VRU 2018 Flashcards
Insulinomas display what intensity on T2W fat saturated images?
Hyperintensity
Insulinomas display what intensity on T1W fat saturated images post contrast?
Isointense… this is different from humans.
What is the most common endocrine tumor in dogs?
insulinoma
When is more likely to have rim T2W hyperintensity in insulinomas?
When they are bigger than 2cm in width
What is the most common area for insulinomas to mets to?
Regional lymph nodes (portal) liver Omentum/mesentery
What intensity are mets from insulinomas on T2W?
Hyperintense
Pollard et al: Prevalence of pharyngeal collaspe, What was the prevelance in brachycephalic dogs? Compared to nonbrachycephalics with airway collapse or without airway collapse?
72% - Brachycephalic
28% - NonBC with airway collapse
7% - NonBC withOUT airway collapse
Pollard et al: Prevalence of pharyngeal collaspe, what is the definition of pharyngeal collapse?
Collapse due to dorsal displacement of the soft palate and ventral deviation of the dorsal pharyngeal wall
Pollard et al: Prevalence of pharyngeal collaspe, Partial collapse of the pharynx is considered what?
>50% collapse
Happens most commonly on inspiration
Oh et al: CT bronchial collaspe normal dogs: What was the percentage of collapse seen in the bronchi regularly in this paper?
~50% in normal dogs
Oh et al: CT bronchial collaspe normal dogs: What bronchi were most clinical affect?
Left cranial (dorsal and ventral segments) and left caudal lungs
The left cranial dorsal segment and the left caudal had collapse of over 50% on all of them.
Mavromatis et al: Utility of two view vs 3 view abdominal rads in canine: In this paper they found what significant difference between 3 and 2 view on acute abdomens in dogs?
No significant difference so said not to use it.
This is contraversial.
Mostafa et al: Prevalence of MCP in lame large breed dogs on rads: What was the prevalence of medial coronoid process disease in large breed dogs?
21%
Mostafa et al: Prevalence of MCP in lame large breed dogs on rads: What breeds were most associated with this disease?
Goldens
Labrador
30% of all cases
Mostafa et al: Prevalence of MCP in lame large breed dogs on rads: Gray-scale values (changes in regions based on opacity) was significantly increased in what region and associated with MCP disease? What region was not?
Subtrochlear-ulnar region grayscale value was increased
Radial grayscale was not.
Mostafa et al: Prevalence of MCP in lame large breed dogs on rads: Most common radiographic findings in diseased dogs?
- MCP shortened of deformed
- Subtrochlear-ulnar sclerosis.
- Osteophytosis (periarticular) - (50%)
- Medial coronoid process osteophytosis (7.5%)
Hahn et al: CT and rad comparsion of asmatic cats: What do the soft tissue pulmonary nodules represent on rad of asmatic cats?
Eosinophilic granulomas or mucus plugs
Hahn et al: CT and rad comparsion of asmatic cats: What does the “tree in bud” sign on CT represent?
Bronchiolar dilation with bronchiolar plugging by mucus, pus or fluid.
Usually associated with Bronchial disease
IT is non-enhancing
Hahn et al: CT and rad comparsion of asmatic cats: What is the definition of a bronchioles?
Lacking cartilaginous wall
Measuring <2mm
Hahn et al: CT and rad comparsion of asmatic cats: What is honeycombing and what does it mean?
It is peripherial cystic structures that are cogent with thick distinct walls.
This is evidence of fibrosis.
Hahn et al: CT and rad comparsion of asmatic cats: What is a mosaic pattern on CT and what does it mean?
A mosaic pattern is a patch work of hyper and hypoattenuation throughout the lungs.
This can mean two things:
- Vascular disease causing shunting away from the affect area
- Air trapping caused by bronchial disease or focal pulmonary emphysema.
- Pulmonary emphysema is a permanent elargement of the air spaces caused by destruction of the walls of the air spaces. - On CT it shows loss of normal tissue
Only way to differentiate this is using expiratory series which if bronchial disease you will see the mosaic pattern more but if vascular then it will stay the same.
Hahn et al: CT and rad comparsion of asmatic cats: What lungs were most affected on both modalities?
Right cranial and right caudal
Hahn et al: CT and rad comparsion of asmatic cats: Which modality found the most lesions?
