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Konstantinidis AO, Adamama-Moraitou KK, Patsikas MN, Papazoglou LG. Congenital Portosystemic Shunts in Dogs and Cats: Treatment, Complications and Prognosis. Vet Sci 2023; 10:vetsci10050346. [PMID: 37235429 DOI: 10.3390/vetsci10050346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Congenital portosystemic shunts (CPSS) are a common vascular anomaly of the liver in dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise the clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests and diagnostic imaging. The aim of this article is to review the management, both medical and surgical, complications, and prognosis of CPSS in dogs and cats. Attenuation of the CPSS is the treatment of choice and may be performed by open surgical intervention using ameroid ring constrictors, thin film banding, and partial or complete suture ligation or by percutaneous transvenous coil embolization. There is no strong evidence to recommend one surgical technique over another. Medical treatment strategies include administration of non-absorbable disaccharides (i.e., lactulose), antibiotics, and dietary changes, and are indicated for pre-surgical stabilization or when surgical intervention is not feasible. After CPSS attenuation, short- and long-term post-surgical complications may be seen, such as post-operative seizures and recurrence of clinical signs, respectively. Prognosis after surgical attenuation of CPSS is generally favorable for dogs and fair for cats.
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Affiliation(s)
- Alexandros O Konstantinidis
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Katerina K Adamama-Moraitou
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Michail N Patsikas
- Laboratory of Diagnostic Imaging, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Lysimachos G Papazoglou
- Companion Animal Clinic (Surgery and Obstetrics Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
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Konstantinidis AO, Patsikas MN, Papazoglou LG, Adamama-Moraitou KK. Congenital Portosystemic Shunts in Dogs and Cats: Classification, Pathophysiology, Clinical Presentation and Diagnosis. Vet Sci 2023; 10:vetsci10020160. [PMID: 36851464 PMCID: PMC9961057 DOI: 10.3390/vetsci10020160] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Congenital portosystemic shunts (CPSS) are abnormal vascular communications between the portal and the systemic circulation, bypassing the hepatic parenchyma and resulting in liver hypoplasia and hepatic insufficiency. Such connections develop in utero and persist postnatally. CPSS are among the two most common congenital vascular anomalies of the liver in small animals, along with primary hypoplasia of the portal vein without portal hypertension (PHPV without PH). CPSS can be extrahepatic (ECPSS), most commonly diagnosed in small and toy breed dogs and cats, or intrahepatic (ICPSS), most commonly seen in large breed dogs. Single ECPSS is the most common type encountered in both dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests, such as determination of fasting plasma ammonia (FA) levels, and pre- and postprandial serum bile acids concentrations, and diagnostic imaging. The purpose of this article is to review the definition, classification, pathogenesis, clinical presentation, and diagnosis of CPSS in dogs and cats, highlighted by the authors' clinical experience.
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Affiliation(s)
- Alexandros O. Konstantinidis
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
- Correspondence:
| | - Michail N. Patsikas
- Laboratory of Diagnostic Imaging, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Lysimachos G. Papazoglou
- Companion Animal Clinic (Surgery and Obstetrics Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Katerina K. Adamama-Moraitou
- Companion Animal Clinic (Medicine Unit), School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
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Mohamad JRJ, González-Rodríguez E, Arencibia A, Déniz S, Carrascosa C, Encinoso M. Anatomical Description of Loggerhead Turtle ( Caretta caretta) and Green Iguana ( Iguana iguana) Skull by Three-Dimensional Computed Tomography Reconstruction and Maximum Intensity Projection Images. Animals (Basel) 2023; 13:621. [PMID: 36830407 PMCID: PMC9951731 DOI: 10.3390/ani13040621] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023] Open
Abstract
The growing interest in reptiles has posed a challenge to veterinary clinicians due to the lack of a standardized system to perform anatomical studies similar to those used for dogs and cats. In this paper, we have attempted to describe, employing computed tomography and subsequent three-dimensional reconstructions, the normal anatomical features that comprise the skulls of two species of reptiles: the loggerhead turtle (Caretta caretta) and the green iguana (Iguana iguana). Computed tomography (CT) and subsequent image processing allowed the identification of the bony structures that comprise the head of these species. As a result, and based on previous articles, we propose the most significant anatomical differences and similarities between these species.
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Affiliation(s)
- Jose Raduan Jaber Mohamad
- Department of Morphology, Veterinary Faculty, University of Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain
| | - Eligia González-Rodríguez
- Veterinary Teaching Hospital, University of Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain
| | - Alberto Arencibia
- Department of Morphology, Veterinary Faculty, University of Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain
| | - Soraya Déniz
- Veterinary Teaching Hospital, University of Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain
| | - Conrado Carrascosa
- Department of Morphology, Veterinary Faculty, University of Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain
| | - Mario Encinoso
- Veterinary Teaching Hospital, University of Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain
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Wilson S, Culp WTN, Wisner ER, Cissell DD, Finn JP, Zwingenberger AL. Ferumoxytol-enhanced magnetic resonance angiography provides comparable vascular conspicuity to CT angiography in dogs with intrahepatic portosystemic shunts. Vet Radiol Ultrasound 2021; 62:463-470. [PMID: 33634935 DOI: 10.1111/vru.12963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 11/26/2022] Open
Abstract
Computed tomography angiography (CTA) is currently the gold standard imaging modality for anatomically characterizing canine hepatic vascular anomalies; with conventional, gadolinium-enhanced MR angiography being less frequently utilized. However, both imaging modalities are limited by a brief, first pass peak of contrast medium in the vasculature that necessitates precisely timed image acquisition. A long-acting purely intravascular magnetic resonance imaging (MRI) contrast agent, ferumoxytol, offers the potential to reduce complexity of magnetic resonance angiography (MRA) protocol planning by ensuring diagnostic contrast medium concentration in all the vessels that are targeted for imaging. Aims of this prospective, pilot, methods comparison study were to develop an optimized MRA protocol using ferumoxytol in dogs with hepatic vascular anomalies, perform a dose escalation trial to compare image quality with four-dose regimens of ferumoxytol, and compare accuracy of vascular anatomic depiction based on the gold standard of CTA. Six dogs (10.7-36.1 kg) with portosystemic shunts (four intrahepatic left divisional shunts and two intrahepatic right divisional shunts) were recruited for inclusion in the study. A dose-escalation trial was performed to compare image quality at four incremental dose levels of ferumoxytol (1, 2, 3, and 4 mg/kg) and to compare the accuracy of vascular anatomic detection to CTA. Ferumoxytol contrast-enhanced MRA (CE-MRA) at 4 mg/kg provided similar conspicuity of normal and abnormal vasculature compared to CTA with a minimal decrease in spatial resolution. Findings indicated that ferumoxytol holds promise for comprehensive, single breath hold CE-MRA of all abdominal vessels in dogs with portosystemic shunts. Background information provided in this study can be used to support development of other future applications such as intracranial and cardiac MRA, real-time imaging, flow quantification, and potentially sedated MRI imaging.
