THE EFFECT OF MANUAL LUNG INFLATION VS. SPONTANEOUS INSPIRATION ON THE CARDIAC SILHOUETTE IN ANESTHETIZED DOGS

The purpose of this study was to assess radiographic heart size in anesthetized dogs, comparing radiographs made with the patient breathing spontaneously to radiographs obtained using positive pressure manual lung inflation. The hypothesis was that manual inflation would cause reduction in the cardiac size. With dogs in right recumbency a radiograph was made at peak spontaneous inspiration followed immediately a radiograph made with application of positive pressure manual inflation of the thorax. Cardiac size was assessed, both subjectively and objectively using the vertebral heart scale (VHS). Two hundred and six dogs were studied. Manual inflation resulted in a significantly greater degree of lung inflation assessed radiographically ( P <0.0001). The subjectively assessed heart size was significantly smaller in radiographs made with manual inflation, leading to different subjective categorization of heart size in 67 (32%) of dogs. The objectively measured VHS was also significantly smaller in the radiographs made using manual inflation by a mean of 0.24 of a vertebral length (95% CL of mean difference: −0.29, −0.19, P <0.0001). A statistically significant reduction in subjective heart size and in VHS occurred with manual inflation of the lungs, and these differences may be clinically significant. Thus, if serial radiographs are obtained to assess cardiac size, the radiographic technique used should be the same.     

COMPUTED TOMOGRAPHIC FEATURES OF LUNG LOBE TORSION

The imaging features of lung lobe torsion in 10 dogs (nine complete, one partial torsion) acquired with a helical single‐slice computed tomography (CT) unit are described. Attenuation values of normal, rotated, and adjacent collapsed lung lobes before and after intravenous contrast medium administration were compared. Affected lung lobes were: left cranial (5), right middle (3), right cranial (1), and left caudal (1). CT findings in nine dogs with complete lung lobe torsion included pleural effusion and an abruptly ending bronchus. In eight of these dogs, enlargement, consolidation, emphysema of the affected lung lobe, and mediastinal shift to the contralateral side were present. Rotated lung lobes did not enhance, whereas adjacent collapsed and aerated lung lobes did (P<0.05). Apnea induced with hyperventilation or breath‐hold is essential to reduce motion artefacts and obtain a diagnostic study.     

COMPUTED TOMOGRAPHIC APPEARANCE OF PRIMARY LUNG TUMORS IN DOGS

Canine primary lung tumors typically appear radiographically as a well‐circumscribed solitary mass in the periphery of a caudal lung lobe. Consolidated and diffuse forms of primary lung tumors have also been described. Nineteen dogs with computed tomographic (CT) images of the thorax and a histological diagnosis of primary lung tumor (17 primary carcinomas and two primary sarcomas) were evaluated retrospectively to characterize the CT findings. All primary lung tumors were bronchocentric in origin with internal air bronchograms. The bronchi were typically narrowed, displaced, and often obstructed by the tumor. Eighteen of 19 (95%) of the tumors were solitary and there was one pneumonic/alveolar form. Most solitary tumors were well circumscribed (17/18), located in the central to periphery of the lung (14/18), and in a cranial or caudal lobe (16/19). Most primary lung tumors (11/17) had mild to moderate heterogeneous contrast enhancement. Five of 19 dogs (26%) had evidence of pulmonary metastasis. Internal mineralization (3/19) and tracheobronchial lymphadenopathy (4/19) were also identified. On CT examination, solitary, well circumscribed, bronchocentric masses with internal air bronchograms are consistent with a primary pulmonary tumor in dogs.     

RADIOGRAPHIC DIAGNOSIS OF LUNG LOBE TORSION

Clinical data, thoracic radiographs, ultrasonographic exams, and histopathologic reports in 13 dogs and two cats with confirmed lung lobe torsion were reviewed. Age of dogs ranged from 4 months to 11.5 years, (mean of 6.4 years) and several breeds of large and small dogs were represented. Right middle lobe torsion was predominant in large dogs (five of eight large breed dogs) and left cranial lobe torsion was more commonly seen in small dogs (three of five small-breed dogs). Two domestic short-hair cats, 10 and 14 years of age, had right cranial and right middle lobe torsion, respectively. Underlying thoracic disease was found in only five of 15 patients. On thoracic radiographs, increased lobar opacity and pleural effusion were found in all patients (100%). Small dispersed air bubbles were found within the affected lobe of 13 patients (87%). This pattern, which was the result of vesicular emphysema, was variably extensive, and became more evident on follow-up radiographs in five of six dogs. The lobar bronchi could be seen in only eight of 15 patients (54%), and appeared irregular, focally narrowed or blunted in six of the eight patients, and displaced in five of the eight. Other common radiographic findings included mediastinal shift (nine), curved and dorsally displaced trachea (seven), and axial rotation of the carina (seven). Ultrasonography was used in seven patients and considered generally useful, although variable signs were observed.     