CT and some were asymptomatic
Hahn et al: CT and rad comparsion of asmatic cats: What was the cutoff for HUs for dogs with pleural effusion and differentiating the types of pleural effusion? Cats?
14HU in dogs
<14HU likely transduate or chlyous
>14HU likley exudate, modified transudate or hemorrhage
No difference was noted in cats!
Pollard et al: Pharyngeal collapse in dogs: What specific brachycephalic breeds are predisposed?
English bulldogs
French bulldogs
Pugs
What type of sequence is a STIR and FLAIR?
FLAIR is a T2W
STIR is T1W
Dichinson et al: Loss of fluid suppression on post contrast FLAIR images: What des this mean to loose fluid suppression on post contrast FLAIR images?
Leakage of contrast in the ventricles or arachnoid space.
Gremillion et al: Radiographic findings and clinical factors in dogs with colonic torsions: What are radiographic findings of a colonic torsion?
- Segmental distention of the colon
- Focal narrowing of the colon
- Displacement of the cecum
- Displacement of the descending colone
- Mild to no SI distention
Gremillion et al: Radiographic findings and clinical factors in dogs with colonic torsions: What is the torsion sign after giving a barium enema?
Focal narrowing of the colon
Lognitudinal striation in a helical pattern
Gremillion et al: Radiographic findings and clinical factors in dogs with colonic torsions: What was the most common clinical signs?
- Vomiting
- Abdominal pain
- Hypovolemic shock.
Secrest et al: Triple phase CT of the pancreas in normal cats: Which limb of the pancreas was the biggest in cats?
Left lobe
No association with sex or age.
Secrest et al: Triple phase CT of the pancreas in normal cats: what was the mean attenuation of a normal cat pancreas and what was the highest phase?
Pre constrat - 45
Arterial - 96
Portal - 166 *** Highest
Delayed - 122
Sonet et al: Evaluation of the US findings with lepto: What were the findings (Renal, liver, gallbladder, intestines, peritoneum)?
Renal - Found in all dogs
- Increased cortical echogenicity - 100%
- Increased medullary echogenicity - 85%
- Reduced corticomedullary definition - 80%
- Cortical thickening - 75%
- Renomegaly - 60%
- Medullary bands - 14%
Liver - Found in 83% of dogs
- Hypoechoic
- Hepatomegaly
- Gallbladder sludge
- Wall thickening
- Mucocele (26%)
Intestines/peritoneum
- SI wall thickening
- Renrenal and peritoneal effusion.
- Lymphadenopathy
Sonet et al: Evaluation of the US findings with lepto: The presence of what might be a warning sign of lepto in dogs?
Gallbladder mucocele
Specchi et al: Saghetti sign in feline abdominal rads: What does this represent and what sex was this commonly in?
This represents spleno-systemic collateral circulation
Only seen in spayed females
Specchi et al: Saghetti sign in feline abdominal rads: Was this finding associated with hypertension?
NO… only one cat had hypertension secondary to a thrombus.
Specchi et al: Saghetti sign in feline abdominal rads: Where was this abnormal vessel normally?
Lateral to the left kidney, caudal to the spleen, extending caudally.
Smith et al: CT pulmonary trunk to aorta ratio in dogs with pulmonary hypertension: What severity of pulmonary hypertension is detectable (significantly difference ratio) compared to normal dogs?
Moderate and severe cases
Mild pulmonary hypertension is hard to see on CT.
Smith et al: CT pulmonary trunk to aorta ratio in dogs with pulmonary hypertension: What was the mean pulmonary trunk to aorta ratio in normal dogs in this study? What is the threshold suggested for severe and moderate pulmonary hypertension?
1.26 +/- 1.1
Suggest a threshold of >1.4 for moderate/severe hypertension
Thierry et al: Vascular conspicuity differs among injection protocols and scanner types for canine abdominal CTA: What three types of injection protocols were used in this study?
- Test bolus
- Bolus tracking
- Fixed- injection duration
Thierry et al: Vascular conspicuity differs among injection protocols and scanner types for canine abdominal CTA: What protocol was the best and easiest to reproduce in the portal phase, and in the arterial phase for low speed scanners?
Fixed injection duration protocol
This protocol was also the best “compromise” for the portal phase on all scanners
Thierry et al: Vascular conspicuity differs among injection protocols and scanner types for canine abdominal CTA: What protocol was the best for 64 row scanners?