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Affiliation(s)
- Sabrina Wilson
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - William T N Culp
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Erik R Wisner
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - Derek D Cissell
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
| | - J Paul Finn
- Diagnostic Cardiovascular Imaging Research Laboratory, Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, School of Medicine, Davis, California, USA
| | - Allison L Zwingenberger
- Department of Surgical and Radiological Sciences, University of California Davis, School of Veterinary Medicine, Davis, California, USA
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White RN, Warren-Smith C, Shales C, Parry AT. Classification of portosystemic shunts entering the caudal vena cava at the omental foramen in dogs. J Small Anim Pract 2020; 61:659-668. [PMID: 33035379 DOI: 10.1111/jsap.13209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/13/2020] [Accepted: 07/08/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To re-evaluate the anatomy and classification of congenital extrahepatic portosystemic shunts entering the caudal vena cava at the level of the omental foramen. MATERIAL AND METHODS A retrospective review of a consecutive series of dogs undergoing CT angiography as part of the diagnostic work-up for a congenital extrahepatic portosystemic shunt. RESULTS In total, 53 dogs met the inclusion criteria revealing four anatomically distinct omental foramen shunt types; one of which (32 of 53 dogs) showed no shunting blood flow through the right gastric vein and three of which (21 of 53 dogs) involved shunting flow through this vessel. The anatomy of these four distinct shunt types, as defined by CT angiography, was found to be highly consistent. In all cases, regardless of the tributary vessels, the left gastric vein was the final vessel that communicated with the caudal vena cava. Using these findings, a more accurate naming classification for congenital portosystemic shunts entering the caudal vena cava at the level of the omental foramen was proposed. CLINICAL SIGNIFICANCE A precise pre-treatment anatomical classification of congenital extrahepatic portosystemic shunts entering the caudal vena cava at the level of the omental foramen is important for a more complete understanding of the severity of clinical signs and prognosis, and for the better communication between clinicians and researchers in this clinical field.
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Affiliation(s)
- R N White
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - C Warren-Smith
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol, BS40 5DU, UK
| | - C Shales
- Willows Referral Service, Highlands Road, Shirley, Solihull, West Midlands, B90 4NH, UK
| | - A T Parry
- Willows Referral Service, Highlands Road, Shirley, Solihull, West Midlands, B90 4NH, UK
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Plested MJ, Zwingenberger AL, Brockman DJ, Hecht S, Secrest S, Culp WTN, Drees R. Canine intrahepatic portosystemic shunt insertion into the systemic circulation is commonly through primary hepatic veins as assessed with CT angiography. Vet Radiol Ultrasound 2020; 61:519-530. [PMID: 32663370 DOI: 10.1111/vru.12892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/15/2020] [Accepted: 04/27/2020] [Indexed: 02/06/2023] Open
Abstract
Congenital intrahepatic portosystemic shunts (IHPSS) in dogs are traditionally classified as right, left, or central divisional. There are few descriptive studies regarding the variation of IHPSS within these categories. This multicenter, analytical, cross-sectional study aimed to describe a large series of dogs with CT angiography (CTA) of IHPSS, hypothesizing that there would be variation to the existing classification. Ninety CTA studies were assessed for IHPSS type, insertion, and the relationship of the insertion to the primary hepatic veins. Ninety-two percent of IHPSS inserted into a primary hepatic vein (HV) or phrenic vein, 8% inserted directly into the ventral aspect of the intrahepatic caudal vena cava. The most common IHPSS type was a single right divisional (44%), including those inserting via the right lateral HV or the caudate HV. Left divisional IHPSS (33%) inserted into the left HV or left phrenic vein. Central divisional IHPSS (13%) inserted into the quadrate HV, central HV, dorsal right medial HV, or directly into the ventral aspect of the intrahepatic caudal vena cava. Multiple sites of insertion were seen in 9% of dogs. Within left, central, and right divisional types, further subclassifications can therefore commonly be defined based on the hepatic veins with which the shunting vessel communicates. Relating IHPSS morphology to the receiving primary HV could make IHPSS categorization more consistent and may influence the type and method of IHPSS attenuation recommended.
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Affiliation(s)
- Mark J Plested
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Allison L Zwingenberger
- Department of Surgical and Radiological Sciences, Davis, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Daniel J Brockman
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Scott Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | - William T N Culp
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Randi Drees
- Department of Clinical Sciences and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
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Plested MJ, Drees R. Survey of surgical specialists' content preferences in radiology reports for extrahepatic portosystemic shunts. Vet Radiol Ultrasound 2019; 60:316-322. [PMID: 30851002 DOI: 10.1111/vru.12730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/06/2018] [Accepted: 01/10/2019] [Indexed: 11/30/2022] Open
Abstract
The aim of this prospective, survey study was to assess the opinions of specialist surgeons as to the preferred content, nomenclature, and classification of extrahepatic portosystemic shunts for inclusion in radiology reports. A link to an online survey was sent by email to members of the European College of Veterinary Surgeons and the Association of Veterinary Soft Tissue Surgeons, and was made available on the American College of Veterinary Surgeons web forum and Facebook page. There were 93 respondents (survey sent to over 2500 email addresses and made available in two online locations). Most respondents agreed that they both review the images themselves (87/92, 95%) and read the radiology report (82/92, 89%) prior to surgery. Most respondents believed that the radiology report should contain a detailed anatomic description of the insertion (83/92, 90%), origin (54/91, 59%), and course (70/92, 76%) of the shunt, as well as a measure of the diameter of the shunting vessel at its insertion (54/92, 59%). Most respondents (70/90, 78%) disagreed that a brief description of shunt type, such as portocaval or portophrenic, was sufficient. Respondents were undecided regarding the use of an alphanumeric classification system (36/92, 39% agree; 32/92, 35% disagree). There was agreement that details of the presence or absence of urolithiasis (91/93, 98%), renomegaly (54/93, 58%), and peritoneal fluid (72/92, 78%) should be included in the report. The results of this study will help to guide reporting radiologists in providing descriptions of extrahepatic portosystemic shunts that include information most preferred by the recipient surgeons.
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Affiliation(s)
- Mark J Plested
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, North Mymms, UK
| | - Randi Drees
- Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, North Mymms, UK
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Bertolini G. Anomalies of the Portal Venous System in Dogs and Cats as Seen on Multidetector-Row Computed Tomography: An Overview and Systematization Proposal. Vet Sci 2019; 6:vetsci6010010. [PMID: 30678218 PMCID: PMC6466037 DOI: 10.3390/vetsci6010010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 01/01/2023] Open
Abstract
This article offers an overview of congenital and acquired vascular anomalies involving the portal venous system in dogs and cats, as determined by multidetector-row computed tomography angiography. Congenital absence of the portal vein, portal vein hypoplasia, portal vein thrombosis and portal collaterals are described. Portal collaterals are further discussed as high- and low-flow connections and categorized in hepatic arterioportal malformation, arteriovenous fistula, end-to-side and side-to-side congenital portosystemic shunts, acquired portosystemic shunts, cavoportal and porto-portal collaterals. Knowledge of different portal system anomalies helps understand the underlying physiopathological mechanism and is essential for surgical and interventional approaches.
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Affiliation(s)
- Giovanna Bertolini
- San Marco Veterinary Clinic and Laboratory, via dell'Industria 3, 35030 Veggiano, Padova, Italy.
