of CEUS of intra-thoracic masses, what were the main differences between the contrast enhancement patterns of mediastinal lymphomas and thymomas?
Mediastinal thymomas tended to have non-enhancing regions within them, and had a centripetal pattern of enhancement.
Mediastinal lymphomas enhanced throughout the lesion and had a centrifugal pattern of enhancement.
https://doi.org/10.1111/vru.12691
In a study of CEUS of intrathoracic masses, what was the general trends of vascular supply for neoplastic vs. non-neoplastic pulmonary masses/nodules?
While there was a fair amount of overlap, most non-neoplastic masses had pulmonary arterial supply (78%) and most neoplastic masses had bronchial arterial supply (63%).
https://doi.org/10.1111/vru.12691
What are the predilection sites for manica flexoria tears?
Lateral aspect of the MF in the hind limbs
https://doi.org/10.1111/vru.12675
What are the sonographic features of a manica flexoria tear? How does dynamic positioning aid in diagnosis?
- Asymmetric hypoechogenicity and thickening
- Unattached margin of the MF
- Ruptured edges of the MF floating in effusion
- Flexor tendon sheath effusion
Dynamic flexion: reduced sliding of SDFT, anechoic gap between SDFT and DDFT, medial displacement of SDFT relative to DDFT (this one may be characteristic of MF tear)
https://doi.org/10.1111/vru.12675
Name the numbered structures.
What is indicated by the white arrow and how was this achieved?
- Subcutaneous tissue
- SDFT
- DDFT
- Digital flexor tendon sheath cavity
2a: MF
4a: SDFT mesotenon
4b, thickened synovial membrane
*anechoic synovial effusion of the digital flexor tendon sheath
White arrow: medial displacement of the SDFT relative to the DDFT, acquired with dynamic flexion of the fetlock, likely a characteristic appearance of MF tear
https://doi.org/10.1111/vru.12675
What is glioblastoma multiforme? What is gliomatosis cerebri?
GBM = grade IV astrocytoma
GC = wide-spread, diffusely infiltrative glial neoplasia of the CNS that affects 3+ contiguous cerebral lobes
According to a 2014 study, what is the prevalence of incidental thyroid nodules in hypercalcemic dogs undergoing cervical ultra- sound (excluding dogs with palpable cervical masses)?
What percenrage of these were malignant?
Prevalence: 15% of dogs had at least one thyroid nodule
Of these nodules, 22% were malignant (adenocarcinoma)
Pollard, R.E., Bohannon, L.K. & Feldman, E.C. (2014) PREVALENCE OF INCIDENTAL THYROID NODULES IN ULTRASOUND STUDIES OF DOGS WITH HYPERCALCEMIA (2008-2013). Veterinary Radiology & Ultrasound 56, 63–67
According to a 2014 study of incidental thyroid nodules in hypercalcemic dogs found on cervical ultrasound:
- What types of nodules were identified?
- What were the sonographic features that could be used to differentiate them?
- Adenomas, cysts, adenocarcinoma, and nodular hyperplasia were identified.
- No sonographic features could be used to differentiate these lesions.
Pollard, R.E., Bohannon, L.K. & Feldman, E.C. (2014) PREVALENCE OF INCIDENTAL THYROID NODULES IN ULTRASOUND STUDIES OF DOGS WITH HYPERCALCEMIA (2008-2013). Veterinary Radiology & Ultrasound 56, 63–67
According to a 1997 study, what were the typical sonographic features of parathyroid lesions? Were there any distinguishing features between neoplastic and non-neoplastic lesions?
- All parathyroid lesions were round or oval-shaped and hypoechoic to the thyroid parenchyma. Some had distal acoustic enhancement.
- Significant difference in size between neoplastic and non-neoplastic nodules.
- All neoplastic nodules were > 4mm in maximum dimension
- All but one hyperplastic nodules were < 4mm – this larger one was secondary to CKD
Wisner, VRU 1997 38(6)
What were the significant findings related to contrast-enhanced ultrasonography of canine insulinomas?
Nakamura, K., Lim, S.-Y., Ochiai, K., et al. (2014) CONTRAST-ENHANCED ULTRASONOGRAPHIC FINDINGS IN THREE DOGS WITH PANCREATIC INSULINOMA. Veterinary Radiology & Ultrasound 56, 55–62
- All pancreatic nodules were visible on B-mode ultrasound
- CEUS resulted in increased conspicuity of the nodules and better demarcation of their margins.
- CE patterns were different in all three nodules (hyperechoic for 5 sec, mildly hyperechoic for 1 sec, hypoechoic for over 30 sec)
What is the general pattern of contrast enhancement in the feline small bowel?
- Rapid, intense enhancement of the serosa and submucosa
- Gradual enhancement of the remainder of the wall
- At peak enhancement, loss of demarcation between wall layers
- Slow wash-out, with submucosa wash out occurring last
Diana, A., Specchi, S., Baron Toaldo, M., et al. (2011) CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SMALL BOWEL IN HEALTHY CATS. Veterinary Radiology & Ultrasound 52, 555–559
CEUS of the small bowel in healthy cats:
- Arrival time
- Time to peak (from injection)
Arrival time: 7 sec
TTP: 10 sec
Diana, A., Specchi, S., Baron Toaldo, M., et al. (2011) CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SMALL BOWEL IN HEALTHY CATS. Veterinary Radiology & Ultrasound 52, 555–559
What are the 3 vascular patterns described on CEUS of dogs with pituitary-dependent HAC? What is the normal CE pattern?
Normal: central vessel –> radial vessels –> homogeneous CE with phrenicoabdominal vein visible
Three Abnormal Patterns in PDH:
- central vessel –> disorderly uptake in the entire gland –> homogeneous CE
- no central vessel –> disorderly uptake in the entire gland –> homogeneous CE
- abnormal, nodular-appearing vessels –> progressive nodular appearance –> homogeneous CE
What was the relationship of adrenal contrast enhancement pattern of dogs with PDH and their biochemical paramenters?
The disorderly CE pattern was more pronounced in dogs with higher cortisol levels (> 24 ug/dl)
Bargellini, P., Orlandi, R., Paloni, C., et al. (2013) CONTRAST-ENHANCED ULTRASONOGRAPHIC CHARACTERISTICS OF ADRENAL GLANDS IN DOGS WITH PITUITARY-DEPENDENT HYPERADRENOCORTICISM. Veterinary Radiology & Ultrasound 54, 283–292
What is a normal gallbladder ejection fraction (EF)? How is a standard GB EF study performed?
12 hour fast –> measure GB volume –> feed a standardized meal +/- administer erythromycin –> re-measure GB at set time points within 2 hours of meal.
Normal EF > 25% within 2 hours
Tsukagoshi, T., Ohno, K., Tsukamoto, A., et al. (2011) DECREASED GALLBLADDER EMPTYING IN DOGS WITH BILIARY SLUDGE OR GALLBLADDER MUCOCELE. Veterinary Radiology & Ultrasound 53, 84–91
How does the ejection fraction compare between the following groups of dogs/gallbladders: normal, mobile sludge, immobile sludge, mucocele?
What about the GB volume?
EJECTION FRACTION
- DECREASED in all groups compared to normal dogs
- Mobile sludge EF > immobile = mucocele
VOLUME: INCREASED in all groups compares to normal dogs; largest in mucocele group
Tsukagoshi, T., Ohno, K., Tsukamoto, A., et al. (2011) DECREASED GALLBLADDER EMPTYING IN DOGS WITH BILIARY SLUDGE OR GALLBLADDER MUCOCELE. Veterinary Radiology & Ultrasound 53, 84–91
What is the order of enhancement of intra-ocular structures when assessed with CEUS?
How does CEUS compare to Doppler evaluation?
- Retina, choroid, and retrobulbar structures
- Iris and ciliary body
- Optic nerve
Color Doppler signal intensity was much weaker, especially around the iris and ciliary body
What is the normal CE pattern of the spleen on CEUS?