Test bolus
Thierry et al: Vascular conspicuity differs among injection protocols and scanner types for canine abdominal CTA: What is the advantage of the fixed injection duration protocol?
Lower and longer aortic peak with good separation between portal and arterial phases - this gives you more time to get a arterial phase
More homogeneous pattern of vascular enhancement REGARDLESS of body weight.
Thierry et al: Vascular conspicuity differs among injection protocols and scanner types for canine abdominal CTA: What type of scanner allowed for the best arterial enhancement?
High speed >64 slice scanners.
This did not affect the portal phase.
Soppet et al: Extruded gallbladder mucoceles US features: What were the characteristics?
- Discrete
- Heterogeneous
- Multilayered
- Stellate or straited masses
- No blood flow
Some were found in the caudal abdomen
DDX for a 8yo dog
Intramedullary sclerosis
-
Endocondromatosis (diaphysis) - Ollier’s syndrome - mainly young dogs
- Poodles may have an inherited thing
- Can have malignant transformation
- Can be radiolucent if still cartilage
- Bone infarct (multiple)
- Osteopetrosis
- Osteosclerosis
- Neoplasia
- Osteomyelitis (chronic)
Thierry et al: CT of tonsillar neoplasia in dogs: What are the most commonly neoplasms related to the tonsil?
SCC - most common
Melanoma
Lymphoma
Thierry et al: CT of tonsillar neoplasia in dogs: What was the main point of this paper?
5/12 dogs had normal looking tonsils on CT… however, all dogs had medial retropharyngeal changes (marked enlargement, heterogeneity, loss of hypoattenuating center) therefore, if you see changes in the medial retro LN then you have to think tonsilar neoplasia.
Butler et al: Rads vs CT to evaluate fractures of the canine tarsus: What was compared in this study?
They compared 2-view, 10-view rads and CT.
Butler et al: Rads vs CT to evaluate fractures of the canine tarsus: What differences in finding the fractures was noted in this study?
No difference in finding the fracture when comparing 2-view rads and 10-view rads
CT out performed rads (77% sensitivity vs 57% sensitivity)
Butler et al: Rads vs CT to evaluate fractures of the canine tarsus: What was the most commonly fractured bones?
Talus and calcaneus
Emery et al: Need for diagnostic imaging beyond CT in evaluation of dogs with thoracolumbar myelopathy in dogs: What percentage of dogs needed additional imaging after CT?
Only 7.6%
Emery et al: Need for diagnostic imaging beyond CT in evaluation of dogs with thoracolumbar myelopathy in dogs: where was there significant differences in this study?
- Dachshunds need significantly less imaging
- Increasing age significantly needed more imaging
- After-hours scanning significantly needed more imaging
Emery et al: Need for diagnostic imaging beyond CT in evaluation of dogs with thoracolumbar myelopathy in dogs: Dogs that did not have additional imaging performed were how many times likely to require surgery?
22x more likely to need surgery.
Packer et al: Consensus recommendations on standardized MRI protocols for dog brain tumor clinical trials: What are the recommeded sequences?
- Pre and Post CE 3D T1W
- T2W TSE in all three planes
- T2* trans
- FLAIR T2W Trans
- DWI trans
FOV <150mm
Slice thickness <2mm
Matrix >256 for 2D and >150 for 3D
Require a 1.5T
Packer et al: Consensus recommendations on standardized MRI protocols for dog brain tumor clinical trials: When is the recommended post-operative image timing?
<24h in 3T
6 weeks post
3 months post
Bertram et al: Caudal articular process dysplasia in the thoracic vertebrae of normal bulldogs and pugs: what was the percentage of dogs in the specific breeds studied that were affected with caudal articular process dysplasia?
Pugs: 97%
Frenchies: 84%
English: 71%
Bertram et al: Caudal articular process dysplasia in the thoracic vertebrae of normal bulldogs and pugs: Pugs showed a high prevalence of what type of dysplasia?
Aplasia
They had a lower number of hypoplasia
Bertram et al: Caudal articular process dysplasia in the thoracic vertebrae of normal bulldogs and pugs: What was the distribution showed in Pugs more commonly?