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Joffe MR, Hall E, Tan C, Brunel L. Evaluation of different methods of securing cellophane bands for portosystemic shunt attenuation. Vet Surg 2018; 48:42-49. [DOI: 10.1111/vsu.13125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/26/2018] [Accepted: 10/04/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Michelle Robyn Joffe
- Sydney School of Veterinary Science, Faculty of Science; University of Sydney; Sydney New South Wales Australia
| | - Evelyn Hall
- Sydney School of Veterinary Science, Faculty of Science; University of Sydney; Sydney New South Wales Australia
| | - Christopher Tan
- Sydney School of Veterinary Science, Faculty of Science; University of Sydney; Sydney New South Wales Australia
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - Laurencie Brunel
- Sydney School of Veterinary Science, Faculty of Science; University of Sydney; Sydney New South Wales Australia
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Wallace ML, Ellison GW, Giglio RF, Batich CD, Berry CR, Case JB, Kim SE. Gradual attenuation of a congenital extrahepatic portosystemic shunt with a self-retaining polyacrylic acid-silicone device in 6 dogs. Vet Surg 2018; 47:722-728. [DOI: 10.1111/vsu.12797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/25/2017] [Accepted: 01/03/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Mandy L. Wallace
- Department of Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Gary W. Ellison
- Department of Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Robson F. Giglio
- Department of Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Christopher D. Batich
- Department of Materials Science and Engineering; University of Florida; Gainesville Florida
| | - Clifford R. Berry
- Department of Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - J. Brad Case
- Department of Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Stanley E. Kim
- Department of Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
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Hayakawa S, Sato K, Sakai M, Kutara K, Asano K, Watari T. CT cholangiography in dogs with gallbladder mucocoele. J Small Anim Pract 2018; 59:490-495. [PMID: 29603237 DOI: 10.1111/jsap.12832] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To summarise CT cholangiography findings in dogs with gallbladder mucocoele. MATERIALS AND METHODS Each of 10 dogs with gallbladder mucocoele underwent CT cholangiography using meglumine iotroxate before cholecystectomy. The following structures of the biliary system were evaluated: the right and left hepatic ducts, common hepatic duct, cystic duct, common bile duct and gallbladder. RESULTS The hepatic duct, cystic duct, common bile duct and gallbladder were imaged by contrast-enhanced CT cholangiography. The passage of the contrast medium through the bile duct into the duodenum was visible in nine dogs. The curved planar reformation images of two dogs showed they had filling defects in the bile duct system. In one dog with hyperbilirubinaemia due to chronic hepatitis, the bile duct system was not completely contrast-enhanced. Surgical exploration revealed no evidence of common bile duct obstruction in any dog. CLINICAL SIGNIFICANCE CT cholangiography delineates the structural characteristics of the biliary system and partially estimates its patency in dogs with gallbladder mucocoele. Therefore this procedure may be useful as a preoperative screen of the bile duct system in dogs with gallbladder mucocoele.
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Affiliation(s)
- S Hayakawa
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - K Sato
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - M Sakai
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - K Kutara
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - K Asano
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
| | - T Watari
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, 252-0880, Japan
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Sakamoto Y, Sakai M, Watari T. Portal Vein/Aorta Ratio in Dogs with Acquired Portosystemic Collaterals. J Vet Intern Med 2017. [PMID: 28804949 DOI: 10.1111/jvim.14802.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The portal vein (PV) diameter increases in humans with portal hypertension (PH). However, there is no evidence of PV enlargement in dogs with PH. OBJECTIVES To measure the PV-to-aorta (PV/Ao) ratio in dogs with PH (chronic hepatitis [CH], primary hypoplasia of the PV [PHPV]), in dogs with extrahepatic congenital portosystemic shunt (EH-CPSS), and in healthy dogs, and to evaluate the relationship between PV/Ao ratio and splenic pulp pressure (SPP). ANIMALS Twenty-five dogs with acquired portosystemic collaterals (APSCs; 15 with CH, 10 with PHPV), 32 dogs with EH-CPSS, and 20 healthy dogs. METHODS Retrospective study. The PV/Ao ratio was calculated with images obtained by computed tomography. SPP was measured at the time of liver biopsy in 45 dogs. RESULTS Median PV/Ao ratio was similar between dogs with CH (1.35, range 1.05-2.01) and healthy dogs (0.95, 0.80-1.15), but differed significantly between the CH group and both the PHPV (0.40, 0.24-0.67) and EH-CPSS groups (0.30, 0.11-0.64) (P < .001). The PV/Ao ratio was significantly lower in the PHPV group than in healthy dogs (P < .05). It also correlated positively with SPP (rs = 0.71; P < .001). However, there was no intragroup correlation between SPP and the PV/Ao ratio in any group. CONCLUSIONS AND CLINICAL IMPORTANCE The PV/Ao ratio can be evaluated in dogs with APSCs on computed tomography. Further studies are needed to examine the relationship between SPP and the PV/Ao ratio in larger groups of dogs with PH and to determine its clinical relevance.
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Affiliation(s)
- Y Sakamoto
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - M Sakai
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - T Watari
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
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13
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Sakamoto Y, Sakai M, Watari T. Portal Vein/Aorta Ratio in Dogs with Acquired Portosystemic Collaterals. J Vet Intern Med 2017; 31:1382-1387. [PMID: 28804949 PMCID: PMC5598892 DOI: 10.1111/jvim.14802] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/18/2017] [Accepted: 07/13/2017] [Indexed: 12/16/2022] Open
Abstract
Background The portal vein (PV) diameter increases in humans with portal hypertension (PH). However, there is no evidence of PV enlargement in dogs with PH. Objectives To measure the PV‐to‐aorta (PV/Ao) ratio in dogs with PH (chronic hepatitis [CH], primary hypoplasia of the PV [PHPV]), in dogs with extrahepatic congenital portosystemic shunt (EH‐CPSS), and in healthy dogs, and to evaluate the relationship between PV/Ao ratio and splenic pulp pressure (SPP). Animals Twenty‐five dogs with acquired portosystemic collaterals (APSCs; 15 with CH, 10 with PHPV), 32 dogs with EH‐CPSS, and 20 healthy dogs. Methods Retrospective study. The PV/Ao ratio was calculated with images obtained by computed tomography. SPP was measured at the time of liver biopsy in 45 dogs. Results Median PV/Ao ratio was similar between dogs with CH (1.35, range 1.05–2.01) and healthy dogs (0.95, 0.80–1.15), but differed significantly between the CH group and both the PHPV (0.40, 0.24–0.67) and EH‐CPSS groups (0.30, 0.11–0.64) (P < .001). The PV/Ao ratio was significantly lower in the PHPV group than in healthy dogs (P < .05). It also correlated positively with SPP (rs = 0.71; P < .001). However, there was no intragroup correlation between SPP and the PV/Ao ratio in any group. Conclusions and Clinical Importance The PV/Ao ratio can be evaluated in dogs with APSCs on computed tomography. Further studies are needed to examine the relationship between SPP and the PV/Ao ratio in larger groups of dogs with PH and to determine its clinical relevance.