Small splenic arteries become visible –> heterogeneous enhancement in the early phase –> homogeneous at peak CE
Rossi, F., Fina, C., Stock, E., et al. (2016) EFFECT OF SEDATION ON CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SPLEEN IN HEALTHY DOGS. Veterinary Radiology & Ultrasound 57, 276–281
What is the effect of butorphanol on CEUS of the spleen? What about dexmedetomidine?
No effect of torb
Dex causes reduced enhancement, appears diffusely hypoechoic. Measured parameters of time were all delayed (AT, TTP, wash-in) and peak intensity was reduced.
Rossi, F., Fina, C., Stock, E., et al. (2016) EFFECT OF SEDATION ON CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SPLEEN IN HEALTHY DOGS. Veterinary Radiology & Ultrasound 57, 276–281
What is the normal appearance of horse urine on US?
Swirling, echogenic. Likely due to mucus and calcium carbonate.
doi: 10.1111/j.1740-8261.2007.00297.x
How do you distinguish ureters from ductus deferens, ampullae and seminal vesicles?
What is the normal appearance of the UVJs?
- Peristaltic movements of the ureters can be used for ID of this structure.
- Ductus deferens is seen dorsomedial to the ureters.
- Ampullae are very round and hyperechoic, dorsolateral to ureters.
- Seminal vesicles are fluid-filled and dorsal to the urethra.
The UVJs are seen as somewhat flattened, oval-shaped structures on the dorsal surface of the bladder.
doi: 10.1111/j.1740-8261.2007.00297.x
Some normal measurements of the horse LUT:
- Bladder wall
- Ureteral wall
- Urethral wall
- Bladder wall: 3mm
- Ureteral wall: 1.8 mm
- Urethral wall: 5mm
Clumping of the suspended echoes in cat bladder is associated with increased concentration of what compound?
Diacylglycerol – very hydrophobic
doi: 10.1111/vru.12100
What is the relationship between renal cortical echogenicity and lipiduria?
Increasing cortical echogenicity is related to increased concentrations of urinary lipid
doi: 10.1111/vru.12100
What is twinkle artifact?
What factors will increase twinkle artifact?
Twinkle artifact occurs deep to a strongly reflective surface, appearing as a quickly fluctuating mixture of Doppler signals. This occurs due to a narrow band signal error.
Dependent on size and surface texture of a structure, but not mineral composition.
Louvet, A. (2006) TWINKLING ARTIFACT IN SMALL ANIMAL COLOR-DOPPLER SONOGRAPHY. Veterinary Radiology & Ultrasound 47, 384–390
Muscularis layer thickening is associated with infiltrative disease in what layer(s) of the small bowel in cats? What about lymphadenopathy?
Muscularis thickening is associated with disease in the mucosa and submucosa
Lymphadenopathy is associated with disease in the mucosa and submucosa +/- muscularis
Zwingenberger, A.L., Marks, S.L., Baker, T.W., et al. (2010) Ultrasonographic Evaluation of the Muscularis Propria in Cats with Diffuse Small Intestinal Lymphoma or Inflammatory Bowel Disease. Journal of Veterinary Internal Medicine 24, 289–292
What are the suggested etiologies of muscularis layer thickening?
Zwingenberger, A.L., Marks, S.L., Baker, T.W., et al. (2010) Ultrasonographic Evaluation of the Muscularis Propria in Cats with Diffuse Small Intestinal Lymphoma or Inflammatory Bowel Disease. Journal of Veterinary Internal Medicine 24, 289–292
Muscular hypertrophy, muscular shortening, or infiltrative disease not identified on histopath (i.e. not biopsied at the same site as seen on US)
Zwingenberger, A.L., Marks, S.L., Baker, T.W., et al. (2010) Ultrasonographic Evaluation of the Muscularis Propria in Cats with Diffuse Small Intestinal Lymphoma or Inflammatory Bowel Disease. Journal of Veterinary Internal Medicine 24, 289–292
This paper had discordant results about the sonographic appearance of IBD and LSA in comparison to other studies. What was the significant difference in this patient population?
IBD was not associated with muscularis thickening.
What are the normal US measurements of thickness for the following:
- Esophageal wall
- Cardia wall
- Pyloric wall
- Muscularis layer of the pylorus
- Length of the proximal duodenal submucosal thickening
- Esophageal wall: 5 mm
- Cardia wall: 5 mm
- Pyloric wall: 4.4 mm
- Muscularis layer of the pylorus: 2.5 mm
- Length of the proximal duodenal submucosal thickening: 4.7 mm
Couturier, L., Rault, D., Gatel, L., et al. (2012) ULTRASONOGRAPHIC CHARACTERIZATION OF THE FELINE CARDIA AND PYLORUS IN 34 HEALTHY CATS AND THREE ABNORMAL CATS. Veterinary Radiology & Ultrasound 53, 342–347
In a study of arteriportal communications, extra-hepatic AP communications were classified as (AVF/AVM) and intra-hepatic AP communications were classified as (AVF/AVM).
What distinguishes AVF from AVM?
AVF - direct communication between artery and vein, usually acquired
AVM - network of abnormal vessels representing AV connection (“nidus”). Suspected to be congenital.
Extra-hepatic = AVF
Intra-hepatic = AVM
Specchi, S., Rossi, F., Weisse, C., et al. (2018) Canine and feline abdominal arterioportal communications can be classified based on branching patterns in computed tomographic angiography. Veterinary Radiology and Ultrasound 59, 687–696
What are the MRI features of thiamine deficiency?
Bilaterally symmetrical T2w-hyperintensities of the lateral geniculate nuclei, caudal colliculi, facial nuclei, medial vestibular nuclei, red nuclei, and cerebellar nodulus
LG CC F MV R CN
LarGe Crunchy Cats Forcibly Meowing Very Rudely. CAT NO!
What are some of the MRI findings associated with clinically relevant hydrocephalus (7)?
- V/B > 0.6
- Elevation of corpus callosum
- Flattening of the interthalamic adhesion (dorsoventrally)
- Periventricular edema
- Dilation of the olfactory recesses
- Thinning of the cortical sulci +/- subarachnoid space
- Disruption of the internal capsule adjacent to the caudate nucleus
The following images are obtained from a young Lionhead rabbit with acute GI stasis. Where are the abnormalities located? (Bonus points if you remember the diagnosis)
Marked thickening of the sacculus rotundus and the appendix with preservation of wall layering and mucosal speckling.
DX: granulomatous sacculitis and appendicitis
What is the maximum bronchial collapsibility identified on forced expiratory CT in healthy Beagles at 10 ml/kg? How about 15 ml/kg?
10 ml/kg: 25-55%
15 ml/kg: 50-74%
Highest in the left lung lobes
Kim, H., Kim, Y.J., Lee, H., et al. (2018) Computed tomographic and radiographic bronchial collapse may be a normal characteristic of forced expiration in dogs. Veterinary Radiology and Ultrasound 59, 551–563
How did the collapsibility of the bronchi compare between Beagles and asymptomatic brachycephalic dogs on forced expiratory CT (10 ml/kg)?
Brachys were more collapsible in all lung lobes (70-85%) compared to 25-55% in normal Beagles.
Yoon, H., Yu, J., An, G., et al. (2020) CT and radiographic evaluation of bronchial collapsibility at forced expiration in asymptomatic brachycephalic dogs. Veterinary Radiology and Ultrasound 61, 167–180
CT MPR imaging and radiography may OVERESTIMATE/UNDERESTIMATE the collapsibility of right caudal lobar bronchi in both brachycephalic and healthy Beagle dogs.
The degree of difference is greater is BEAGLES/BRACHYS.
OVERESTIMATE
The degree of overestimation is larger in brachycephalic dogs than that in healthy Beagle dogs
In a study comparing single-voxel and multi-voxel spectroscopy MRI of the canine brain:
- What differences were noted between metabolite ratios determined by single-voxel vs. multi-voxel techniques?
- What differences were noted between different areas of the brain?
- No difference between single and multi-voxel techniques
- N-acetyl aspartase was higher in the thalamus than in the parietal lobe
- Contralateral ROI were similar to one another
Lee, A.M., Beasley, M.J., Barrett, E.D., et al. (2018) Single-voxel and multi-voxel spectroscopy yield comparable results in the normal juvenile canine brain when using 3 Tesla magnetic resonance imaging. Veterinary Radiology and Ultrasound 59, 577–586
Rank the relative incidence of pharyngeal collapse in the following groups:
- Brachycephalic dogs
- Normal dolicho/mesaticephalic dogs
- Dolicho/mesaticephalic dogs with airway collapse
What other factors were significantly correlated to pharyngeal collapse?
