DIAGNOSTIC SENSITIVITY OF ULTRASOUND,RADIOGRAPHY AND COMPUTED TOMOGRAPHY FOR GENDER DETERMINATION IN FOUR SPECIES OF LIZARDS

Gender determination is frequently requested by reptile breeders, especially for species with poor or absent sexual dimorphism. The aims of the current study were to describe techniques and diagnostic sensitivities of ultrasound, radiography, and computed tomography for gender determination (identification of hemipenes) in four species of lizards. Nineteen lizards of known sex, belonging to four different species (Pogona vitticeps, Uromastyx aegyptia, Tiliqua scincoides, Gerrhosaurus major) were prospectively enrolled. With informed owner consent, ultrasound, noncontrast CT, contrast radiography, and contrast CT (with contrast medium administered into the cloaca) were performed in conscious animals. Imaging studies were reviewed by three different operators, each unaware of the gender of the animals and of the results of the other techniques. The lizard was classified as a male when hemipenes were identified. Nineteen lizards were included in the study, 10 females and nine males. The hemipenes were seen on ultrasound in only two male lizards, and appeared as oval hypoechoic structures. Radiographically, hemipenes filled with contrast medium appeared as spindle‐shaped opacities. Noncontrast CT identified hemipenes in only two lizards, and these appeared as spindle‐shaped kinked structures with hyperattenuating content consistent with smegma. Hemipenes were correctly identified in all nine males using contrast CT (accuracy of 100%). Accuracy of contrast radiography was excellent (94.7%). Accuracy of ultrasound and of noncontrast CT was poor (64.3% and 63.1%, respectively). Findings from the current study supported the use of contrast CT or contrast radiography for gender determination in lizards.     

DISPERSAL PATTERN OF INJECTATE FOLLOWING CT‐GUIDED PERINEURAL INFILTRATION IN THE CANINE THORACOLUMBAR SPINE: A CADAVER STUDY

An increasing proportion of canine patients are presented with chronic thoracolumbar back pain and without compressive spinal lesions. In humans, spinal perineural infiltrations have been reported to have a favorable effect on pain control. The purpose of this prospective cadaver study was to describe the dispersal pattern of injectate following CT‐guided spinal perineural infiltration in the canine thoracolumbar region. Seven fresh canine cadavers were first scanned using multislice CT and then CT‐guided spinal perineural infiltration was performed at 42 sites from T13/L1 to L6/L7. The injectate for each site was a mixture of new methylene blue and iodinated contrast medium. Immediately following CT‐guided injection, cadavers were frozen, cut, and dissected macro‐ and mesoscopically (using a magnifying glass) to identify anatomic structures that were infiltrated. In the majority of sites (64.3%), complete epidural and hypaxial staining of spinal nerve components (including the spinal ganglion, trunk, and ventral branch) was successfully achieved. However, no (11.9%) or unpredictable staining (9.5%) of nervous tissue occurred in some sites despite careful CT guidance and the application of relatively large volumes of injectate. Optimal results were achieved when the needle tip was positioned periforaminally ventral to the cranial contour of the cranial articular process. Findings from this ex vivo study indicated that CT‐guided spinal perineural infiltration is feasible for testing in the canine thoracolumbar region and that successful nerve tissue infiltration would likely occur in the majority of sites. Future in vivo studies are needed to determine the safety and efficacy of this technique.     

EFFECTS OF FLUID AND COMPUTED TOMOGRAPHIC TECHNICAL FACTORS ON CONSPICUITY OF CANINE AND FELINE NASAL TURBINATES

Turbinate destruction is an important diagnostic criterion in canine and feline nasal computed tomography (CT). However decreased turbinate visibility may also be caused by technical CT settings and nasal fluid. The purpose of this experimental, crossover study was to determine whether fluid reduces conspicuity of canine and feline nasal turbinates in CT and if so, whether CT settings can maximize conspicuity. Three canine and three feline cadaver heads were used. Nasal slabs were CT‐scanned before and after submerging them in a water bath; using sequential, helical, and ultrahigh resolution modes; with images in low, medium, and high frequency image reconstruction kernels; and with application of additional posterior fossa optimization and high contrast enhancing filters. Visible turbinate length was measured by a single observer using manual tracing. Nasal density heterogeneity was measured using the standard deviation (SD) of mean nasal density from a region of interest in each nasal cavity. Linear mixed‐effect models using the R package ‘nlme’, multivariable models and standard post hoc Tukey pair‐wise comparisons were performed to investigate the effect of several variables (nasal content, scanning mode, image reconstruction kernel, application of post reconstruction filters) on measured visible total turbinate length and SD of mean nasal density. All canine and feline water‐filled nasal slabs showed significantly decreased visibility of nasal turbinates (P < 0.001). High frequency kernels provided the best turbinate visibility and highest SD of aerated nasal slabs, whereas medium frequency kernels were optimal for water‐filled nasal slabs. Scanning mode and filter application had no effect on turbinate visibility.     

