RELEVANCE OF SONOGRAPHIC ARTIFACTS OBSERVED DURING IN VITRO CHARACTERIZATION OF UROCYSTOLITH MINERAL COMPOSITION

Nine pure mineral type canine uroliths (bladder or urethral origin only) were imaged ultrasonographically using 3.5 MHz, 5.0 MHz, and 7.5 MHz fixed focus, mechanical sector transducers in a urinary bladder phantom. The uroliths studied were those composed of 100% magnesium ammonium phosphate, calcium oxalate monohydrate, calcium oxalate dihydrate, calcium phosphate appatite, and calcium hydrogen phosphate dihydrate (brushite), ammonium acid urate, sodium acid urate, cystine, and silica. The occurrence of both reverberation/streak and acoustic shadowing artifacts were compared to urocystolith mineral type (classified by effective atomic number), urocystolith width, urocystolith height (thickness), and ultrasonographic imaging frequency. No predictable relationship was found between either of the artifacts seen beyond the urocystolith (reverberation/streak or the acoustic shadowing) and urocystolith mineral type. There was no statistical relationship between the occurrence of reverberation/streak artifact and the size (width or height) of the urocystolith or the ultrasonographic frequency. There was, however, a statistically relevant relationship between ultrasonographic imaging frequency and the occurrence of acoustic shadowing and between urocystolith height (thickness) and the occurrence of acoustic shadowing. However, regardless of ultrasound frequency, acoustic shadowing was observed less than 35% of the time in any of the urocystolith mineral types examined. Based on the imaging of the bladder phantom supporting apparatus (7.0 mm bolts covered by plastic), the accurate characterization of a curved object surface directly facing the transducer was found to be directly related to the frequency of sound used for imaging and at best predictably limited to curved vs flat. Accurate measurement of the maximum transverse dimension of an echogenic curved object or accurate characterization of the lateral borders of such an object was considered unlikely with general ultrasonographic equipment of the frequencies studied. Therefore, detailed architectural characterization of urocystoliths suitable for mineral composition prediction is considered highly unlikely with general pulse-echo ultrasonographic techniques.     

Magnetic resonance imaging metallic artifact of commonly encountered surgical implants and foreign material

Magnetic resonance imaging (MRI) artifacts secondary to metallic implants and foreign bodies are well described. Herein, we provide quantitative data from veterinary implants including total hip arthroplasty implants, cranial cruciate repair implants, surgical screws, a skin staple, ligation clips, an identification microchip, ameroid constrictor, and potential foreign bodies including air gun and BB projectiles and a sewing needle. The objects were scanned in a gelatin phantom with plastic grid using standardized T2-weighted turbo-spin echo (TSE), T1-weighted spin echo, and T2*-weighted gradient recalled echo (GRE) image acquisitions at 1.5 T. Maximum linear dimensions and areas of signal voiding and grid distortion were calculated using a DICOM workstation for each sequence and object. Artifact severity was similar between the T2-weighted TSE and T1-weighted images, while the T2*-weighted images were most susceptible to artifact. Metal type influenced artifact size with the largest artifacts arising from steel objects followed by surgical stainless steel, titanium, and lead. For animals with metallic surgical implants or foreign bodies, the quantification of the artifact size will help guide clinicians on the viability of MRI.     

APPEARANCE OF COMMON ULTRASOUND ARTIFACTS IN CONVENTIONAL VS. SPATIAL COMPOUND IMAGING

Abdominal sonographic artifacts produced by conventional and spatial compound sonographic imaging using linear and curved array transducers were compared. Spatial compound imaging produced multiple diverging ring‐down artifacts from a single source with increasing width and decreasing intensity. Overlap of the diverging artifacts was conspicuous when the focal point was in the far field. Increased width and reduced intensity of acoustic shadowing artifacts was observed with spatial compound imaging. Edge shadowing was eliminated, or reduced. Diverging edge shadowing from the source of the artifact with reduced intensity was detected when the focal point was in the near field. There was no apparent difference of the acoustic enhancement artifact with spatial compound imaging. There was absence or reduction of clutter seen in the urinary bladder when using spatial compound imaging. The appearance of artifacts with spatial compound imaging is slightly different from those with conventional ultrasound imaging.     