Brachy > Doli with airway collapse > Normal
Other correlated factors positively correlated with PC:
- Higher BCS
- Higher BW
- Older
Regarding B-mode and power Doppler ultrasonography of the suspensory ligament in hoses, which of the following is INCORRECT?
- Both sound horses and lame horses had power Doppler flow within the SL
- B-mode abnormalities were identified in sound horses and lame horses
- Doppler score was increased in horses with more severe changes on B-mode ultrasound
- Doppler flow was identified in the SL of sound horses with no abnormalities on B-mode ultrasound
4 is incorrect. Power Doppler flow was only identified in horse had HAD abnormalities on B-mode ultrasound. This was noted in both the sound and lame horses and in lame horses.
Rabba, S., Grulke, S., Verwilghen, D., et al. (2018) B-mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses. Veterinary Radiology & Ultrasound 59, 453–460
Regarding the the plantaroproximal region of MTIII on a bone scan, what is the likely significance of the following in a lame horse that blocks to this region?
- Focal, intense IRU
- No IRU
- IRU at this level is specific, so unlikely to be a false positive –> this is likely a real lesion associated with the proximal suspensory ligament
- Poor sensitivity at this level –> normal does not rule out a lesion of the suspensory ligament! In fact, according to a study from 2006, most cases of SL desmitis appear normal on bone scans.
Quiney, L.E., Ireland, J.L. & Dyson, S.J. (2018) Evaluation of the diagnostic accuracy of skeletal scintigraphy in lame and poorly performing sports horses. Veterinary Radiology & Ultrasound 59, 477–489
What are some of the sonographic features that loosely indicated that a mammary mass is likely to be carcinoma?
W:L ratio >0.5
Perfusion parameters on CEUS
NOT: echotexture, margins, invasiveness, doppler
Feliciano, M.A.R., Ramirez, R.A.U., Maronezi, M.C., et al. (2018) Accuracy of four ultrasonography techniques in predicting histopathological classification of canine mammary carcinomas. Veterinary Radiology & Ultrasound 59, 444–452
What are the common sonographic abnormalities found in cats with cholangitis? Were there any features specific to either neutrophilic or lymphocytic cholangitis?
Can be normal, but common abnormalities include gallbladder debris, common bile duct dilation, liver enlargement, hyperechoic liver parenchyma, and an enlarged pancreas.
No significant difference, but cats with neutrophilic cholangitis seemed more likely to have changes consistent with pancreatitis.
Marolf, A.J., Leach, L., Gibbons, D.S., et al. (2012) Ultrasonographic Findings of Feline Cholangitis. Journal of the American Animal Hospital Association 48, 42–46
What sonographic features in cats were significantly associated with an increased probability of a positive result of bile culture?
When abnormalities of the gallbladder were noted, what was the sensitivity of this finding for positive culture? Specificity?
Gallbladder wall thickening and sludge were associated with increased probability of positive bile culture.
96% sensitivity: nearly all cats with positive results of bile bacterial culture had abnormal results of gallbladder US
50% specific: abnormal results of gallbladder US were poorly specific because of their common occurrence in cats with negative results of bile culture (high false-negative rate).
Policelli Smith, R., Gookin, J.L., Smolski, W., et al. (2017) Association between Gallbladder Ultrasound Findings and Bacterial Culture of Bile in 70 Cats and 202 Dogs. Journal of Veterinary Internal Medicine 31, 1451–1458
Name the origin and insertion of the iliopsoas muscle. Which parts of this muscle is consistently difficult to image on US?
Origin: transverse processes of L2 and L3
Insertion: lesser trochanter of the femur
The origin at L2 and the origin of the iliacus portion of the muscle were consistently difficult to image.
What are the common CT features of liposarcomas?
- Mean attenuation ranged from -50 to +50 HU
- Most masses had at least some fat attenuating area within them (77%)
- All liposarcomas are contrast enhancing (thus distinguishing them from lipomas and infiltrative lipomas)
- About half are encapsulated
- Few have mineralization
- Rarely can infiltrate bone
Fuerst, J.A., Reichle, J.K., Szabo, D., et al. (2017) COMPUTED TOMOGRAPHIC FINDINGS IN 24 DOGS WITH LIPOSARCOMA. Veterinary Radiology & Ultrasound 58, 23–28
Spinal MCT are uncommon and highly variable in their imaging features, but there are three “typical” forms that have been described.
What are these forms? What are some of the described imaging features of these tumors?
- Threee forms: extradural mass, paravertebral mas with invasion through foramina, or polyostotic spinal lesions
- MRI: T2 hyper, T1 hypo, mildly CE, STIR HYPER!!
-
CT:
- Extradural lesion: iso- to mildly hyperattenuating to cord causing severe compression
- Paravertebral mass: invaded through foramina, periosteal reaction of adjacent rib without lysis, mild CE
In a study of dogs with MUE, what imaging and/or clinical findings were significantly associated with survival/prognosis?
- Increased age and TNCC were significantly associated with poorer prognosis
- Midline shift, CSF total protein, and weight were not significant
Oliphant, B.J., Barnes Heller, H.L. & White, J.M. (2017) Retrospective Study Evaluating Associations Between Midline Brain Shift on Magnetic Resonance Imaging and Survival in Dogs Diagnosed With Meningoencephalitis of Unknown Etiology. Veterinary Radiology and Ultrasound 58, 38–43
Which of the following statements ARE CORRECT regarding GFR determination in cats with chronic kidney disease?
- Reliability of GFR measurements was high among experienced observers.
- Variations in GFR measurements rarely led to differences in clinical classification among less exeperienced observers.
- Changes in GFR values by (+) 0.4 ml/min/kg in cats with chronic kidney disease may be due to inherent variability rather than treatment effect.
- Cats with subclinical renal insufficiency have global GFR values between 1.2 and 2.5 ml/min/kg.
- Reliability of GFR measurements was high among experienced observers. TRUE
- Variations in GFR measurements rarely led to differences in clinical classification among MORE exeperienced observers.
- Changes in GFR values by (+) 0.4 ml/min/kg in cats with chronic kidney disease may be due to inherent variability rather than treatment effect. TRUE
- Cats with subclinical renal insufficiency have global GFR values between 1.2 and 2.5 ml/min/kg. TRUE
Variation of a horse’s stance can affect radiographic measurements of hoof balance. Which of the following measurements tend to be affected by these variations:
- Distal phalanx angle
- DIPJ angle
- PIPJ angle
- Lateral and medial joint spaces of the DIPJ
- Lateral and medial joint spaces of the PIPJ
- Hoof pastern axis
(Bold = affected by varied stance)
- Distal phalanx angle
- DIPJ angle
- PIPJ angle
- Lateral and medial joint spaces of the DIPJ
- Lateral and medial joint spaces of the PIPJ
- Hoof pastern axis
Pauwels, F.E., Rogers, C.W., Wharton, H., et al. (2017) Radiographic Measurements of Hoof Balance Are Significantly Influenced By a Horse’S Stance. Veterinary Radiology and Ultrasound 58, 10–17
This horse sustained a wound over the dorsal aspect of the thoracic limb DIPJ. There is soft tissue swelling and a draining tract at the site of the wound. How does this image help with the patient’s diagnosis?
Hair shafts within the dorsal recess of the PIPJ confirm intra-articular communication of the wound. This does not, however, always mean the joint is septic!
Hair = thin, linear, hyperechoic structures without shadowing
Partlow, J.L., Lustgarten, M. & Redding, W.R. (2017) Clinical, Ultrasonographic, and Arthroscopic Characteristics of Hair Shafts Within Synovial Structures of Seven Horses. Veterinary Radiology and Ultrasound 58, 76–82
What is Qs/Qp? How is it calculated? What is the proposed clinical significance?