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Affiliation(s)
- Y Sakamoto
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - M Sakai
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - T Watari
- Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa, Japan
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Ricciardi M. Unusual haemodynamics in two dogs and two cats with portosystemic shunt - implications for distinguishing between congenital and acquired conditions. Open Vet J 2017; 7:86-94. [PMID: 28616388 PMCID: PMC5440612 DOI: 10.4314/ovj.v7i2.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 04/12/2017] [Indexed: 01/03/2023] Open
Abstract
Extrahepatic porto-systemic shunt (PSS) in small animals can be congenital (CPSS) or acquired (APSS) as a consequence of portal hypertension (PH), and are distinguished on the bases of their anatomical pattern. A precise morphologic imaging assessment, along with clinical and histopathologic findings, is important for distinguishing patients with PH from those with congenital PSSs, which require different therapeutic approach. Expected findings in patients with PH are presence of ascites, multiple APSS, and a confirmed cause of portal flow obstruction. On the other hand, a single PSS, absence of ascites and no evidence of portal vein, caudal vena cava or hepatic disorders are typical findings of CPSS patients. This paper describes four cases of PSSs in which the combination of the computed tomographic imaging findings did not match the standards for APSS nor for CPSS: one dog had chronic hepatitis causing PH and ascites and a splenoazygos PSS, to date considered a CPSS pattern. One dog showed a left splenogonadal PSS and porto-caval varices, to date considered an APSS pattern, without ascites, portal vein obstruction, primary structural hepatic disorders nor evidence of PH. Two cats, with and without diffuse hepatic structural disorders respectively, had a single left splenogonadal PSS without ascites. Possible interpretation of such unusual haemodynamic conditions and clinical repercussion, especially for orientation of treatment choice, are discussed.
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Affiliation(s)
- Mario Ricciardi
- "Pingry" Veterinary Hospital, via Medaglie d'Oro 5, Bari, Italy
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Secrest S, Bugbee A, Waller K, Jiménez DA. COMPARISON OF TRANSVERSE COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IMAGES AND MAXIMUM INTENSITY PROJECTION IMAGES FOR DIAGNOSING ECTOPIC URETERS IN DOGS. Vet Radiol Ultrasound 2016; 58:163-168. [DOI: 10.1111/vru.12461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/13/2016] [Accepted: 10/25/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Scott Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging; University of Georgia; Athens GA 30602
| | - Andrew Bugbee
- Department of Small Animal Medicine and Surgery; University of Georgia; Athens GA 30602
| | - Kenneth Waller
- Department of Surgical Sciences; University of Wisconsin; Madison WI 53706
| | - David A. Jiménez
- Department of Veterinary Biosciences and Diagnostic Imaging; University of Georgia; Athens GA 30602
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Comparison of contrast-enhanced multidetector computed tomography angiography and splenoportography for the evaluation of portosystemic-shunt occlusion after cellophane banding in dogs. BMC Vet Res 2016; 12:283. [PMID: 27938359 PMCID: PMC5148836 DOI: 10.1186/s12917-016-0910-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/02/2016] [Indexed: 01/23/2023] Open
Abstract
Background Many patients with a congenital extrahepatic portosystemic shunt (PSS) do not tolerate an immediate shunt closure. Therefore, slow progressive techniques were developed. To evaluate the success of shunt closure diagnostic imaging is essential to identify possible residual blood flow through the shunt vessel. There is a lack of information about the reliability of computed tomography angiography (CTA) for evaluating residual flow through a PSS after treatment. The purpose of this prospective study was to compare the results of CTA with splenoportography. Three months after cellophane banding CTA and splenoportography were performed in 20 dogs and reviewed by three independent examiners, respectively. In both imaging modalities the presences of a residual shunt was judged as present or absent and the extent of visibility of portal vasculature was recorded. Results Based on the evaluation of the splenoportography residual flow through shunt was present in 6 dogs. The classification of residual shunt present or absent showed a substantial to perfect agreement (κ = 0.65–1.00) between the observers in splenoportography and a slight to moderate agreement (κ = 0.11–0.51) for CTA. Sensitivity and specificity varied between 0.50 and 1.00 and 0.57–0.85, respectively. Significant correlation between CTA and splenoportography for the classification of residual shunt was present only in one observer but not in the other two. Conclusion More studies were classified as residual shunt positive with CTA compared to splenoportography. It remains unclear which methods do reflect reality better and thus which method is superior. The greater inter-rater agreement for splenoportography suggests a greater reliability of this technique.
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Ricciardi M. Splenophrenic portosystemic shunt in dogs with and without portal hypertension: can acquired and congenital porto-caval connections coexist? Open Vet J 2016; 6:185-193. [PMID: 27882305 PMCID: PMC5116438 DOI: 10.4314/ovj.v6i3.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 10/15/2016] [Indexed: 11/17/2022] Open
Abstract
The possible existence of the same pattern of porto-caval connection in dogs having a single congenital portosystemic shunt (CPSS) and in dogs having multiple acquired portosystemic shunt (MAPSS) secondary to portal hypertension (PH) was evaluated. Retrospective evaluation of all CT examinations of patients having portosystemic shunt (PSS) was performed in a 4-year time period. All anomalous porto-caval connections were assessed for anatomical pattern and compared with published veterinary literature. Records of 25 dogs were reviewed. 16 dogs had a single CPSS (CPSS group), and 9 dogs had multiple acquired PSS secondary to PH (APSS group). The splenophrenic shunt pattern was found in 3 dogs of the CPSS group as a single congenital anomaly without PH and in 2 dogs of the APSS group associated with MAPSS and ascites due to different hepatic diseases causing PH. These findings corroborate two hypotheses: 1) Splenophrenic PSS should be considered as a classical CPSS but if this is not sufficient to alleviate a PH developed after birth because of eventual hepatic or portal diseases, in this case ascites and acquired portal collaterals may develop. In this case, MAPSS and CPSS may coexist. 2) The pattern of splenophrenic PSS, classically described among CPSS, may develop as acquired portal collateral in dogs with PH and it should also be included in the category of APSS. These preliminary findings may be helpful in reconsidering the classical haemodynamics of porto-caval diseases, enrich the classification of APSS in dogs and refine the imaging evaluation of patients with PH.
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Affiliation(s)
- M Ricciardi
- "Pingry" Veterinary Hospital, via Medaglie d'Oro 5, Bari Italy
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18
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Chau J, Young AC, Dhand N, Makara MA. Estimation of time to peak contrast enhancement of the aorta and liver for dual-phase computed tomography on the basis of contrast medium arrival time, injection duration, and injection technique in dogs. Am J Vet Res 2016; 77:1093-100. [PMID: 27668580 DOI: 10.2460/ajvr.77.10.1093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the accuracy of estimating time to peak enhancement (TPE) of the aorta and liver parenchyma on the basis of contrast medium arrival time in the aorta, injection duration, and injection technique in dogs. ANIMALS 18 dogs of specific body weight categories (≥ 2 dogs/category) with no liver abnormalities detected via CT. PROCEDURES Dogs were randomly assigned within weight categories to receive contrast medium IV at a fixed injection rate (5 mL/s) or fixed injection duration (20 seconds). Time-contrast attenuation curves were generated from dynamic CT scans acquired at the hepatic hilus. Data collected for contrast medium arrival time and injection duration were used to estimate TPEs of the aorta and liver, and results were compared with the observed TPEs for the aorta and liver. RESULTS Contrast medium arrival time, injection duration, and injection technique were significantly associated with observed values for aortic TPE and explained 96.1% of variation in TPE. For the fixed rate technique, the regression equation for estimating aortic TPE was 0.8 × (injection duration + contrast medium arrival time) + 1.6. For the fixed duration technique, the regression equation changed by only the constant (-2.6). However, the hepatic TPE estimated from the 3 predictor variables was not significantly different from the mean of observed TPEs. CONCLUSIONS AND CLINICAL RELEVANCE Aortic TPE could be accurately estimated from contrast medium arrival time, injection duration, and injection technique in dogs with apparently healthy livers. The regression equations derived from this relationship can be used to improve the efficiency of dual-phase CT of the liver in dogs.