Advances in diagnostic ultrasonography

A wide variety of ultrasonographic equipment currently is available for use in equine practice, but no one machine is optimal for every type of imaging. Image quality is the most important factor in equipment selection once the needs of the practitioner are ascertained. The transducer frequencies available, transducer footprints, depth of field displayed, frame rate, gray scale, simultaneous electrocardiography, Doppler, and functions to modify the image are all important considerations. The ability to make measurements off of videocassette recorder playback and future upgradability should be evaluated. Linear array and sector technology are the backbone of equine ultrasonography today. Linear array technology is most useful for a high-volume broodmare practice, whereas sector technology is ideal for a more general equine practice. The curved or convex linear scanner has more applications than the standard linear array and is equipped with the linear array rectal probe, which provides the equine practitioner with a more versatile unit for equine ultrasonographic evaluations. The annular array and phased array systems have improved image quality, but each has its own limitations. The new sector scanners still provide the most versatile affordable equipment for equine general practice.     

B-mode ultrasonography of the bovine udder and teat

The udders and teats of cows were examined by brightness mode (B-mode) ultrasonography. A 5-MHz linear array transducer and a 5-MHz or 10-MHz mechanical sector transducer were used in the examinations. In lactating animals, the teat sinus, gland sinus, and lactiferous ducts were imaged easily. The scans also allowed visualization of the layers of the teat wall. The annular fold and the folding of the mucosa at the junction of the teat sinus and the papillary duct were seen best with the 5-MHz and 10-MHz mechanical sector transducers. In one cow lacking milk flow from one quarter, a mass at the junction of the papillary duct and the teat sinus was observed ultrasonographically. Surgical removal of the mass resulted in a return of milk flow from that quarter.     

EVALUATION OF THE WARP‐TURBO SPIN ECHO SEQUENCE FOR 3 TESLA MAGNETIC RESONANCE IMAGING OF STIFLE JOINTS IN DOGS WITH STAINLESS STEEL TIBIAL PLATEAU LEVELING OSTEOTOMY IMPLANTS

Susceptibility artifacts caused by ferromagnetic implants compromise magnetic resonance imaging (MRI) of the canine stifle after tibial plateau leveling osteotomy (TPLO) procedures. The WARP‐turbo spin echo sequence is being developed to mitigate artifacts and utilizes slice encoding for metal artifact reduction. The aim of the current study was to evaluate the WARP‐turbo spin echo sequence for imaging post TPLO canine stifle joints. Proton density weighted images of 19 canine cadaver limbs were made post TPLO using a 3 Tesla MRI scanner. Susceptibility artifact sizes were recorded and compared for WARP vs. conventional turbo spin echo sequences. Three evaluators graded depiction quality for the tibial tuberosity, medial and lateral menisci, tibial osteotomy, and caudal cruciate ligament as sufficient or insufficient to make a diagnosis. Artifacts were subjectively smaller and local structures were better depicted in WARP‐turbo spin echo images. Signal void area was also reduced by 75% (sagittal) and 49% (dorsal) in WARP vs. conventional turbo spin echo images. Evaluators were significantly more likely to grade local anatomy depiction as adequate for making a diagnosis in WARP‐turbo spin echo images in the sagittal but not dorsal plane. The proportion of image sets with anatomic structure depiction graded adequate to make a diagnosis ranged from 28 to 68% in sagittal WARP‐turbo spin echo images compared to 0–19% in turbo spin echo images. Findings indicated that the WARP‐turbo spin echo sequence reduces the severity of susceptibility artifacts in canine stifle joints post TPLO. However, variable depiction of local anatomy warrants further refinement of the technique.     