Higher number of affected vertebrae per dog
More generalized
More bilateral
Bertram et al: Caudal articular process dysplasia in the thoracic vertebrae of normal bulldogs and pugs: Where was the anatomically distribution of the caudal articular process dysplasia in Pugs and how did this differ from other breeds?
High prevalence between T10-T13
Frenchies and English were T4-T9 and T5 (English)
Bertram et al: Caudal articular process dysplasia in the thoracic vertebrae of normal bulldogs and pugs: The caudal articular process dysplasia in the thorax make up how much of the spines stability?
30%
Porter et al: Nonarticular osseous cyst-like lesions of the intermedioradial carpal bone may be incidental in dogs:
What is the difference between myeloid and lymphoid cells?
Myeloid cells are cells that will become cells such as neutrophils, macrophages, eosinophils and basophils
Lymphoid are lymphocytes (B-T)
Epperly et al: Dogs with actue myeloid luekemia or lymphoid neoplasms may have indistinguishable mediastinal masses on radiographs: Was there a size difference between the myeloid and lymphoid neoplasms when comparing the mediastinal masses?
No.. they are the same so you should keep acute myeloid leukemia on the ddx for a mediastinal mass.
Epperly et al: Dogs with actue myeloid luekemia or lymphoid neoplasms may have indistinguishable mediastinal masses on radiographs: Which neoplasm has a worse prognosis… lymphoma or acute myeloid neoplasia?
Acute myeloid neoplasia… and that is why in this study they were hoping to distiguish the two masses by size…which wasn’t done.
Epperly et al: Dogs with actue myeloid luekemia or lymphoid neoplasms may have indistinguishable mediastinal masses on radiographs: Can you have normal thoracic radiographs with lymphoma and acute myeloid leukemia?
Yes.. up to 50% of them will be normal.
Mostafa et al: Prevalence of MCP disease is high in lame large breed dogs: What breeds were most effect?
Labs and Goldens at 20 and 30% respectively.
Mostafa et al: Prevalence of MCP disease is high in lame large breed dogs: What were the most common radiographic signs?
- Shortened coronoid process (lack of concavity on lateral radiographs)
- Deformed MCP
- Subtrochlear ulnar sclerosis
- Periarticular osteophytosis
Osteophytosis associated with the MCP was only 7%
Name the anatomical structures at the level of the fetlock?
- Subcutaneous tissues
- SDF and 2a. Manica flexoria
- DDF
What is the purpose of the manica flexoria?
Hold the SDF and DDF in a central position at the level of the fect lock
Martins et al: Dynamic US for identifying manica flexoria tears in horses: What do the author recommend for the poisition of the leg when evaluating the manica? what about the digital sheath?
Static flexed limb position for the manica
Flexion and extension positioning for horses with suspect digital sheath injury.
Boursier et al: US can more accurtately count thoracolumbar disc spaces than percutaneous palpation: US was more accurate than percutaneous papation in finding the correct disc space especially in what type of animal?
Fat animals.
Boursier et al: US can more accurtately count thoracolumbar disc spaces than percutaneous palpation: what was the down side of US in this paper?
It took longer.
Eivers et al: Computed tomographic arthrography is useful adjunct to survey computed tomography when evaluating the canine shoulder: What anatomical structure does CT arthrography help assess and where does it have limited diagnostic value?
CT arthrography is superior in assessing:
- Biceps tendon
- Biceps tendon sheath
- Humeral head cartilage
CT arthrography has limited value in assessing
- Medial and lateral glenohumeral ligaments
- Subscapularis tendon
So it is helpful but should not replace survey CT or arthroscopy.
Gorgas et al: MRI features of canine glimatosis cerebri: What is the criteria to be described at gliomatosis cerebri?
Involvement of at least 3 lobes
Gorgas et al: MRI features of canine glimatosis cerebri: what portion of the brain did this commonly effect?
The diencephalon (thalamus, caudate nucleus, hypothalamus, hippocampus, etc)
Gorgas et al: MRI features of canine glimatosis cerebri: what did the signal intensity reflect on histopath?
Density of neoplastic cells
Gorgas et al: MRI features of canine glimatosis cerebri: MRI consistently over or underestimated extent of the lesio and meningeal infiltration?
Underestimated.
Gorgas et al: MRI features of canine glimatosis cerebri: What is glimatosis cerebri?