The role of head computed tomography in equine practice

This retrospective study describes the computed tomography (CT) findings in 59 horses presented with diseases of the head over 8 years that underwent CT examination of this region, including dental or sinonasal diseases (Group A) (n = 42), osseous and/or articular diseases (Group B) (n = 11) and soft tissue diseases (Group C) (n = 6). For Group A, radiographic and CT findings comparison was possible. Computed tomography had higher sensitivity (100%) and specificity (96.7%) than radiography in diagnosing dental disease. Compared to CT, radiographic identification of sinus involvement was less sensitive, particularly for ventral conchal and sphenopalatine sinuses and presented an overall sensitivity of 43.5 and 16.7%, respectively. In Group B CT allowed identification of a higher number of bone fragments and fractures in the maxillary, lacrimal, sphenoidal, temporal and zygomatic bones not identified radiographically. Accurate identification of CT changes in the temporomandibular joint and temporohyoid articulation was also possible. Group C included both intra‐ and extra‐cranial disease, retrobulbar masses being the most representative pathology (n = 3). In this group, CT was considered the gold standard for detection of periorbital diseases. We conclude that CT is an imaging technique with high diagnostic value for evaluating the equine head, yielding additional information over multiple radiographic views, which may alter the outcome of the case. Additionally, this paper reports several conditions not previously described using CT.     

Accuracy of the modified vertebral heart score and the cardio-vertebral ratio for radiographic evaluation of cardiomegaly in ferrets

Thoracic radiography is commonly used to assess the size of the heart and diagnose cardiac disease in ferrets. Several standardized radiographic heart size indicators have been introduced in this species and values in healthy ferrets have been reported. To date, none of these indicators has been tested in ferrets with cardiac disease. The aim of this prospective and retrospective, analytical observational design study was to assess the accuracy of the modified vertebral heart score (mVHS) and the cardio-vertebral ratio (CVR) in the radiographic detection of cardiomegaly in ferrets. Thoracic radiographs of 24 ferrets with confirmed heart diseases, 22 ferrets with non-cardiac diseases and normal-sized hearts on echocardiogram, and 24 healthy ferrets were mixed and examined by three independent and blinded radiologists who measured mVHS and CVR in right lateral (RL) and ventrodorsal (VD) radiographs. For all readers, ferrets with cardiac disease had significantly higher mVHS and CVR than ferrets without cardiac disease on echocardiography. Optimal cut-points for predicting cardiac enlargement were 6.25 vertebrae and 7.25 vertebrae for RL-mVHS and VD-mVHS, and 1.58 and 1.80 for RL-CVR and VD-CVR, respectively. Using these cut-points, the accuracy was good for indicators measured in RL radiographs (92.9% for RL-mVHS; 91.4% for RL-CVR) and moderate for indicators measured in VD radiographs (88.6% for VD-mVHS; 85.7% for VD-CVR). Findings supported the use of mVHS and CVR for evaluating the size of the heart in diseased ferrets, with caution in values interpretation when pericardial fat prevents precise delineation of the cardiac silhouette contour especially on VD radiographs.     

Prevalence of incidental humeral intracondylar fissures in brachycephalic breed dogs in CT studies

Humeral intracondylar fissures (HIF) have been predominantly reported in spaniel breeds and proposed to be possible risk factors for humeral condyle fractures (HCF). We hypothesized that the prevalence of incidental HIF in French Bulldogs may be greater than that of other brachycephalic breeds. A retrospective, observational, prevalence study was performed using CT examinations of French bulldogs and other brachycephalic breed dogs presenting for an unrelated condition. Two European College of Veterinary Diagnostic and Imaging-certified radiologists reviewed the images of the humeral condyles of these dogs. A classification system was devised to grade the findings. We considered a Score 1 to be normal, Score 2 to have centralised sclerosis, Score 3 to have a partial fissure and Score 4 to have a complete fissure. A total of 228 elbows were reviewed from 122 dogs. Of this population, 145 elbows were from French Bulldogs, 54 were from Pugs, and the remainder were from a mix of other brachycephalic breeds. The prevalence of HIF (score 3 or 4) in elbows of the French bulldog, pug and other breed groups was 6.9% (CI 2.8–11%), 5.6% (CI 0–11.7%), and 3.4% (CI 0–10.15%), respectively. At a dog level, the prevalence of HIF (score 3 or 4 present in at least one elbow) was found to be 11.8% (CI 4.6–19%) in French Bulldogs, 11.1% (CI 0–22.9%) in Pugs, and 5.26% (CI 0–15%) in the other breed group. There was no significant difference between the breed groups. The inter-reviewer reliability for CT scoring of HIF based on Cohen's weighted kappa was low at 0.19.     

Establishment of optimal scan delay for multi-phase computed tomography using bolus-tracking technique in canine pancreas

To establish a protocol for a multi-phase computed tomography (CT) of the canine pancreas using the bolus-tracking technique, dynamic scan and multi-phase CT were performed in six normal beagle dogs. The dynamic scan was performed for 60 sec at 1-sec intervals after the injection (4 ml/sec) of a contrast medium, and intervals from aortic enhancement appearance to aortic, pancreatic parenchymal and portal vein peaks were measured. The multi-phase CT with 3 phases was performed three times using a bolus-tracking technique. Scan delays were 0, 15 and 30 in first multi-phase scan; 5, 20 and 35 in second multi-phase scan; and 10, 25 and 40 sec in third multi-phase scan, respectively. Attenuation values and contrast enhancement pattern were analyzed from the aorta, pancreas and portal vein. The intervals from aortic enhancement appearance to aortic, pancreatic parenchymal and portal vein peaks were 3.8 ± 0.7, 8.7 ± 0.9 and 13.3 ± 1.5 sec, respectively. The maximum attenuation values of the aorta, pancreatic parenchyma and portal vein were present at scan sections with no scan delay, a 5-sec delay and a 10-sec delay, respectively. When a multi-phase CT of the canine pancreas is triggered at aortic enhancement appearance using a bolus-tracking technique, the recommended optimal delay times of the arterial and pancreatic parenchymal phases are no scan delay and 5 sec, respectively.