THE VALUE OF RADIOGRAPHIC SCREENING FOR METALLIC PARTICLES IN THE EQUINE FOOT AND SIZE OF RELATED ARTIFACTS ON LOW‐FIELD MRI

Magnetic susceptibility artifacts as a result of metal debris from shoeing are a common problem in magnetic resonance imaging of the equine foot. Our purpose was to determine the suitability of radiography as a screening tool for the presence and location of metallic particles in the equine foot and to predict the size of the resultant magnetic susceptibility artifact. Radiography had 100% sensitivity for detection of metal particles ≥1 mm diameter. Metal particles of known diameter were placed within the hoof wall of 22 cadaver feet and scanned with a low‐field strength MR imaging unit (0.21 T). Magnetic resonance images were characterized by a signal void with a hyperintense rim and adjacent image distortion at the level of the known metal location. T2* weighted sequences were the most and fast spin echo (FSE) sequences the least affected. For all four sequences (T1 gradient echo [GRE]; T2*W GRE; T2 FSE; and short tau inversion recovery FSE), linear relationships were observed between particle and resultant artifact size. Magnetic susceptibility artifact size, location and superimposition on clinically relevant anatomic structures can be predicted radiographically for particles larger than 1 mm. If metal debris cannot be removed, the least artifact‐prone FSE sequences should be selected.     

Optimization of contrast-enhanced multidetector abdominal computed tomography in sedated canine patients

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.     

ULTRASOUND IMAGE COMPOUNDING: EFFECT ON PERCEIVED IMAGE QUALITY

In order to determine the effect of different image compounding functions on perceived image quality, 84 pairs of ultrasound images were collected, mixed, and reviewed by four independent observers who were asked to identify the highest quality image of each pair. Each image in a pair was made using the same orientation, transducer, frequency, and gain settings but different compounding settings. Outcomes were analyzed using logistic regression. Observers judged compound images to be better quality than noncompound images in 69% cases, the same quality in 24%, and poorer quality in 7%. Overall, compound images were considered significantly better quality than noncompound images (P < 0.001). Compound images were more likely to be considered better quality than the corresponding noncompound images when combined transmit/receive spatial compounding was used rather than receive-only spatial compounding or transmit compounding, and when the vector transducer or the curvilinear transducer were used rather than the linear transducer. Observers considered improved border definition and increased signal to noise ratio to be the properties that accounted most often for higher quality of compound images compared with noncompound images.     

APPARENT WALL THICKENING IN FLUID FILLED VERSUS AIR FILLED TYMPANIC BULLA IN COMPUTED TOMOGRAPHY

A series of CT imaging experiments was performed to test the hypothesis that when the tympanic bulla is filled with fluid there would be a false impression of bulla wall thickening. CT images were obtained before and after introduction of water in the tympanic bulla of a fresh canine cadaver. Images were acquired using different mA settings, slice thicknesses, reconstruction algorithms, and displayed at different window widths. The wall of the fluid filled bulla appeared thicker than that of the air filled bulla. This artifact was also demonstrated on a phantom composed of a thin (0.5 mm) and a thick (5 mm) piece of aluminum imaged in air and water. The effect was more apparent when images were acquired as thick slices (>5 mm), reconstructed with a soft tissue algorithm, or displayed with a narrow window (<250 CT numbers). The radiologist must be aware of this artifact when interpreting CT images of the tympanic bullae.     

Ultrasonographic examination of the ovine thorax

Ultrasonographic examination of the thorax of 15 adult healthy sheep using a 5.0MHz sector transducerrevealed the lung surface as a hyperechoic (white) linear echo at a distance of 1.2–2cm from the transducer head with equidistant reverberation artifacts below this line. Ultrasonographic examination of 10 sheep with pulmonary disorders included five sheep with pleural abscesses which appeared as hypeechoic areas extending up to 8cm deep containing multiple hyperechoic spots (gas echoes). The distribution of gross lung pathology caused by sheep pulmonary adenomatosis (five ewes), with secondary abscess formation in three sheep, could be outlined by ultrasonographic examination. Modern portable ultrasound machines provide the veterinary practitioner with an inexpensive, non-invasive tool with which to examine the pleural surfaces and superficial lung parenchyma of sheep on the farm.     

Postoperative susceptibility artifact during magnetic resonance imaging of the vertebral column in two dogs and a cat.