RADIOGRAPHY REVIEW: THE INTERSTITIAL PATTERN OF PULMONARY DISEASE

The interstitium supports and surrounds the blood vessels, lymph vessels, bronchi, and alveoli. One of the most common interstitial lung patterns is that of multiple, variably sized distinct nodules. Pulmonary granulomas, abscesses, and neoplasms usually have this radiographic appearance. Other interstitial patterns result from the summation of multiple areas of diseased perivascular and peribronchial interstitial tissue and/or alveolar septa. Diseases characterized by this unstructured increase in pulmonary density include pulmonary fibrosis, early dirofilariasis, interstitial edema, viral pneumonia, and certain types of metastatic neoplasia.     

RADIOGRAPHIC CHARACTERIZATION OF PRIMARY LUNG TUMORS IN 74 DOGS

Primary pulmonary neoplasia is well recognized in dogs and prognosis depends upon the tumor type. The purpose of this retrospective study was to characterize the radiographic appearance of different primary lung tumors with the goal of establishing imaging criteria to separate the different types. Three‐view thoracic radiographs of 74 dogs with histologically confirmed pulmonary anaplastic carcinoma (n = 2), adenocarcinoma (n = 31), bronchioalveolar carcinoma (n = 19), histiocytic sarcoma (n = 21), and squamous cell carcinoma (n = 1) were evaluated. Radiographs were assessed for tumor volume, affected lobe, location within lobe, overall pulmonary pattern, presence of cavitation, mineralization, air bronchograms, lymphadenomegaly, and pleural fluid. Histiocytic sarcomas were significantly larger than other tumor types (271 cm³; P = 0.009) and most likely to be found in the left cranial (38%; 8/21) and right middle (43%; 9/21) lung lobes, whereas adenocarcinomas were most likely to be found in the left caudal (29%; 9/31) lung lobe. Fifty‐seven percent (12/21) of histiocytic sarcomas had an internal air bronchogram. Findings indicate that a large mass in the periphery or affecting the whole lobe of the right middle or left cranial lung lobe with an internal air bronchogram is likely to be an histiocytic sarcoma.     

CISTERNOGRAPHY COMBINED WITH LINEAR TOMOGRAPHY FOR VISUALIZATION OF PITUITARY LESIONS IN DOGS WITH PITUITARY-DEPENDENT HYPERADRENOCORTICISM

Cisternography combined with sagittal linear tomography was performed in eight dogs with pituitary-dependent hyperadrenocorticism, in search of pituitary lesions. In one dog with a pituitary microadenoma, the dimensions of the pituitary gland were within normal limits. In six dogs the pituitary gland was enlarged. In the remaining dog the pituitary gland was also enlarged, but could not be measured due to absence of contrast medium in the cisternae around the pituitary gland. In these seven dogs large pituitary tumors were found at autopsy. With linear tomography the height of the pituitary gland could only be measured in the dog with the microadenoma. In all other dogs compression of the subarachnoid space at the dorsal aspect of the pituitary gland interfered with the assessment of the height of the pituitary lesion, and therefore with the assessment of the presence and extent of compression of the hypothalamus. It is concluded that cisternography combined with linear tomography provides information about the size of the pituitary gland and the presence of suprasellar expansion, although the present technique does not allow an assessment of the severity of the suprasellar expansion.     

PRESUMED MINERAL OIL ASPIRATION AND CAVITARY LUNG LESIONS IN A DOG

This report describes an unusual occurrence of cavitary lung lesions which may have been secondary to aspiration of mineral oil and illustrates a possible danger of aspiration pneumonia associated with administration of lipids. Lipid pneumonia should be considered in the differential diagnosis for pulmonary disease with radiographic signs ranging from increased interstitial opacity to nodules or cavitary lung lesions. This report also emphasizes the benefits of serial radiography to detect changing pathology and the occurrence of complications such as pneumothorax.     