- Qs/Qp is a measure of the magnitude of a cardiovascular shunt (systemic flow / pulmonary flow).
- Qs/Qp = SVLV / SV RV
- Qs/Qp < 1 is considered insignificant; up to 2 is borderline
Lee, Y., Jung, J., Park, J., et al. (2017) CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Veterinary Radiology & Ultrasound 58, 62–75
What is the developmental cause of a persistent left cranial vena cava?
Persistent left cranial vena cava occurs when the left-sided cranial venous cardinal system fails to evolve into the coronary sinus.
Lee, Y., Jung, J., Park, J., et al. (2017) CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Veterinary Radiology & Ultrasound 58, 62–75
What are the MRI features of Central Europearn tick-borne meningoencephalomyelitis?
- Bilaterally symmetric, T2w-hyperintense, T1w-hypointense, non-CE lesions WITHOUT edema or mass effect
- Locations: thalamus, hippocampus, brainstem, basal nuceli, ventral horn of the spinal cord
- OR: completely normal. Try MRI Spec.
Beckmann, K., Steffen, F., Ohlerth, S., et al. (2016) THREE TESLA MAGNETIC RESONANCE IMAGING FINDINGS IN 12 CASES OF CANINE CENTRAL EUROPEAN TICK-BORNE MENINGOENCEPHALOMYELITIS. Veterinary Radiology & Ultrasound 57, 41–48
Features of dogs with tick-borne encephalitis as seen on proton MRI spectroscopy.
- Which metabolites were different from control dogs?
- Which metabolites showed no significant difference?
- Affected dogs: higher glutamate/glutamine peaks, lower N-acetyl aspartate and creatine peaks (GGNC)
- No difference: myoinositol and choline signals
- No lactate or lipid signal in any dogs
Sievert, C., Richter, H., Beckmann, K., et al. (2017) Comparison Between Proton Magnetic Resonance Spectroscopy Findings in Dogs With Tick-Borne Encephalitis and Clinically Normal Dogs. Veterinary Radiology and Ultrasound 58, 53–61
When comparing the spectra between dogs with non-infectious meningoencephalitis and dogs with infectious tick-borne encephalitis, what is/are the only common feature(s) among metabolites?
What metabolites might act as a differentiating feature between infectious and non-infectious diseases?
Low concentration of N-acetyl aspartate and creatine is the only common feature.
Lipids, lactate, and taurine signal may help differentiate infectious from non-infectious.
- NONE of the tick-borne encephalitis patients included in this study had these markers, whereas they have been reported with non-infectious inflammatory disease.
Which scintigraphic measurement is most sensitive for detecting hyperthyroidism in cats?
Which measure correlates most closely with serum T4?
What are the three T/B ratios that can be performed, and which one is most sensitive?
- T/S ratio is the most sensitive
- TcTU (% uptake) is most associated with T4
- T/B (axilla, heart, trachea) – heart has best sensitivity
Peterson, M.E., Guterl, J.N., Rishniw, M., et al. (2016) EVALUATION OF QUANTITATIVE THYROID SCINTIGRAPHY FOR DIAGNOSIS AND STAGING OF DISEASE SEVERITY IN CATS WITH HYPERTHYROIDISM: COMPARISON OF THE PERCENT THYROIDAL UPTAKE OF PERTECHNETATE TO THYROID-TO-SALIVARY RATIO AND THYROID-TO-BACKGROUND RATIOS. Veterinary Radiology & Ultrasound 57, 427–440
CATS:
- What is a normal T/S ratio?
- What is a normal percent dose uptake?
- What is a normal T/S ratio? 0.9 (up to 1.5)
- What is a normal percent dose uptake? 0.2% to 4% depending on the paper
What is the prevalence of ectopic thyroid neoplasia in cats and where is it typically found?
Prevalence ~4%
Typically intra-thoracic (midline mediastinal) – >80%
Lingual ~10%
How does the biological behavior of insulinomas in ferrets differ from that of dogs and cats?
What is the typical sonographic appearance of an insulinoma in a ferret?
- Low metastatic rate in ferrets (<5%)
- Hypoechoic, round to oval shape, smooth margins, multiple nodules, in right or left lobe fairly equally with few found in the region of the body
- Abstract says primarily homogeneous, but more of the nodules were classified as heterogeneous in the actual paper….
- (43% homo- vs. 54% hetero-)
Wu, R.-S.S., Liu, Y.-J.J., Chu, C.-C.C., et al. (2017) Ultrasonographic features of insulinoma in six ferrets. Veterinary Radiology & Ultrasound 58, 607–612
What are the imaging features of oligodendrogliomas in the spinal cord?
- Intramedullary, eccentric, well-marginated, ovoid masses
- Cause increased diameter of the spinal cord and narrowing of the subarachnoid space
- Most commonly T1w iso- to hypointense and T2w hyperintense
- A case report (cited below) described a T1w-HYPERintense, extensive intramedullary oligodendroglioma (possibly due to extensive necrosis)
Schkeeper, A.E., Moon, R., Shrader, S., et al. (2016) IMAGING DIAGNOSIS-MAGNETIC RESONANCE IMAGING FEATURES OF A MULTIFOCAL OLIGODENDROGLIOMA IN THE SPINAL CORD AND BRAIN OF A DOG. Veterinary Radiology & Ultrasound 58, E49–E54
Differentials for T1w hyperintensity
- Fat
- Flow-related changes (slow flow)
- Cholesterol
- Calcification (manganese, iron, copper)
- Methemoglobin
- Melanin
- Necrosis
- Proteinaceous fluid
- Posterior pituitary (vasopressin)
FFCCMMPP + N
Regarding a paper comparing the MCPJ injury patterns between Thoroughbreds and Standardbreds on MRI:
- What was the relative prevalence of stress fractures?
- What was the relative prevalence of soft tissue injuries and what was the clinical relevance of these findings?
- Which population had a higher incidence of synovitis and joint capsule thickening?
- TBs had a higher incidence of stress fracture (40%)
- Both groups had a higher incidence of soft tissue injuries than had been previously reported, but these were most often not thought to be primarily responsible for lameness
- TBs 20%
- SBs 37%
- SBs had higher incidence of synovitis and joint capsule thickening
Olive, J., Serraud, N., Vila, T., et al. (2017) Metacarpophalangeal joint injury patterns on magnetic resonance imaging: A comparison in racing Standardbreds and Thoroughbreds. Veterinary Radiology and Ultrasound 58, 588–597
Regarding a paper comparing the MCPJ injury patterns between Thoroughbreds and Standardbreds on MRI:
- How did the characterization of subchondral bone injuries differ between SBs and TBs?
- TBs had an increased incidence and severity of subchondral sclerosis
- SBs had more frequent subchondral defects and resorption, and more frequent dorsomedial subchondral lesions
Olive, J., Serraud, N., Vila, T., et al. (2017) Metacarpophalangeal joint injury patterns on magnetic resonance imaging: A comparison in racing Standardbreds and Thoroughbreds. Veterinary Radiology and Ultrasound 58, 588–597
In a study using CT to describe phenotypic characteristics of LS stenosis in Labrador Retrivers:
- Which quantitative parameters were most predictive?
- What qualitative parameter was also predictive of LS stenosis?
- Fat area and fat area ratio
- FAR = fat area/mean vertebral body area
- Qualitative: trapezoidal shape of the intervertebral foramina at L6 and L7
Mukherjee, M., JONES, J.C., Holásková, I., et al. (2017) Phenotyping of lumbosacral stenosis in Labrador retrievers using computed tomography. Veterinary Radiology & Ultrasound 58, 565–580
Regarding nasal airflow resistance in English Bulldogs, which of the following is/are CORRECT:
- There was marked variation of airway resistance within the nasal cavity in most dogs.
- In most dogs, the middle and caudal portions of the nasal cavity had the highest resistance to airflow.
- Measures of airflow are likely underestimated by this model.
- Nasal turbinectomy may reduce airflow resistance at the level of highest resistance.
Regarding nasal airflow resistance in English Bulldogs, which of the following is/are CORRECT: (correct answers in bold)
- There was marked variation of airway resistance within the nasal cavity in most dogs.
