Imaging diagnosis-cholangiocellular adenoma: contrast-enhanced ultrasonographic findings of a benign tumor mimicking malignant neoplasia in a dog

Intraluminal Contrast-Enhanced Ultrasonography Application in Dogs and Cats

Administering intraluminal fluid can improve the acoustic window for the visualization of the lumen and wall layers in the cavitary organs. Microbubbles in ultrasound contrast agents can also be used for intracavitary applications to enhance visualization of the lesion in human patients. However, there was no literature extending the clinical application of intraluminal contrast-enhanced ultrasonography (CEUS) to patients with naturally occurring diseases in veterinary medicine. This case series aims to describe the detailed application and diagnostic value of intraluminal CEUS in six clinical cases with naturally occurring gastrointestinal (GI) and urinary tract diseases.

Canine intrahepatic biliary disease - what have we learned?

The intrahepatic biliary tract is essential for physiologic homeostasis. Disease that results in aberrant function can have serious deleterious consequences and result in considerable morbidity and mortality. This review aimed to summarise clinically relevant updates on intrahepatic biliary disorders in dogs including human corollaries.

The cytologic features of biliary diseases: A retrospective study

BACKGROUND

Histologic examination, together with clinical data and instrument support, contributes to the recognition of biliary diseases. Although quantitative and qualitative changes in hepatic and biliary cells can occur, descriptions of cytologic samples from the liver affected by cholangiopathies are rare.

OBJECTIVES

This study aimed to describe the quantitative and qualitative changes in cholangiocytes, hepatocytes, and inflammatory cells in cytologic samples from dogs and cats affected by histologically confirmed cholangiopathies.

METHODS

Cytologic samples from the liver with histologically confirmed cholangiopathies were reviewed and compared to describe the changes seen on cytology. The samples were obtained from the Archive of Clinica Veterinaria Sant'Antonio and the Laboratorio Veterinario Bresciano. Statistical analysis was not performed.

RESULTS

A total of 196 cytologic samples retrieved from the database fit the selection criteria, 88 from dogs, and 108 from cats. A total of eight categories of cholangiopathies have been identified and described, while histology is often required to achieve a definitive diagnosis, six categories of cholangiopathy in dogs and seven in cats provide cytologic information.

CONCLUSIONS

Cytologic examination, together with clinical and ultrasonographic data, can be useful for identifying hepatic abnormalities in acute and chronic cholestasis, chronic cholangitis, feline lymphoplasmacytic cholangitis, and cholangiocellular neoplasms.

Contrast-enhanced ultrasonography features of hepatobiliary neoplasms in cats

BACKGROUND

Contrast-enhanced ultrasonography (CEUS) features of primary hepatobiliary neoplasms have been reported in dogs but no information is available in cats.

METHODS

Qualitative and quantitative features of bile duct adenomas (BDAs, n=20), bile duct carcinomas (BDCs, n=16), and hepatocellular carcinomas (HCCs, n=8) are described in 44 cats.

RESULTS

There was an overlap in CEUS qualitative features between different histotypes, both in wash-in and wash-out phases. Distinction between different neoplasms based only on the CEUS qualitative features was not possible. At peak of enhancement, the BDAs, BDCs and HCCs showed a large range of echogenicities, from hypoenhancement to hyperenhancement, in comparison to the liver parenchyma. Eight of 20 BDAs showed inhomogeneous hyperenhancement during wash-in, which is a feature reported as typical of malignant lesions in dogs. BDC had a significantly faster wash-in compared with both BDA and HCC but the diagnostic accuracy of all the included quantitative variables was only moderate. No significant differences in the wash-out quantitative features of BDA and BDC were evident.

CONCLUSION

There is poor evidence that CEUS may be used to distinguish between different primary hepatobiliary neoplasms in cats.

Findings of contrast-enhanced ultrasonography with Sonazoid for cholangiocellular adenoma in three dogs

Contrast-enhanced ultrasonography (CEUS) is useful to distinguish benign and malignant focal liver lesions in dogs. Cholangiocellular adenoma is an extremely rare benign tumor in dogs and has not been examined using CEUS with Sonazoid. The aim of this study was to describe findings of CEUS with Sonazoid in three dogs with cholangiocellular adenoma. All three dogs showed contrast defects in the Kupffer phase and these findings mimicked malignant neoplasia during the Kupffer phase. Moreover, all dogs showed early washout and hypoechoic lesions relative to the surrounding normal liver parenchyma in the portal phase. To our knowledge, this is the first study to report that CEUS findings of cholangiocellular adenoma with Sonazoid mimicked malignancy in three dogs.

Contrast-enhanced ultrasonography to assess blood perfusion of skeletal muscles in normal dogs

This study evaluated perfusion of skeletal muscle using contrast enhanced ultrasonography in humerus, radius, femur and tibia in normal dogs. Contrast enhanced ultrasonography for each region was performed after injecting 0.5 mL and 1 mL of contrast medium (SonoVue) in every dog. Blood perfusion was assessed quantitatively by measuring the peak intensity, time to the peak intensity and area under the curve from the time-intensity curve. Vascularization in skeletal muscle was qualitatively graded with a score of 0-3 according to the number of vascular signals. A parabolic shape of time-intensity curve was observed from muscles in normal dogs, and time to the peak intensity, the peak intensity and area under the curve of each muscle were not significantly different according to the appendicular regions examined and the dosage of contrast agent administered. This study reports that feasibility of contrast enhanced ultrasonography for assessment of the muscular perfusion in canine appendicular regions.