INITIAL INFLUENCE OF RIGHT VERSUS LEFT LATERAL RECUMBENCY ON THE RADIOGRAPHIC FINDING OF DUODENAL GAS ON SUBSEQUENT SURVEY VENTRODORSAL PROJECTIONS OF THE CANINE ABDOMEN

Identification of the duodenum and potential abnormalities on survey abdominal radiographs is often difficult unless it contains gas. This study investigated the effect of patient positioning on the presence of duodenal gas in survey abdominal radiographs. One hundred dogs receiving a three‐view survey abdominal radiographic study were enrolled in a prospective, randomized study where all dogs were divided into two groups. Group A (n = 51) dogs had a left lateral projection first, followed by a ventrodorsal projection, ending with a right lateral projection. Group B (n = 49) dogs had a right lateral projection first, followed by a ventrodorsal projection, ending with a left lateral projection. The presence of gas within the duodenum and level of distribution of gas throughout the duodenum were recorded for all three projections. In addition, the presence or absence of duodenal pseudoulcers was evaluated on all three projections for each dog. The results for the two groups were compared using Chi‐square analysis with a P‐value of less than 0.05 being considered significant. Results showed that dogs first placed in left lateral recumbency were significantly more likely to have duodenal gas on the subsequent ventrodorsal and right lateral radiographic projections compared to dogs first placed in right lateral recumbency (P‐value < 0.0001). Pseudoulcers were seen in 11 dogs that had duodenal gas making the visualization of pseudoulcers on survey abdominal radiographs somewhat commonplace. This study emphasizes the benefit of using initial left lateral abdominal projections prior to other views for subsequent evaluation of the duodenum.     

CYSTOGRAPHY: EFFECT OF TECHNIQUE ON DIAGNOSIS OF CYSTITIS IN DOGS

Double-constrast and positive-contrast cystograms were performed in 12 dogs. After cystography, E. coli cystitis was induced in nine of the 12 dogs. The remaining three dogs were used as controls. Double contrast and positive-contrast cystograms were repeated threee, seven and 14 days later. During cystography, bladders were distended to mild, moderate, and complete degrees of distention. Mucosal irregularity decreased with increasing bladder distention and was more likely to be seen on double-contrast than on the positive-contrast cystogram. When seen on both types of studies, mucosal irregularity was more obvious on double-contrast than it was on the positive-contrast custogram. Bladder wall thickness decreased with increasing distention; in some dogs with mild cystitis, abnormal wall thickness was masked by complete bladder distention. Bladder wall thickness could be measured more often on double-contrast than on the positive contrast cystograms. Wall thickness measurments made on both types of studies were similar. It was concluded that lesions of mild to moderate cystitis may be missed when the bladder is completely distended, and that the double-contrast cystogram is more sensetive for evaluating mucosal margivation and bladder wall thickness than is the positive-contrast cystogram     

THE EFFECT OF ANESTHESIA ON THE RADIOGRAPHIC APPEARANCE OF THE COXOFEMORAL JOINTS

The effect of anesthesia on the radiographic appearance of the coxofemoral joints was evaluated by taking pelvic radiographs of thirty dogs. Each dog was radiographed twice, once under general anesthesia and once without anesthesia. The radiographs were submitted to the Orthopedic Foundation for Animals independently of one another to be evaluated for signs of hip dysplasia. Results suggest there was no statistical difference between the two groups of dogs. Twenty five dogs received the same reading. Three dogs received readings that were worse by one grade while under anesthesia and two dogs received readings that were one grade better while under anesthesia. This study failed to demonstrate any changes due to anesthesia on the radiographic appearance of the coxofemoral joints. Anesthesia may, however, be beneficial for proper positioning and to decrease unnecessary patient, and personnel exposure to radiation.     

A COMPARISON OF NORMAL FELINE THORACIC RADIOGRAPHS MADE IN DORSAL VERSUS VENTRAL RECUMBENCY

Thoracic radiographs of 11 normal cats were made in dorsal (VD) and ventral (DV) recumbency with a vertically directed x-ray beam. These radiographs were compared subjectively and objectively with each other and with an additional pair of radiographs made with the cats in dorsal and ventral recumbency using a horizontally directed x-ray beam. Differences were found between VD and DV thoracic radiographs but they were minimal. In VD radiographs the caudal mediastinum and accessory lobe regïon of the lung were more clearly seen but cardiac shape varied somewhat. In DV radiographs, the appearance of the heart was more constant and caudal lobar pulmonary arteries more clearly seen. The results of this study indicated that both VD and DV radiographs are satisfactory for radiographic examination of the feline thorax     

INTERMITTENT CRANIAL LUNG HERNIATION IN TWO DOGS

Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.     