- In most dogs, the middle and caudal portions of the nasal cavity had the highest resistance to airflow.
- Rostral portion of the nasal cavity had the highest resistance.
- Measures of airflow are likely underestimated by this model.
- Nasal turbinectomy may reduce airflow resistance at the level of highest resistance.
Hostnik, E.T., Scansen, B.A., Zielinski, R., et al. (2017) Quantification of nasal airflow resistance in English bulldogs using computed tomography and computational fluid dynamics. Veterinary Radiology & Ultrasound 58, 542–551
Regarding the use of CT arthrography for evaluating the ovine stifle:
- What was the sensitivity and specificity for detection of articular cartilage defects?
- What was the PPV and NPV?
- What locations had the highest number of lesions?
- Excellent sens/spec (high 90s)
- PPV 98%; NPV 85%
- Most frequent locations of lesions:
- Middle third of each of the following: medial tibial condyle, medial femoral condyle, and the patella
- Similar to humans
Hontoir, F., Clegg, P., Simon, V., et al. (2017) Accuracy of computed tomographic arthrography for assessment of articular cartilage defects in the ovine stifle. Veterinary Radiology & Ultrasound 58, 512–523
What are the primary CT features of dogs with Angiostrongylus vasorum? What is the correlation between imaging findings and severity of clinical signs?
- Multifocal increased lung attenuation affecting multiple lobes with a primarily peripheral distribution
- GGO and consolidation
- Nodules with ill-defined margins
- TB LN enlargement in most dogs
- Pulmonary arterial filling defects in some dogs??
- They literally only mention this as an afterthought in the discussion section. Like assholes.
- Mild peripheral bronchial dilation
Coia, M.E., Hammond, G., Chan, D., et al. (2017) Retrospective evaluation of thoracic computed tomography findings in dogs naturally infected by Angiostrongylus vasorum. Veterinary Radiology & Ultrasound 58, 524–534
CT lymphangiography for the identification of sentinel lymph nodes in dogs with tumors of the head:
- What was the success rate? What complicating factors were identified that reduced the success of this procedure?
- How long did it typically take for the sentinal LN to be identified?
- Successful in 89% within 3 minutes of injection
- Pressure from ET tube ties or recumbency may have interrupted lymphatic flow.
Grimes, J.A., Secrest, S.A., Northrup, N.C., et al. (2017) Indirect computed tomography lymphangiography with aqueous contrast for evaluation of sentinel lymph nodes in dogs with tumors of the head. Veterinary Radiology & Ultrasound 58, 559–564
CT lymphangiography for the identification of sentinel lymph nodes in dogs with tumors of the head:
- What was the predominent pattern of sentinel lymph nodes?
- What were the unexpected patterns of sentinel lymph nodes?
- What volume of contrast is recommended?
- Majority of SLNs were the ipsilateral mandibular LN
- Contralateral mandibular LN or both ipsilateral and contralateral mandibular LN in 12%
- Dose: 1 ml
Grimes, J.A., Secrest, S.A., Northrup, N.C., et al. (2017) Indirect computed tomography lymphangiography with aqueous contrast for evaluation of sentinel lymph nodes in dogs with tumors of the head. Veterinary Radiology & Ultrasound 58, 559–564
Regarding CT morphometry of tympanic bulla shape and position in brachycephalic and mesaticephalic dog breeds:
- What was the major finding regarding bulla shape?
- Volume?
- Overlap with TMJ?
- CKCS had significantly flatter bullae
- Pugs and both types of Bulldogs had thicker walls of the bullae and an increasingly rostral location of the bullae relative to the TMJ
- No significant relationship between bulla morphology and middle ear effusion, however about 50% of brachycephalics had effusion
- 68% of CKCS – primary secretory otitis media
- 0% of Labs/JRTs had it (how is this not significant?)
Mielke, B., Lam, R. & ter Haar, G. (2017) Computed tomographic morphometry of tympanic bulla shape and position in brachycephalic and mesaticephalic dog breeds. Veterinary Radiology & Ultrasound 58, 552–558
Regarding PET imaging of the equine distal limb:
- What was the most metabolically active anatomic structure?
- Which anatomic structure(s) were the least active?
- What was the range of lesions detected in this patient population?
- Coronary band = most active
- Tendons = least active
- Lesions included:
- Lysis of the flexor cortex (granulation tissue = active)
- Lesions of the flexor tendons and SL (active >> inactive)
- Multifocal lack of uptake in the lamina of horses with laminitis
What is the likely cause of this pattern of IRU?
Focal muscle uptake (and possible myonecrosis) after a peroneal nerve block.
Superimposed with tibial diaphysis on the lateral view, but slightly lateral to the tibia on the caudal view.
Griffin IV, J.F., Young, B.D., Fosgate, G.T., et al. (2010) FOCAL SKELETAL MUSCLE UPTAKE OF 99mTECHNETIUM-HYDROXYMETHYLENE Diphosphonate FOLLOWING PERONEAL NERVE BLOCKS IN HORSES. Veterinary Radiology & Ultrasound 51, 338–343
What are the MRI features of intraventricular ependymomas in cats?
How do these features compare to dogs?
- T2w/FLAIR/PD hyperintense to gray matter
- T1w iso- to hyperintense
- Dogs are iso- to hypointense
- T2* GRE iso- to hyperintense
- CE primarily strong and homogeneous, but can be mild
DeJesus, A., Cohen, E.B., Galban, E., et al. (2017) MAGNETIC RESONANCE IMAGING FEATURES OF INTRAVENTRICULAR EPENDYMOMAS IN FIVE CATS. Veterinary Radiology & Ultrasound 58, 326–333
What is a pseudo-odontoma?
What is the typical CT appearance of a pseuo-odontoma?
- Pseudo-odontoma = odontogenic dysplasia in ageing rodents and lagomorphs; odontogenic tissue is continuously deposited in the apical area of the affected incisor, causing remodeling and disruption of the alveolar bone
- CT Appearance:
- Hyperattenuating pulp and dentin in the reserve crown and apical zone
- Multilobular hyperattenuating mass encroaching on midline and growing caudally and ventrally
- 60% of prairie dogs with maxillary incisor pseudo-odontomas had deformities of the hard palate with the mass bulging into the oral cavity
Pelizzone, I., Di Ianni, F., Volta, A., et al. (2017) COMPUTED TOMOGRAPHIC FEATURES OF INCISOR PSEUDO-ODONTOMAS IN PRAIRIE DOGS ( CYNOMYS LUDOVICIANUS). Veterinary Radiology & Ultrasound 58, 273–283
What are the MRI features of idiopathic oculomotor neuropathy?
What is the prognosis with this condition?
- MRI features:
- Variable enlargement - mild to marked in 11/14
- Variable CE - mild to marked in 12/14
- More often focal than diffuse
- Lesions restricted to CN III
- Prognosis: non-progressive, improves in 50%
Tetas Pont, R., Freeman, C., Dennis, R., et al. (2017) CLINICAL AND MAGNETIC RESONANCE IMAGING FEATURES OF IDIOPATHIC OCULOMOTOR NEUROPATHY IN 14 DOGS. Veterinary Radiology & Ultrasound 58, 334–343
Name the numbered images (HORSE TARSUS)
doi: 10.1111/vru.12444
Lateral is to the right and plantar to the top.
- SDFT
- lateral digital flexor tendon
- medial digital flexor tendon;
- metatarsocalcaneal ligament
- accessory ligament of the suspensory ligament (SL)
- long plantar ligament inserting on the fourth metatarsal bone (MtIV)
- vessel
- interosseous ligament between the third and the MtIV bones
Arrows: accessory ligament of the deep digital flexor tendon
Regarding thoracic radiographs in rats:
- What findings were associated with neoplasia?
- What findings were associated with infectious disease?
- What signalment characteristics favored neoplasia over infectious disease?
- What findings were associated with neoplasia?
- Cranial mediastinal mass
- What findings were associated with infectious disease?
- Alveolar pulmonary pattern/atelectasis with mediastinal shift/nodules (abscesses)
- What signalment characteristics favored neoplasia over infectious disease?
- None.