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Specchi S, Pey P, Ledda G, Lustgarten M, Thrall D, Bertolini G. COMPUTED TOMOGRAPHIC AND ULTRASONOGRAPHIC CHARACTERISTICS OF CAVERNOUS TRANSFORMATION OF THE OBSTRUCTED PORTAL VEIN IN SMALL ANIMALS. Vet Radiol Ultrasound 2015; 56:511-9. [DOI: 10.1111/vru.12265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 02/08/2015] [Indexed: 01/26/2023] Open
Affiliation(s)
- Swan Specchi
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire; Université de Montréal; 3200 Rue Sicotte Saint-Hyacinthe QC J2S 2M2 Canada
| | - Pascaline Pey
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire; Université de Montréal; 3200 Rue Sicotte Saint-Hyacinthe QC J2S 2M2 Canada
| | - Gianluca Ledda
- San Marco Veterinary Clinic, Diagnostic Imaging and Interventional Radiology; Via Sorio 114/c; Padua 35141 Italy
| | - Meghann Lustgarten
- College of Veterinary Medicine; North Carolina State University; Raleigh NC 27695
| | - Donald Thrall
- College of Veterinary Medicine; North Carolina State University; Raleigh NC 27695
| | - Giovanna Bertolini
- San Marco Veterinary Clinic, Diagnostic Imaging and Interventional Radiology; Via Sorio 114/c; Padua 35141 Italy
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20
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Bertolini G, Diana A, Cipone M, Drigo M, Caldin M. MULTIDETECTOR ROW COMPUTED TOMOGRAPHY AND ULTRASOUND CHARACTERISTICS OF CAUDAL VENA CAVA DUPLICATION IN DOGS. Vet Radiol Ultrasound 2014; 55:521-30. [DOI: 10.1111/vru.12162] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/15/2014] [Indexed: 01/01/2023] Open
Affiliation(s)
- Giovanna Bertolini
- “San Marco Private Veterinary Clinic”; via Sorio 114/c 35141 Padua Italy
| | - Alessia Diana
- Veterinary Clinical Department; Faculty of Veterinary Medicine; University of Bologna; Via Tolara di Sopra, 50 Ozzano dell’Emilia Italy
| | - Mario Cipone
- Veterinary Clinical Department; Faculty of Veterinary Medicine; University of Bologna; Via Tolara di Sopra, 50 Ozzano dell’Emilia Italy
| | - Michele Drigo
- Department of Animal Medicine; Production and Health; University of Padua; Viale dell’Università; 35020 Legnaro Italy
| | - Marco Caldin
- “San Marco Private Veterinary Clinic”; via Sorio 114/c 35141 Padua Italy
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21
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Specchi S, d’Anjou MA, Carmel EN, Bertolini G. COMPUTED TOMOGRAPHIC CHARACTERISTICS OF COLLATERAL VENOUS PATHWAYS IN DOGS WITH CAUDAL VENA CAVA OBSTRUCTION. Vet Radiol Ultrasound 2014; 55:531-8. [DOI: 10.1111/vru.12167] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 01/17/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Swan Specchi
- Department of Clinical Sciences; Faculté de Médecine Vétérinaire; Université de Montréal; 3200 Rue Sicotte, J2S7C6 Sainte Hyacinthe Québec Canada
| | - Marc-André d’Anjou
- Department of Clinical Sciences; Faculté de Médecine Vétérinaire; Université de Montréal; 3200 Rue Sicotte, J2S7C6 Sainte Hyacinthe Québec Canada
| | - Eric Norman Carmel
- Department of Clinical Sciences; Faculté de Médecine Vétérinaire; Université de Montréal; 3200 Rue Sicotte, J2S7C6 Sainte Hyacinthe Québec Canada
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22
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De Rycke LM, Kromhout KJ, van Bree HJ, Bosmans T, Gielen IM. Computed Tomography Atlas of the Normal Cranial Canine Abdominal Vasculature Enhanced by Dual-phase Angiography. Anat Histol Embryol 2013; 43:413-22. [DOI: 10.1111/ahe.12090] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 11/30/2022]
Affiliation(s)
- L. M. De Rycke
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - K. J. Kromhout
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - H. J. van Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - T. Bosmans
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - I. M. Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
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23
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Shanaman MM, Schwarz T, Gal A, O'Brien RT. Comparison between survey radiography, B-mode ultrasonography, contrast-enhanced ultrasonography and contrast-enhanced multi-detector computed tomography findings in dogs with acute abdominal signs. Vet Radiol Ultrasound 2013; 54:591-604. [PMID: 23919809 DOI: 10.1111/vru.12079] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/18/2013] [Indexed: 12/14/2022] Open
Abstract
Contrast-enhanced multi-detector computed tomography (CE-MDCT) is used routinely in evaluating human patients with acute abdominal symptoms. Contrast-enhanced ultrasound (CEUS) continues to be in its infancy as it relates to evaluation of the acute abdomen. The purpose of this study was to compare survey radiography, B-mode ultrasound, CEUS, and CE-MDCT findings in canine patients presenting with acute abdominal signs; with a focus on the ability to differentiate surgical from non-surgical conditions. Nineteen dogs were prospectively enrolled. Inclusion required a clinical diagnosis of acute abdominal signs and confirmed surgical or non-surgical causes for the clinical signs. Agreement for the majority of recorded imaging features was at least moderate. There was poor agreement in the identification of pneumoperitoneum and in the comparison of pancreatic lesion dimensions for B-mode vs. CEUS. The CT feature of fat stranding was detected in cases including, but not limited to, gastric neoplasia with perforation, pancreatitis, and small intestinal foreign body. Ultrasound underestimated the size and number of specific lesions when compared with CE-MDCT. Contrast-enhanced ultrasound was successful in detecting bowel and pancreatic perfusion deficits that CE-MDCT failed to identify. Accuracy for differentiation of surgical vs. non-surgical conditions was high for all modalities; 100%, 94%, and 94% for CE-MDCT, ultrasonography and survey radiography respectively. Findings indicated that CE-MDCT is an accurate screening test for differentiating surgical from non-surgical acute abdominal conditions in dogs. Focused CEUS following CE-MDCT or B-mode ultrasonography may be beneficial for identifying potentially significant hypoperfused lesions.