THE EFFECT OF DORSAL VERSUS VENTRAL RECUMBENCY ON THE RADIOGRAPHIC APPEARANCE OF THE CANINE THORAX

The thorax of nine dogs was radiographed with a vertical beam in both dorsal (VD) and ventral (DV) recumbency. The radiographs were evaluated subjectively and objectively for differences in appearance. To help explain appearance differences, lateral thoracic radiographs were made with the dogs in dorsal and ventral recumbency using a horizontally (laterally) directed x-ray beam. The appearance of thoracic viscera in VD and DV vertical beam radiographs differed. In VD vertical beam radiographs the craniocaudal axis of the heart appeared longer, the heart had a more consistent positional relationship to the thoracic spine, a larger area of the accessory lung lobe was visible, and a greater length of the caudal vena cava was visible. In DV radiographs the caudal lobar pulmonary arteries were more easily identified. The selection of dorsal versus ventral recumbency for thoracic radiography should be based on the clinical status of the patient and the reason(s) for which the radiograph is being made.     

MAGNETIC RESONANCE IMAGING OF THE CANINE ABDOMEN: EFFECT OF PULSE SEQUENCE ON DIAGNOSTIC QUALITY

Motion artifact is an important limiting factor for abdominal magnetic resonance imaging (MRI) in veterinary patients. The purpose of this study was to determine the effects of pulse sequence on abdominal MRI diagnostic quality in dogs. Ten normal dogs were each scanned using 16 MRI pulse sequences. Sequences included breath‐holding sequences, respiratory navigation sequences, and traditional spin‐echo sequences. Four observers independently scored diagnostic quality for each sequence based on the appearance of specific organs, overall diagnostic quality, and degree of artifactual interference. Signal‐to‐noise ratio and contrast‐to‐noise ratio were also calculated for each sequence. The sequence with the highest overall mean diagnostic quality score was the dorsal T2 turbo spin echo (TSE) with fat saturation and breath‐holding. The sequence with the lowest mean diagnostic quality score was the dorsal T2 fast spin echo. The sequence with the highest signal‐to‐noise ratio for all evaluated organs was the sagittal T1 spin echo. Signal‐to‐noise and contrast‐to‐noise ratios did not correlate with subjective assessment of overall diagnostic quality for the majority of the sequences evaluated (P < 0.05). The three sequences considered to have the highest diagnostic quality for the cranial abdomen were the dorsal T2 TSE with fat saturation and breath‐hold, transverse T1 turbo fast low‐angle shot gradient echo with breath‐hold, and dorsal T2 half‐Fourier acquisition single shot TSE with respiratory navigation. These sequences had short acquisition times, yielded studies of similar diagnostic quality, provided complementary information, and are therefore recommended for routine canine abdominal MRI protocols.     

THE EFFECT OF BODY WALL ON VIDEO SIGNAL ANALYSIS MEASUREMENTS

Rectangular body wall specimens were extracted from 16 juvenile swine and 9 adult beagle hounds after euthanasia. The body wall specimen included the epidermis to parietal membrane, with falciform fat removed. Ten images of a reference phantom with known attenuation and 10 additional images of the phantom with the specimen placed between the transducer and phantom surface were collected with a 5-MHz ultrasound system and computer with frame grabber board. Mean pixel values were converted to relative echogenicities. Echogenicity versus depth yielded an estimate of attenuation. An unpaired t test was applied to compare reference attenuation values with and without body wall, and a Pearson correlation was applied to body wall parameters versus measured attenuation through body wall. Measured attenuation through body wall increased significantly in dogs (P = 0.0016) and swine (P < 0.0001) when compared with phantom material alone. Increased attenuation positively correlated to body wall thickness (r = 0.6442) and mean gray level within body wall (r = 0.5069) for swine but not in canine. The presence of body wall in images used for video signal analysis significantly increases the measured attenuation in a phantom. This increase does not correlate with a measurable body wall parameter in dogs.     