- Pleural effusion seen with both
Fouriez-Lablée, V., Vergneau-Grosset, C., Kass, P.H., et al. (2017) COMPARISON BETWEEN THORACIC RADIOGRAPHIC FINDINGS AND POSTMORTEM DIAGNOSIS OF THORACIC DISEASES IN DYSPNEIC COMPANION RATS ( RATTUS NORVEGICUS). Veterinary Radiology & Ultrasound 58, 133–143
What is illustrated in the sagittal single-shot turbo spin echo (SSTSE) image in a dachshund with acute pelvic limb paralysis?
What is the proposed cut-off for the disease process?
Attenuation of the subarachnoid fluid, either due to spinal cord swelling of changes to the fluid composition related to myelomalacia.
The CSF:L2SSTSE ratio is small (1.9), which makes it unlikely that this dog has myelomalacia. Proposed cut-off = 7.4
Gilmour, L.J., Jeffery, N.D., Miles, K., et al. (2017) SINGLE-SHOT TURBO SPIN ECHO PULSE SEQUENCE FINDINGS IN DOGS WITH AND WITHOUT PROGRESSIVE MYELOMALACIA. Veterinary Radiology & Ultrasound 58, 197–205
What is the likely cause of the abnormalities in this goat?
Summarize the findings described in this case.
Bilaterally symmetric T2w-hyperintensity of the cerebral and cerebellar gray matter with moderate CE of the gray matter lesions and the leptomeninges.
Dx: polioencephalomalacia
Ertelt, K., Oevermann, A., Precht, C., et al. (2016) MAGNETIC RESONANCE IMAGING FINDINGS IN SMALL RUMINANTS WITH BRAIN DISEASE. Veterinary Radiology & Ultrasound 57, 162–169
What is the likely cause of the MRI abnormalities in this lamb?
Summarize the reported findings.
- Bilaterally symmetrical lesions of the basal nuclei, thalamus, midbrain, and brainstem.
- Variably T2w-hyperintense +/- hypointense peripherally
- T1w hypointense in one; mixed hypo + hyperintense in another
- Dx: enterotoxemia – severe generalized vasogenic edema
Ertelt, K., Oevermann, A., Precht, C., et al. (2016) MAGNETIC RESONANCE IMAGING FINDINGS IN SMALL RUMINANTS WITH BRAIN DISEASE. Veterinary Radiology & Ultrasound 57, 162–169
What is the likely cause of the abnormalities in this goat?
Listeriosis
- Age the following lesions.
- What is creating the appearance of A and C?
- Where is B located?
- Age the following lesions.
A: Late subacute; B: Acute; C: Acute
- What is creating the appearance of A and C?
A: hypointense halo caused by clot retraction over time
C: hematocrit effect – hypodense fluid = serum and hyperdense material = concentrated RBCs
- Where is B located? Epidural hemorrhage
What is the typical appearance of subdural hemorrhage vs. epidural hemorrhage?
- Subdural: crescent-shaped, can cross suture lines but is limited by falx and tentorium
- Epidural: bi-convex (lens-shaped), can cross dural folds but NOT sutures
Age this hemorrhage (T1 and T2 sequences)
Acute (~48 hours)
Parizel, P.M., Makkat, S., Van Miert, E., et al. (2001) Intracranial hemorrhage: Principles of CT and MRI interpretation. European Radiology 11, 1770–1783
Describe the evolution of intracranial hemorrhage over time on CT and MRI
Fractures of the central tarsal bone in horses:
- What is the typical orientation in racehorses vs. non-racehorses?
- What view was most helpful for identifying these fractures in non-racehorses?
- What is the typical orientation in racehorses vs. non-racehorses?
- Racehorses: proximal-distal orientation
- Non-racehorses: dorsomedial to plantarolateral orientation
- What view was most helpful for identifying these fractures in non-racehorses? PLDMO
Knuchell, J.A., Spriet, M., Galuppo, L.D., et al. (2016) FRACTURE OF THE CENTRAL TARSAL BONE IN NONRACEHORSES: FOUR CASES. Veterinary Radiology & Ultrasound 57, 403–409
Describe the abnormality. What is the most likely job of this horse?
Slab fracture in a dorsal plane of the central tarsal bone. This is most likely a racehorse.
Murphey, E.D., Schneider, R.K., Adams, S.B., et al. (2000) Long-term outcome of horses with a slab fracture of the central or third tarsal bone treated conservatively: 25 cases (1976-1993). Journal of the American Veterinary Medical Association 216, 1949–1954
Identify the following lesions of the equine stifle (A-D)
A & B: cranial cruciate ligament tears
C & D: caudal cruciate ligament tears
Nelson, B.B., Kawcak, C.E., Goodrich, L.R., et al. (2016) COMPARISON BETWEEN COMPUTED TOMOGRAPHIC ARTHROGRAPHY, RADIOGRAPHY, ULTRASONOGRAPHY, AND ARTHROSCOPY FOR THE DIAGNOSIS OF FEMOROTIBIAL JOINT DISEASE IN WESTERN PERFORMANCE HORSES. Veterinary Radiology & Ultrasound 57, 387–402
Name the injury in this equine stifle
DX: cranial medial meniscotibial ligament (CrMMTL) tear
(A) Transverse plane image and (B) dorsal plane CTA image, medial is to the right in both images.
The white arrows correspond to areas of contrast diffusion (hyperattenuation) within the CrMMTL suggestive of a longitudinal tear
Ex vivo correlation of small intestinal wall layering with histology in dogs:
- Discuss the variations in sonographic appearance between these sections of bowel (top left = ileum, bottom left = duodenum, right = jejunum)
- What was the conclusion of this paper vis-a-vis correlation with histology?
Top left: Peyer’s patches in the ileum
Bottom left: dual mucosal echogencity; hyperechoic portion = villi and hypoechoic portion = lamina propria
Right: Hyperechoic band separating the interface bettwen the inner circular layer and outer longitudinal muscular layers
Overall no significant differences between US and histo
Le Roux, A.B., Granger, L.A., Wakamatsu, N., et al. (2016) EX VIVO CORRELATION OF ULTRASONOGRAPHIC SMALL INTESTINAL WALL LAYERING WITH HISTOLOGY IN DOGS. Veterinary Radiology & Ultrasound 57, 534–545
Images obtained from 3 different horses at C7.
(A) Normal vertebral anatomy
(B) Unilateral left-sided presence of a ventral protuberance at the transverse process of C7 (arrow) in concurrence with a vertebral foramen at the base of the transverse process (asterisk)
(C) Bilateral presence of a ventral protuberance at the transverse process of C7 (arrows).
Veraa, S., Bergmann, W., van den Belt, A.-J., et al. (2016) EX VIVO COMPUTED TOMOGRAPHIC EVALUATION OF MORPHOLOGY VARIATIONS IN EQUINE CERVICAL VERTEBRAE. Veterinary Radiology & Ultrasound 57, 482–488
- What ratio is used to predict chronic bronchitis in dogs on CT?
- What is the cut-off?
- Where is this measured?
- Bronchial wall:pulmonary artery diameter
- > 0.6 indicates wall thickening with 77% sensitivity and 100% specificity
- Measured in the cranial lung lobes
Szabo, D., Sutherland-Smith, J., Barton, B.A., et al. (2014) ACCURACY OF A COMPUTED TOMOGRAPHY BRONCHIAL WALL THICKNESS TO PULMONARY ARTERY DIAMETER RATIO FOR ASSESSING BRONCHIAL WALL THICKENING IN DOGS. Veterinary Radiology & Ultrasound 56, 264–271
Although there is significant overlap, what clinical and imaging findings may help differentiate eosinophilic bronchopneumopathy (EBP) and eosinophilic pulmonary granulomatosis (EPG)?