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Affiliation(s)
- Miriam M Shanaman
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, 61802
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24
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Kim SE, Giglio RF, Reese DJ, Reese SL, Bacon NJ, Ellison GW. COMPARISON OF COMPUTED TOMOGRAPHIC ANGIOGRAPHY AND ULTRASONOGRAPHY FOR THE DETECTION AND CHARACTERIZATION OF PORTOSYSTEMIC SHUNTS IN DOGS. Vet Radiol Ultrasound 2013; 54:569-74. [DOI: 10.1111/vru.12059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 05/04/2013] [Indexed: 12/01/2022] Open
Affiliation(s)
- Stanley E. Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville; FL; 32610
| | - Robson F. Giglio
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville; FL; 32610
| | - David J. Reese
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville; FL; 32610
| | - Shona L. Reese
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville; FL; 32610
| | - Nicholas J. Bacon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville; FL; 32610
| | - Gary W. Ellison
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville; FL; 32610
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25
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Mai W, Suran JN, Cáceres AV, Reetz JA. Comparison between bolus tracking and timing-bolus techniques for renal computed tomographic angiography in normal cats. Vet Radiol Ultrasound 2013; 54:343-350. [PMID: 23490196 DOI: 10.1111/vru.12029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 02/08/2013] [Indexed: 12/01/2022] Open
Abstract
Renal dual-phase computed tomograpic angiography (CTA) is used to assess suitability of feline donors prior to transplantation. A prerequisite for successful CTA is optimal synchronization between the arterial passage of contrast material and CT data acquisition. This retrospective study was conducted to compare quality of renal vascular enhancement at dual-phase CTA in normal cats between two techniques of timing of data acquisition: the timing-bolus and the bolus tracking method. Nine cats were scanned using the timing-bolus technique and 14 with the bolus tracking technique using otherwise similar scanning parameters in a 16-slice multidetector row CT scanner. The quality of enhancement of the renal vessels at the scanned arterial phase and venous phase was assessed both subjectively and objectively by three board-certified radiologists. Arterial enhancement was not observed at the scanned arterial phase in three of the nine cats with the timing-bolus technique but only 1 of the 14 cats with the bolus tracking technique. Early venous enhancement at the scanned arterial phase was common with the bolus tracking technique. Data acquisition was significantly faster with the bolus tracking technique. We conclude that the bolus tracking technique is a valid technique that could be integrated into the routine protocol for 16-detector row CT renal angiography in cats.
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Affiliation(s)
- Wilfried Mai
- Section of Radiology, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104
| | - Jantra N Suran
- Section of Radiology, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104
| | - Ana V Cáceres
- Section of Radiology, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104
| | - Jennifer A Reetz
- Section of Radiology, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA, 19104
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26
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Liver. CANINE AND FELINE GASTROENTEROLOGY 2013. [PMCID: PMC7161409 DOI: 10.1016/b978-1-4160-3661-6.00061-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Shanaman MM, Hartman SK, O'Brien RT. Feasibility for using dual-phase contrast-enhanced multi-detector helical computed tomography to evaluate awake and sedated dogs with acute abdominal signs. Vet Radiol Ultrasound 2012; 53:605-12. [PMID: 22995037 DOI: 10.1111/j.1740-8261.2012.01973.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 07/18/2012] [Indexed: 11/29/2022] Open
Abstract
Canine patients with acute abdominal signs are often clinically unstable and need a rapid and accurate diagnosis. Contrast-enhanced multi-detector computed tomography (CT) is the current modality of choice for evaluating acute abdominal pain in people. We hypothesized that contrast-enhanced multi-detector CT would be a feasible and safe technique for use in awake and lightly sedated dogs with acute abdominal signs. Eighteen client-owned dogs were enrolled, all presenting with acute abdominal signs. Dogs were scanned using a dual-phase protocol that included precontrast, arterial, and portal venous phases. Eight dogs were scanned awake and ten were given light sedation as chosen by the primary care clinician. Two observers who were unaware of clinical findings and sedation status scored image quality for each scan by consensus opinion. Mean serum creatinine in the sedated group was higher than in the awake group but was within the normal reference range. Other laboratory and physiologic measures did not differ between awake and sedated groups. No IV contrast-related adverse reactions were seen. Median scan time for all patients was less than 10 min. Sixteen of 18 contrast-enhanced multi-detector CT scans were scored fair to excellent in diagnostic quality, with no statistical difference in diagnostic quality for awake vs. sedated patients. Causes for two poor quality diagnostic scans included severe beam hardening from previously administered barium contrast agent and severe motion artifacts. We conclude that dual-phase contrast-enhanced multi-detector CT is a feasible and safe technique for evaluating awake and minimally sedated dogs presenting with acute abdominal signs.
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Affiliation(s)
- Miriam M Shanaman
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL 61802, USA
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28
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Abstract
SUMMARY The primary purpose of diagnostic imaging is to enable clinicians to make correct decisions about a patient's diagnosis and severity of its condition and, thereby, to contribute to effective and efficient treatment. Advanced imaging modalities are inherently better detectors of morphological lesions than radiography; hence, they offer the possibility of more accurate diagnosis and staging, with correspondingly better patient outcomes. However, there is a lack of evidence that better outcomes are being realised for veterinary patients. Furthermore, increased use of advanced imaging carries the possibility of increased misuse, primarily through unnecessary studies that contribute little to patient management other than increased costs. SCOPE This article is intended to be relevant to all veterinary species. Advanced imaging of cats is not sufficiently developed as a specific discipline that a balanced review could be based purely on feline examples or references.
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Affiliation(s)
- Christopher R Lamb
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK.
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29
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Kavanagh C, Shaw S, Webster CRL. Coagulation in hepatobiliary disease. J Vet Emerg Crit Care (San Antonio) 2012; 21:589-604. [PMID: 22316251 DOI: 10.1111/j.1476-4431.2011.00691.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To review the pathogenesis and clinical consequences of coagulation abnormalities accompanying hepatobiliary disorders and to highlight the need for further studies to characterize these derangements and their treatment options in small animal patients. DATA SOURCES Veterinary and human medical literature: original research articles, scientific reviews, consensus statements, and recent texts. SUMMARY The liver plays an important role in the production and clearance of many components of coagulation. A wide range of hemostatic derangements can occur in patients with hepatobiliary disease including alterations in platelet number and function, coagulation factor levels, anticoagulants, vascular endothelial function, and fibrinolysis. As these hemostatic alterations include both pro- and anticoagulation pathways, the net result is often a rebalanced hemostatic system that can be easily disrupted by concurrent conditions resulting in either clinical bleeding or thrombosis. Conventional coagulation tests are inadequate at identifying the spectrum of coagulation alterations occurring in patients with hepatobiliary disease, but their evaluation is necessary to assess bleeding risk and provide prognostic information. A paucity of information exists regarding the treatment of the coagulation derangements in small animals with hepatobiliary disease. Extrapolation from human studies provides some information about potential treatment options, but further studies are warranted in this area to elucidate the best management for coagulation abnormalities in dogs and cats with hepatobiliary disease. CONCLUSION Hepatobiliary disease can have profound effects on coagulation function leading to hypercoagulable or hypocoagulable states. Overall coagulation status with hepatobiliary disease depends on both the type and severity of disease and the presence of associated complications.