LOSS OF UROCYSTOLITH ARCHITECTURAL CLARITY DURING IN VIVO RADIOGRAPHIC SIMULATION VERSUS IN VITRO VISUALIZATION

Urocystoliths of 9 mineral types from 434 canine patients submitted to the University of Minnesota Urolith Bank were imaged in a urinary bladder phantom. Imaging techniques simulated were survey radiography and double contrast cystography. Morphologic characteristics visually observed in vitro or by interpretation of high-resolution specimen radiographs were compared to those seen using the simulated in vivo imaging techniques. Shape characteristics that were accurately detected > or = 25% of the time on simulated survey or double contrast radiography were faceted, irregular, jackstone, ovoid, and round. Surface characteristics that were accurately detected > or = 25% of the time on simulated survey or double contrast radiography were rough, smooth, and smooth with blunt tips. Internal architecture characteristics that were accurately detected > or = 25% of the time on simulated survey or double contrast radiography were lucent center, random-nonuniform, and uniform. Shapes such as bosselated, faceted-ovoid, and rosette; surfaces such as botryoidal, and knife-edged; and internal architecture characteristics such as dense center, dense shell, laminated, and fissures were of almost no value either due to poor detectability or poor accuracy of recognition. Based on optimized simulated survey and double contrast radiographic procedures, it appears that a number of shape, surface, and internal architecture characteristics may be of limited or no value in discriminating among urocystolith mineral types under clinical circumstances. Shapes and surfaces were more accurately characterized by the simulated double contrast technique, but for internal architecture, the simulated survey radiographic technique seemed slightly superior overall.     

EFFECT OF ANISOTROPY AND SPATIAL COMPOUND IMAGING ON RENAL CORTICAL ECHOGENICITY IN DOGS

The echogenicity of the renal cortex is an important parameter to consider in dogs that are suspected to have renal dysfunction. Focal increases in echogenicity have been attributed to neoplasia, infection, calcification, fibrosis, gas, and infarction. Anisotropic backscatter has been described as a source of focally increased renal cortical echogenicity in several species. The source of anisotropy appears to be the medullary rays, which are oriented perpendicular to the renal capsule. Spatial compound imaging (SCI) is an ultrasound setting that uses beam steering to acquire and average several overlapping scans of an object from different view angles, creating a compound image that is updated in real time. The impact of insonation angle and SCI on renal cortical echogenicity was evaluated ex vivo in eight kidneys from four dogs. Significant angle‐dependent differences in cortical echogenicity were detected with both microconvex and linear transducers (P < 0.0001). Furthermore, the angle‐dependent echogenicity differences persisted when SCI mode was used. Our finding that echogenicity was increased using a perpendicular insonation angle (90°) relative to the tubules, compared to a parallel insonation angle (0°) should assist in the interpretation of ultrasonographic images of the dog kidney.     

IMAGING DIAGNOSIS—ENOSTOSIS-LIKE LESION IN THE FEMUR OF A HORSE

An enostosis-like lesion was diagnosed in the left femur of a Swedish Warmblood horse that had a left hindlimb lameness of 3 weeks duration. With scintigraphy using technetium 99m-hydroxymethylene diphosphonate (^99m Tc-HDP) a marked regional focal increase in radioactivity was identified in the medullary cavity of the left femur. Radiographically there was a corresponding focal increase in bone opacity in the middiaphysis of the left femur. Histopathologically, a 5 cm area of bone matrix was present in the diaphysis of the left femur and confirmed as an enostosis-like lesion. Enostosis-like lesions should be considered as a source of pain in horses with difficult to localize, moderate to severe chronic lameness.     

THE EFFECT OF A TECHNICAL QUALITY ASSESSMENT OF HIP‐EXTENDED RADIOGRAPHS ON INTEROBSERVER AGREEMENT IN THE DIAGNOSIS OF CANINE HIP DYSPLASIA

Experienced and inexperienced observers evaluated the assessability of 50 radiographs (25 dogs) and determined the hip status (dysplasia/nondysplasia and final scoring according Fédération Cynologique Internationale [FCI]‐criteria) individually. A radiographic technical quality assessment was performed in a separate reading session. Interobserver agreement in determining dysplasia/nondysplasia and FCI‐scoring did not significantly increase with the increasing quality of a radiograph, irrespective whether these observers are experienced or not. There was a significant agreement between the technical quality assessment and assessability (P<0.0005). Despite the effort to objectify radiographic quality and to present high‐quality radiographs to observers, interobserver agreement on dysplasia/nondysplasia and final scoring, remains low, even in the experienced group. Although increased radiographic quality narrows the range of scoring, the range remains unacceptably high.