EPG is differentiated by:
- more severe clinical signs
- presence of multiple masses of various sizes that tend to obliterate the normal pulmonary architecture
- heterogeneous, honeycomb-like enhancement pattern characterized by multiple non-enhancing, hypoattenuating areas (NOTE: also seen in 1 dog with EBP)
- poorer prognosis
- However it is uncertain if eosinophilic pulmonary granulomatosis represents a progressive form of EBP or a different disease
Fina, C., Vignoli, M., Terragni, R., et al. (2014) COMPUTED TOMOGRAPHIC CHARACTERISTICS OF EOSINOPHILIC PULMONARY GRANULOMATOSIS IN FIVE DOGS. Veterinary Radiology & Ultrasound 55, 16–22
Mesquita, L., Lam, R., Lamb, C.R., et al. (2014) COMPUTED TOMOGRAPHIC FINDINGS IN 15 DOGS WITH EOSINOPHILIC BRONCHOPNEUMOPATHY. Veterinary Radiology & Ultrasound 56, 33–39
Name the labeled structures in this transverse section (at the level of the coronary band)
- P2
- Navicular bone
- Dorsal recess of the DIPJ
- Common digital extensor tendon
- Coronal cushion
- Collateral (ungular) cartilage
CT of melanomas in horses:
- A median of ___ melanoma lesions were identified in each horse
- What were the typical locations of melanoma?
- What was the typical appearance?
- What is the authors’ theory about why melanomas have the characteristic appearance that they have?
- A median of 11 lesions were identified in each horse
- What were the typical locations of melanoma?
- Parotid SG, guttural pouch, surrounding the larynx and pharynx, and adjacent to the hyoid apparatus
- What was the typical appearance?
- Hyperattenuating to the masseter muscle; average HU 113
- About 25% were partially mineralized
- About 20% contained hypoattenuating regions likely representing necrosis
- What is the authors’ theory about why melanomas have the characteristic appearance that they have?
- Melanin has a high affinity for binding metal ions; the high atomic number of these theoretical ions would increase the attenuation of the melanomas
Dixon, J., Smith, K.C., Perkins, J., et al. (2016) COMPUTED TOMOGRAPHIC APPEARANCE OF MELANOMAS IN THE EQUINE HEAD: 13 CASES. Veterinary Radiology & Ultrasound 57, 246–252
Regarding anatomical variations of C6 in horses:
- What was the prevalence and in which breed was it most common? Was there a sex predilection?
- Was there a correlation between anatomical variation and intravertebral sagittal ratio?
- What was the association between anatomical variation and the presence of arthritis and/or cervical pain?
- What was the prevalence and in which breed was it most common? Was there a sex predilection?
- Prevalence: 25% and most often in WBs
- No sex predilection
- Was there a correlation between anatomical variation and intravertebral sagittal ratio?
- No significant difference in the measured IVSR but significantly more horses with anomalous C6 had IVSR < 0.5
- What was the association between anatomical variation and the presence of arthritis and/or cervical pain?
- No association with OA but positive association with cervical pain
DeRouen, A., Spriet, M. & Aleman, M. (2016) PREVALENCE OF ANATOMICAL VARIATION OF THE SIXTH CERVICAL VERTEBRA AND ASSOCIATION WITH VERTEBRAL CANAL STENOSIS AND ARTICULAR PROCESS OSTEOARTHRITIS IN THE HORSE. Veterinary Radiology & Ultrasound 57, 253–258
- What is the prevalence of supracollicular fluid accumulation (SFA) in dogs?
- What are the three patterns of SFA?
- What concomitant, breed-related malformation was seen in 20% of the dogs with SFA?
- What is illustrated by the arrow in this image?
- What is the prevalence of supracollicular fluid accumulation (SFA) in dogs?
- 2%
- What are the three patterns of SFA?
- Third ventricle (most common)
- Quadrigeminal cistern (least common)
- TV + QC
- What concomitant, breed-related malformation was seen in 20% of the dogs with SFA?
- Occipital dysplasia
- What is illustrated by the arrow in this image?
- Thin septation between the 3rd ventricle and the quadrigeminal cistern, showing there is no communication between these compartments
Bertolini, G., Ricciardi, M. & Caldin, M. (2016) MULTIDETECTOR COMPUTED TOMOGRAPHIC AND LOW-FIELD MAGNETIC RESONANCE IMAGING ANATOMY OF THE QUADRIGEMINAL CISTERN AND CHARACTERIZATION OF SUPRACOLLICULAR FLUID ACCUMULATIONS IN DOGS. Veterinary Radiology & Ultrasound 57, 259–268
Comparing RX, US, and MRI for the detection of shoulder OC/OCD in dogs:
- Which modality had the highest sensitivity? Highest specificity? Accuracy?
- What RX views were most useful?
- What MR sequences were most useful?
- Which modality had the highest sensitivity? Highest specificity? Accuracy?
- MRI = highest sensitivity and accuracy
- Then US > RX
- RX = highest specificity
- MRI = highest sensitivity and accuracy
- What RX views were most useful?
- Mediolateral view with supination and/or pronation in addition to neutral positioning
- What MR sequences were most useful?
- Sagittal T2w FS and/or PD FS FSE
Wall, C.R., COOK, C.R. & COOK, J.L. (2014) DIAGNOSTIC SENSITIVITY OF RADIOGRAPHY, ULTRASONOGRAPHY, AND MAGNETIC RESONANCE IMAGING FOR DETECTING SHOULDER OSTEOCHONDROSIS/OSTEOCHONDRITIS DISSECANS IN DOGS. Veterinary Radiology & Ultrasound 56, 3–11
What are the structures indicated by arrows in this image? What is the clinical significance of this finding?
Tympanic bone spicules (likely hyperostotic type).
Small spicules are likely a normal age-related change and it is likely that HTBS develop from these normal smaller spicules
Parzefall, B., Rieger, A., Volk, H.A., et al. (2015) PREVALENCE AND CHARACTERIZATION OF SMALL TYMPANIC BONE SPICULES AND DRUMSTICK-LIKE HYPEROSTOTIC TYMPANIC BONE SPICULES IN THE MIDDLE EAR CAVITY OF DOGS. Veterinary Radiology & Ultrasound 56, 25–32
- What was the prevalence of caudal aberrant turbinates in a group of 40 clinically healthy Bulldogs?
- What type of CATs were not identified in this group?
- Was the presence of CATs correlated with age, sex, or weight?
- What was the prevalence of caudal aberrant turbinates in a group of 40 clinically healthy Bulldogs?
- 100%
- What type of CATs were not identified in this group?
- No nasopharyngeal CATs
- Was the presence of CATs correlated with age, sex, or weight?
- No
Vilaplana Grosso, F., Haar, G. Ter & Boroffka, S.A.E.B.E.B. (2015) GENDER, WEIGHT, AND AGE EFFECTS ON PREVALENCE OF CAUDAL ABERRANT NASAL TURBINATES IN CLINICALLY HEALTHY ENGLISH BULLDOGS: A COMPUTED TOMOGRAPHIC STUDY AND CLASSIFICATION. Veterinary Radiology & Ultrasound 56, 486–493
Carotid body paragangliomas:
- What is the typical CT and MRI appearance?
- Where do these occur and what type of receptor are they associated with?
- What is the most common presenting complaint?
- What is the typical signalment?
- What is the typical CT and MRI appearance?
- CT: isodense to muscle often extends toward and sometimes invades through the base of the skull or bullae
- MRI: T2w AND T1 hyper to muscle
- Strongly, heterogeneously CE on both
- Variable margination
- Often entraps external carotid, sometimes invades jugular, maxillary, and linguofacial veins
- Where do these occur and what type of receptor are they associated with?
- Bifurcation of the common carotid
- Chemoreceptors
- What is the most common presenting complaint?
- Cervical mass, dyspnea
- Less common: Horner’s, head tilt, facial nerve paralysis, dysphagia
- What is the typical signalment?
- Older, MC, Boston
What is the hot structure in these images?
3rd trochanter
- What abnormality of the third trochanter is evident in these images?
- Was there a correlation between degree of IRU and lameness?
- What is the possible cause of persistently abnormal findings on recheck exam?
- What abnormality of the third trochanter is evident in these images? Fragmentation/fracture
- Was there a correlation between degree of IRU and lameness? No
- What is the possible cause of persistently abnormal findings on recheck exam? Third trochanter heals by fibrous union, so may be healing well but still appears fragmented
Shields, G.E., Whitcomb, M.B., Vaughan, B., et al. (2015) ABNORMAL IMAGING FINDINGS OF THE FEMORAL THIRD TROCHANTER IN 20 HORSES. Veterinary Radiology & Ultrasound 56, 466–473
Fourth ventricle arachnoid diverticula in dogs:
- What are the features described in the 2015 case series of 5 dogs with this condition?