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Affiliation(s)
- Carrie Kavanagh
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
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30
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Fields EL, Robertson ID, Brown JC. Optimization of contrast-enhanced multidetector abdominal computed tomography in sedated canine patients. Vet Radiol Ultrasound 2012; 53:507-12. [PMID: 22612282 DOI: 10.1111/j.1740-8261.2012.01950.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2011] [Accepted: 04/09/2012] [Indexed: 11/27/2022] Open
Abstract
A major disadvantage of computed tomography for abdominal screening in dogs has been the need for general anesthesia to prevent motion artifacts. With multidetector helical CT, it is possible to decrease examination time, allowing patients to be scanned under sedation. It is also desirable to decrease tube loading to prolong x-ray tube life. To develop a protocol that will allow for examination of sedated patients with minimal image artifacts, milliamperage (mA) and helical pitch were varied, providing 16 experimental scan protocols. A standard clinical protocol was also tested, providing 17 protocols for evaluation. These protocols were tested, using a standard CT phantom, canine tissues in a water bath, and a canine cadaver. The cadaver images were scored semiquantitatively by three reviewers to determine the protocol with the best combination of speed and minimal image artifact. The optimized protocol was then applied to 27 sedated canine patients of three body weight categories. The images obtained were compared to the standard protocol by two reviewers for presence of motion, streak, and quantum mottle artifacts. There was significantly more streak artifact noted by one observer using the optimized study protocol, but no significant difference in any other category. Scanning under sedation was well tolerated in all patients, and sedated CT examination is a promising tool for screening abdominal disease in dogs.
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Affiliation(s)
- Erica L Fields
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA
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31
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Bertolini G, Caldin M. Computed tomography findings in portal vein aneurysm of dogs. Vet J 2012; 193:475-80. [PMID: 22269874 DOI: 10.1016/j.tvjl.2011.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Revised: 12/09/2011] [Accepted: 12/14/2011] [Indexed: 01/16/2023]
Abstract
In this retrospective study, the appearances of extrahepatic and intrahepatic portal vein aneurysms (PVAs) in dogs were evaluated using multidetector computed tomography (CT). Data from 3060 dogs that underwent abdominal CT were reviewed for focal portal vein dilatation. PVAs were detected in 15/3060 (0.49%) dogs. The bodyweights of dogs with PVAs were significantly higher than the bodyweights of dogs without aneurysms (P=0.0001). Male sex was also significantly associated with PVAs (OR=6.23). Boxers were predisposed to the development of PVA (OR=11.88). Extrahepatic PVAs were always located in the portal vein at the level of the gastroduodenal vein insertion and were saccular in 10/15 dogs and fusiform in 5/15 dogs. One dog had an additional intrahepatic aneurysm of the umbilical part of the left intrahepatic portal branch. No dogs had clinical signs related to the PVA(s), although one dog developed a portal vein thrombosis in the site of the aneurysm.
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Affiliation(s)
- G Bertolini
- San Marco Veterinary Clinic, Via Sorio 114/c, 35141 Padua, Italy.
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Hagen R. Cross-sectional imaging: the key to anatomy. Vet Rec 2012; 170:17-8. [DOI: 10.1136/vr.e9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Regine Hagen
- Division of Diagnostic Imaging; Vetsuisse Faculty Zürich; Winterthurerstrasse 260 8057 Zürich Switzerland
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Henjes CR, Nolte I, Wefstaedt P. Multidetector-row computed tomography of thoracic aortic anomalies in dogs and cats: patent ductus arteriosus and vascular rings. BMC Vet Res 2011; 7:57. [PMID: 21943366 PMCID: PMC3186751 DOI: 10.1186/1746-6148-7-57] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 09/23/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. We postulated that accurate characterization of malformations of the aorta would benefit from 3-dimensional assessment. Therefore, multidetector-row computed tomography (MDCT) was chosen as a 3-dimensional, new, and noninvasive imaging technique. The purpose of this study was to evaluate patients with 2 common diseases of the intrathoracic aorta, either patent ductus arteriosus or vascular ring anomaly, by contrast-enhanced 64-row computed tomography. RESULTS Electrocardiography (ECG)-gated and thoracic nongated MDCT images were reviewed in identified cases of either a patent ductus arteriosus or vascular ring anomaly. Ductal size and morphology were determined in 6 dogs that underwent ECG-gated MDCT. Vascular ring anomalies were characterized in 7 dogs and 3 cats by ECG-gated MDCT or by a nongated thoracic standard protocol. Cardiac ECG-gated MDCT clearly displayed the morphology, length, and caliber of the patent ductus arteriosus in 6 affected dogs. Persistent right aortic arch was identified in 10 animals, 8 of which showed a coexisting aberrant left subclavian artery. A mild dilation of the proximal portion of the aberrant subclavian artery near its origin of the aorta was present in 4 dogs, and a diverticulum analogous to the human Kommerell's diverticulum was present in 2 cats. CONCLUSIONS Contrast-enhanced MDCT imaging of thoracic anomalies gives valuable information about the exact aortic arch configuration. Furthermore, MDCT was able to characterize the vascular branching patterns in dogs and cats with a persistent right aortic arch and the morphology and size of the patent ductus arteriosus in affected dogs. This additional information can be of help with regard to improved diagnoses of thoracic anomalies and the planning of surgical interventions.
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Affiliation(s)
- Christiane R Henjes
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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Bertolini G, Prokop M. Multidetector-row computed tomography: Technical basics and preliminary clinical applications in small animals. Vet J 2011; 189:15-26. [DOI: 10.1016/j.tvjl.2010.06.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Revised: 06/03/2010] [Accepted: 06/04/2010] [Indexed: 11/27/2022]
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Contreras S, Vázquez JM, Morales M, Rivero MA, Gil F, Latorre R, Arencibia A. Three-dimensional MRA study of the normal canine thorax: MIP sections and volume rendering. Anat Histol Embryol 2010; 40:40-6. [PMID: 21054496 DOI: 10.1111/j.1439-0264.2010.01036.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to investigate the feasibility of three-dimensional contrast-enhanced magnetic resonance angiography (3D-CE-MRA) for the non-invasive anatomical evaluation of the thoracic vasculature in five normal Beagles. After intravenous gadolinium administration and a cardio-respiratory gating protocol, fast 3D gradient echo pulse sequence MRA was performed employing a 1.5 Tesla magnet and a human thorax coil. Three-dimensional vascular software was applied. Sagittal, transverse and dorsal maximum intensity projection (MIP) sections and volume rendering (VR) images were obtained and labelled. Anatomical literature, dissections and gross sections were employed to assist the identification of the vascular structures. With improvements in scanner technology, MIP sections and VR images are a promising, non-invasive and accurate method of evaluating the canine thoracic vasculature. Images provide a reference material for clinical studies of the canine thorax for radiologist-surgeon teamwork assessment and also encourage the development of this technique in veterinary medicine.
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Affiliation(s)
- S Contreras
- Department of Morphology, Faculty of Veterinary, Las Palmas de G.C. University, 35413 Las Palmas de Gran Canaria, Spain.