It is an extensive infiltration of neoplastic glial cells
Looks like inflammatory or infectious or diffuse neoplasia.
Gorgas et al: MRI features of canine glimatosis cerebri: what breed was most affected?
Bearded collies 11/14
Bronchoalveolar lavage affects CT and radiographic characteristics of lungs in healthy dogs: How long is it recommended for you to wait before you image the chest (rads or CT) after a BAL is performed?
24 hours.
In the paper the rads abnormalities resolve after 2 hours but they recommend 24hrs still.
Can DWI and ADC coefficients values differential between malignant and benign lymph nodes of the canine head and neck?
No
What is the normal length, width and height of a feline pituitary gland? Was there a correlation with the cats weight and age? When do you see a more homogenous intensity - pre or post contrast MRI images?
Length: 0.54 cm
Width: 0.5 cm
Height: 0.34cm
No correlation with age and weight
More homogenous intensity was seen on post contrast MRI.
Cummings et al: Objective measurements of the atlantoaxial jt on rads performed without flexion can increase confidence of diagnosis of AA lux: What measurement was found to strongly support AA instability?
Decreased C1-C2 overlap
Cummings et al: Objective measurements of the atlantoaxial jt on rads performed without flexion can increase confidence of diagnosis of AA lux: What is the median C1-C2 overlap in normal dogs and what is it that gives you the most sensitive and specific evidence for AA lux?
Normal median: 4.65 mm
AA lux median: -5.00mm
Most sensitive and specific measurement was: <1.55 (100% sensitivity and 95% specificity)
Seiler et al: Comparison between elastographic stiffness scores for benign vs malignant LNs in dogs and cats: Neoplastic lymph nodes tend to be what when compared to non-neoplastic lymph nodes?
Neoplastic LNs tend to be stiffer
Accuracy of four US techniques in predicting histopath classification of canine mamary carcinoma: What was the width:length ratio that suggested carcinoma in these cases on B-mode US?
0.53
Liu et al: Endotracheal tube placement during CT of brachycephalic dogs alters upper airway measurements: What measurements are the most reliable measurements in brachycephalic dogs as they do not change much when the dog is intubated?
Rostral soft palate thickness
Tracheal perimeter
Cross sectional area of the rostral nasopharynx
Liu et al: Endotracheal tube placement during CT of brachycephalic dogs alters upper airway measurements: What does the placement of an endotracheal tube do?
Tracheal dimensions are larger
Soft palate thickness is smaller
Nasopharynx can change up to 35%
Vititoe et al: Detection of intra-cardiac thrombi and CHF in cats using CTA: Where were most of the thrombi located?
Left auricle
Vititoe et al: Detection of intra-cardiac thrombi and CHF in cats using CTA: What is a sign that is seen on echo that can mean a prothrombotic state has been reached in the cat… this cannot be seen on CTA?
Spontaneous echo contrast (smoke) - Image
Bargellini et al: CEUS in diagnosing gallbladder diseases in dogs: What does the double rim mark or enhancement defect in the gallbladder wall represent?
Edema or necrosis/rupture of the wall
Bargellini et al: CEUS in diagnosing gallbladder diseases in dogs: CEUS has a what sensitivity and specificity in diagnosing gallbladder wall necrosis/rupture?
100% in both
Mortier et al: CT finding in dogs with Crenosoma vulpis: What is Crenosoma vulpis?
It is a lung worm localized in the trachea, bronchi and bronchioles.
NE USA and canada
Mortier et al: CT finding in dogs with Crenosoma vulpis: What are the three types of bronchiectasis?
- Varicose
- Cylindrical
- Saccular
Rossi et al: CT lymphogram staging tumors: When was the primary drainging lymph node most clearly visible after local injection?
1-3 min
Rossi et al: CT lymphogram staging tumors: How much contrast (ioxhexol) was injected into four quadrants around a tumor?
0.8-2ml
Longo et al: Elastography of lipomatous masses and malignant lesions: What was the hardness cutoff for malignant neoplasms?
>50% = malignant neoplasms
>1.5 elasticity score= malignant
Andrade et al: Comparison between MRI, CT and arthrography in identifying artificially induced cart defects in equine carpus: Which modality had the best sensitivity for finding cartilage defects?
CT arthrography = #1
MRI arthrograph #2
MRI #3
CT #4