- What is the prognosis?
- What is the typical signalment and clinical history?
- What are the features described in the 2015 case series of 5 dogs with this condition?
- Moderate to severe dilation of the entire ventricular system with periventricular edema
- Ventral displacement of the brainstem and dorsal elevation of the cerebellum with relatively reduced size of both structures
- Crescent-shaped cerebellum
- Signal void sign of the mesencephalic aqueduct in all dogs
- Moderate to severe syringohydromyelia with surrounding edema
- No CE anywhere
- What is the prognosis?
- Bad with or without surgery
- What is the typical signalment and clinical history?
- Pediatric dogs, Border Collies were 3/5 patients in this report
- Cervical hyperesthesia, obtundation, central vestibular, tetraparesis
Bazelle, J., Caine, A., Palus, V., et al. (2015) MRI CHARACTERISTICS OF FOURTH VENTRICLE ARACHNOID DIVERTICULA IN FIVE DOGS. Veterinary Radiology & Ultrasound 56, 196–203
Use of gadobenate dimeglumine for the detection of liver metastasis:
- What is the property of this contrast medium that allows for differentiation of metastatic nodules from normal parenchyma?
- What is the time delay for a hepatobiliary/hepatocellular phase?
- Which sequence was best for identifying metastatic nodules?
- What is the property of this contrast medium that allows for differentiation of metastatic nodules from normal parenchyma?
- In the hepatobiliary phase, a lesion containing no (or few) functional hepatocytes will appear hypointense
- In 6/10 cases, more nodules were identifiable in this phase
- What is the time delay for a hepatobiliary/hepatocellular phase?
- 23-25 min
- Which sequence was best for identifying metastatic nodules?
- 3D-FLASH
Louvet, A. & Duconseille, A.-C. (2015) FEASIBILITY FOR DETECTING LIVER METASTASES IN DOGS USING GADOBENATE DIMEGLUMINE; ENHANCED MAGNETIC RESONANCE IMAGING. Veterinary Radiology & Ultrasound 56, 286–295
Spirocerca strikes again…
- What is the prevalence of malignant transformation of esophageal nodules and what type of malignancy is found?
- What CT features were significantly different between non-neoplastic and neoplastic esophageal nodules?
- What is the prevalence of malignant transformation of esophageal nodules and what type of malignancy is found?
- Up to 25% of cases will transform
- OSA > FSA > undiff or chondrosarcoma
- What CT features were significantly different between non-neoplastic and neoplastic esophageal nodules?
- Non: smooth, non-mineralized, higher proportion of necro-purulent filled cavities occupying a larger region of the nodule, better perfusion
- Neoplastic: irregular, mineralized foci (93% of cases), worse perfusion
Kirberger, R.M., Cassel, N., Stander, N., et al. (2014) TRIPLE PHASE DYNAMIC COMPUTED TOMOGRAPHIC PERFUSION CHARACTERISTICS OF SPIROCERCOSIS INDUCED ESOPHAGEAL NODULES IN NON-NEOPLASTIC VERSUS NEOPLASTIC CANINE CASES. Veterinary Radiology & Ultrasound 56, 257–263
Equine hoof wall radiography:
- What are the histological layers of the hoof wall from superficial to deep?
- Which layer(s) make up the bulk of the dorsal hoof wall and how much of the total hoof wall thickness does this represent?
- What are the histological layers of the hoof wall from superficial to deep?
- Stratum externum, stratum medium, stratum internum, dermis parietis
- Which layer(s) make up the bulk of the dorsal hoof wall and how much of the total hoof wall thickness does this represent?
- Stratum externum + medium = 65% of total dorsal hoof wall
Goulet, C., Olive, J., Rossier, Y., et al. (2015) Radiographic and anatomic characteristics of dorsal hoof wall layers in nonlaminitic horses. Veterinary Radiology and Ultrasound 56, 589–594
Regarding a hyperechoic band within the colonic muscularis layer:
- What was the prevalence of this finding?
- What histological finding might explain this hyperechoic band?
- T/F: This finding was found in dogs with and without GI signs.
- What was the prevalence of this finding? 32%
- What histological finding might explain this hyperechoic band?
- Focal, mild, increased fibrous tissue in the myenteric plexus or tunica muscularis
- False: none of the dogs with this hyperechoic band had diarrhea
Heng, H.G., Lim, C.K., Miller, M.A., et al. (2015) PREVALENCE AND SIGNIFICANCE OF AN ULTRASONOGRAPHIC COLONIC MUSCULARIS HYPERECHOIC BAND PARALLELING THE SEROSAL LAYER IN DOGS. Veterinary Radiology & Ultrasound 56, 666–669
Elastography of spontaneous soft tissue injuries in horses:
- What level of stiffness was associated with acute, subacute, and chronic lesions?
- What is the explanation for the differences in stiffness?
- Was there a correlation with lesion echogenicity?
- What level of stiffness was associated with acute, subacute, and chronic lesions?
- Acute lesions = softer
- Subacute/chronic = stiffer
- What is the explanation for the differences in stiffness?
- In humans, areas of fiber disruption and hematoma formation are softer
- As tensons heal over time, the progressive collagen deposition increases stiffness
- Was there a correlation with lesion echogenicity?
- Hypoechoic lesions tend to be softer (likely more acute)
Lustgarten, M., Redding, W.R., Labens, R., et al. (2015) ELASTOGRAPHIC EVALUATION OF NATURALLY OCCURING TENDON AND LIGAMENT INJURIES OF THE EQUINE DISTAL LIMB. Veterinary Radiology & Ultrasound 56, 670–679
Image obtained at L7-S1. Name the labeled muscles.
- sacrocaudalis dorsalis medialis
- sacrocaudalis dorsalis lateralis
- longissiumus lumborum
- gluteus medius
- iliopsoas
Jones, J.C., Kimmett, K.L., Sharp, J.L., et al. (2019) CT measures of lumbosacral paraspinal muscle size are not correlated with CT measures of lumbosacral stability in military working Labrador Retrievers. Veterinary Radiology and Ultrasound 60, 513–524
- What is this lesion?
- What is the other characteristic appearance of this lesion?
- Where is it typically found?
- What other CNS abnormality is it commonly associated with?
- What is this lesion? Syringobulbia
- What is the other characteristic appearance of this lesion? Slit-like or bulbous
- Where is it typically found? Medulla oblongata
- What other CNS abnormality is it commonly associated with? Syringomyelia +/- ventriculomegaly
Williamson, B., Davies, E., Epperly, E., et al. (2019) Signs consistent with syringobulbia may be detected in dogs undergoing MRI. Veterinary Radiology & Ultrasound 60, vru.12733
What is the typical MRI appearance of granular cell tumors in dogs? What are the primary differential for these tumors?
- Well-defined, extra-axial masses with a plaque-like, sessile distribution involving the meninges
- T2w AND T1w hyper
- Marked, homogeneous CE
- Moderate edema and mass effect
- Main ddx: meningioma, histiocytic sarcoma
Anwer, C.C., Vernau, K.M., Higgins, R.J., et al. (2013) MAGNETIC RESONANCE IMAGING FEATURES OF INTRACRANIAL GRANULAR CELL TUMORS IN SIX DOGS. Veterinary Radiology & Ultrasound 54, 271–277
- What is the most likely diagnosis in this horse?
- What part(s) of the brain are affected?
- What is the most likely cause of this disease?
- What is the most likely diagnosis in this horse? Nigropallidal encephalomalacia
- What part(s) of the brain are affected? Substantia nigra and globus pallidus
- What is the most likely cause of this disease? Chronic ingestion of yellow star thistle or Russian knapweed
Sanders, S.G., Tucker, R.L. & Bagley, R.S. (2001) MAGNETIC RESONANCE IMAGING FEATURES OF EQUINE NIGROPALLIDAL ENCEPHALOMALACIA. Veterinary Radiology & Ultrasound 42, 291–296