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GÓMEZ-OCHOA PABLO, LLABRÉS-DÍAZ FRANCISCO, RUIZ SERGIO, CORDA ANDREA, PRIETO SAUL, SOSA IVÁN, GREGORI TOMMASO, GASCÓN MANUEL, COUTO GUILLERMOC. USE OF TRANSSPLENIC INJECTION OF AGITATED SALINE AND HEPARINIZED BLOOD FOR THE ULTRASONOGRAPHIC DIAGNOSIS OF MACROSCOPIC PORTOSYSTEMIC SHUNTS IN DOGS. Vet Radiol Ultrasound 2010. [DOI: 10.1111/j.1740-8261.2010.01752.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Brown JC, Chanoit G, Reeder J. Complex extrahepatic portocaval shunt with unusual caval features in a cat: computed tomographic characterisation. J Small Anim Pract 2010; 51:227-30. [DOI: 10.1111/j.1748-5827.2009.00903.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chen TW, Yang ZG, Li X, Wang QL, Qian LL, Wang RR. Evaluation of entire gastric fundic and esophageal varices secondary to posthepatitic cirrhosis: portal venography using 64-row MDCT. ABDOMINAL IMAGING 2010; 35:1-7. [PMID: 19247703 DOI: 10.1007/s00261-009-9506-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 02/08/2009] [Indexed: 02/05/2023]
Abstract
BACKGROUND There are no reports regarding entire gastric fundic and esophageal varices evaluated with 64-row multidetector CT (MDCT). We attempt to clarify the feasibility of portal venography with this scanner in evaluation of these varices. METHODS A total of 33 patients, with clinically confirmed gastric fundic and esophageal varices secondary to posthepatitic cirrhosis, underwent thoracicoabdominal triphasic enhancement scans using 64-row MDCT along with conventional angiographic portography. CT portography and conventional portography were compared by statistical agreement to determine whether CT maximum intensity projection (CT-MIP) portography is useful in evaluation of entire gastric fundic and esophageal varices. RESULTS CT-MIP portography demonstrated gastric fundic and esophageal varices, and the inflowing and outflowing vessels of the varices. Gastric fundic varices were shown in 32 cases (97.0%), and esophageal varices were in 27 (81.8%). The inflowing vessels including the left gastric vein and posterior gastric vein/short gastric vein were illustrated in 31 (94.0%) and 17 (51.5%) cases, respectively. The outflowing vessels including the azygos vein, hemiazygos vein, and gastro-renal shunts were seen in 30 (90.9%), 8 (24.2%), and 12 (36.4%) cases, respectively. Findings of CT-MIP portography and conventional angiographic portography were in close agreement (Kappa value ranged from 0.621 to 1.000). CONCLUSION CT-MIP venography with 64-row MDCT could be considered as a method for detecting entire gastric fundic and esophageal varices developed from posthepatitic cirrhosis.
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Affiliation(s)
- Tian-Wu Chen
- Department of Radiology, West China Hospital of Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China
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BERTOLINI GIOVANNA. ACQUIRED PORTAL COLLATERAL CIRCULATION IN THE DOG AND CAT. Vet Radiol Ultrasound 2010; 51:25-33. [DOI: 10.1111/j.1740-8261.2009.01616.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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BRUEHSCHWEIN ANDREAS, FOLTIN ISA, FLATZ KATHARINA, ZOELLNER MARTIN, MATIS ULRIKE. CONTRAST-ENHANCED MAGNETIC RESONANCE ANGIOGRAPHY FOR DIAGNOSIS OF PORTOSYSTEMIC SHUNTS IN 10 DOGS. Vet Radiol Ultrasound 2010; 51:116-21. [DOI: 10.1111/j.1740-8261.2009.01634.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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JOLY HUGO, D'ANJOU MARCANDRÉ, HUNEAULT LOUIS. IMAGING DIAGNOSIS-CT ANGIOGRAPHY OF A RARE VASCULAR RING ANOMALY IN A DOG. Vet Radiol Ultrasound 2008; 49:42-6. [DOI: 10.1111/j.1740-8261.2007.00315.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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TATEISHI K, KISHIMOTO M, SHIMIZU J, YAMADA K. A Comparison Between Injection Speed and Iodine Delivery Rate in Contrast-Enhanced Computed Tomography (CT) for Normal Beagles. J Vet Med Sci 2008; 70:1027-30. [DOI: 10.1292/jvms.70.1027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Kosuke TATEISHI
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine
| | - Miori KISHIMOTO
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine
| | - Junichiro SHIMIZU
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine
| | - Kazutaka YAMADA
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine
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Sura PA, Tobias KM, Morandi F, Daniel GB, Echandi RL. Comparison of 99mTcO4(-) trans-splenic portal scintigraphy with per-rectal portal scintigraphy for diagnosis of portosystemic shunts in dogs. Vet Surg 2007; 36:654-60. [PMID: 17894591 DOI: 10.1111/j.1532-950x.2007.00317.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate trans-splenic portal scintigraphy (TSPS) and per-rectal portal scintigraphy (PRPS) for diagnosis of congenital portosystemic shunts (CPSS) in dogs, and compare these results with surgical findings. STUDY DESIGN Prospective, randomized cross over clinical trial. ANIMALS Dogs (n=42) with suspected CPSS. METHODS Dogs had TSPS and PRPS 48 hours apart; quantity of radionuclide administered was recorded. Three independent, blinded reviewers evaluated each scintigraphic study for study quality, shunt presence, number, and location of shunt termination (caudal vena cava, azygos vein). All dogs had exploratory celiotomy. Negative scintigraphic findings were confirmed with intraoperative mesenteric portography. Ameroid constrictors were placed on all extrahepatic CPSS, and hepatic biopsies were obtained. RESULTS TSPS was 100% sensitive and specific for diagnosis of CPSS and significantly (P<.05) more likely than PRPS to detect shunt number and termination. Interpretation was consistent between observers, and TSPS required significantly less radionuclide than PRPS. CONCLUSION TSPS was as sensitive as PRPS for detection of shunting vessels, and consistently yielded studies of higher quality, allowing detection of shunt number and location with consistent interpretation among radiologists. CLINICAL RELEVANCE TSPS provides information about shunt number and location, which allows improved surgical planning. Because it requires significantly less radionuclide, TSPS improves safety, allows for more comprehensive patient care, and earlier surgical intervention.
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Affiliation(s)
- Patricia A Sura
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN 37996-4544, USA.
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Yamada K, Morimoto M, Kishimoto M, Wisner ER. VIRTUAL ENDOSCOPY OF DOGS USING MULTI-DETECTOR ROW CT. Vet Radiol Ultrasound 2007; 48:318-22. [PMID: 17691629 DOI: 10.1111/j.1740-8261.2007.00249.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Virtual endoscopy uses CT data to display hollow viscera such as the stomach, duodenum and colon as if by real endoscopic observation. The results are independent of the operator skill because virtual endoscopy does not require direct manipulation of endoscopic equipment. The purpose of this study was to evaluate the utility of virtual endoscopy in small animals. Ten beagles were examined by conventional endoscopy and virtual endoscopy using multidetector CT. Virtual images were image-processed at a workstation designed for depicting virtual endoscopy using CT data. Virtual images were visually comparable with conventional endoscopic images, especially in the area of the angular incisure and pylorus. The advantages of virtual endoscopy are observation from any viewing angle, a reduced learning curve for diagnostic interpretation, quantification of lesion size in three dimensions and a potential for reducing anesthesia time. The disadvantages of virtual endoscopy are a lack of color recognition information, an inability to retrieve biopsy samples, limited visualization of the duodenum, artifacts from respiration/peristalsis motion and an inability to observe function. Based on our results, we suggest that conventional endoscopy is still superior to virtual endoscopy in dogs. However, as technology improves, virtual endoscopy may emerge as a suitable alternative or adjunctive diagnostic tool for certain digestive disorders in small animals.
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Affiliation(s)
- Kazutaka Yamada
- Department of Clinical Veterinary Science, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan.
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