In humans that have undergone cervical diskectomy, magnetic susceptibility artifacts are often found on postoperative magnetic resonance (MR) images of the affected region. In some patients, these artifacts complicate image interpretation, while in others the artifacts lead to a false diagnosis of spinal cord compression. We describe two dogs and one cat that had susceptibility artifacts visible in postoperative MR images. In each patient, multiple, small-to-large, distinct, magnetic susceptibility artifacts were visible along the surgery site. In both dogs, interpretation was impossible and subsequently computed tomography (CT) was performed. During CT, no cause for the MR artifact was identified. The most likely source of the artifact is microscopic metal fragments from the burr, suction tip or other surgical instruments, but other possible causes include hemorrhage or paramagnetic suture material. These artifacts may cause difficulty in interpretation or suggest a clinical problem. MR imaging therefore might not be the most appropriate examination for patients following certain types of surgery due to the possibility of susceptibility artifacts. Although this artifact probably is common in the postoperative patient, the frequency that this finding will prevent accurate diagnosis is unknown.     

SUSCEPTIBILITY ARTIFACTS ON T2*‐WEIGHTED MAGNETIC RESONANCE IMAGING OF THE CANINE AND FELINE SPINE

The T2*‐weighted gradient recalled echo sequence is a sensitive means to detect blood degradation products. While not a routine sequence in magnetic resonance imaging of the spine in small animals, it can provide additional valuable information in select cases. The goal of this retrospective, cross‐sectional study was to describe findings when acquiring this sequence during magnetic resonance imaging examination of the spine in small animals. The University of Tennessee's veterinary radiology database was searched for dogs and cats that underwent magnetic resonance imaging for suspect spinal disease in which a T2*‐weighted gradient recalled echo sequence was acquired and susceptibility artifact was identified. The following information was recorded: signalment, clinical signs, location and appearance of susceptibility artifact, and final diagnosis. Thirty‐nine cases were included in the study. Extradural susceptibility artifacts were observed in cases of intervertebral disc herniation with or without associated hemorrhage (n = 28), extradural hemorrhage associated with spinal trauma (n = 2), hemophilia (n = 1), and in a cystic extradural mass (n = 1). Remaining lesions displaying susceptibility artifact were intramedullary and included presumptive acute noncompressive nucleus pulposus extrusion (n = 2), hematoma (n = 1), hemangiosarcoma metastasis (n = 1), intramedullary disc extrusion (n = 1), presumptive meningomyelitis (n = 1), and a mass of undetermined etiology (n = 1). Inclusion of a T2*‐weighted gradient recalled echo sequence may be helpful in spinal magnetic resonance imaging when standard imaging sequences are ambiguous or intramedullary lesions are observed.     

Effects of surgical implants on high-field magnetic resonance images of the normal canine stifle

To determine the effect of surgical implants on the depiction of canine stifle anatomy in magnetic resonance (MR) images, three canine cadaver limbs were imaged at 1.5 T before and after tibial plateau leveling osteotomy (TPLO), tibial tuberosity advancement (TTA), and extra-capsular stabilization (ECS), respectively. Susceptibility artifacts associated with implants were identified in MR images as a signal void and/or signal misregistration, which obscured or distorted the anatomy. Using the preoperative images as a reference, articular structures of the stifle in postoperative images were graded using an ordinal scale to describe to what degree each anatomic structure could be evaluated for clinical purposes. The TPLO implant, which contains ferromagnetic stainless steel, produced marked susceptibility artifacts that obscured or distorted most stifle anatomy. The titanium alloy TTA implants and the stainless steel crimps used for ECS produced susceptibility artifacts that mainly affected the lateral aspect of the stifle, but allowed the cruciate ligaments and medial meniscus to be evaluated satisfactorily. Susceptibility artifact was significantly less marked in images obtained using turbo spin-echo (TSE) sequences than in sequences employing spectral fat saturation. Clinical MR imaging of canine stifles containing certain metallic implants is feasible using TSE sequences without fat saturation.     

THE VETMOUSETRAP™: A DEVICE FOR COMPUTED TOMOGRAPHIC IMAGING OF THE THORAX OF AWAKE CATS

The VetMousetrap^?, a novel device that allows computed tomography (CT) of awake cats and provides a clinically supportive environment, is described. Ten normal cats were used to test the device for ambient internal oxygen, carbon dioxide levels, and temperature. Twenty‐two awake normal cats were imaged using a 16‐multi‐slice helical CT unit to evaluate dose‐equivalent protocols. Two different X‐ray tube potentials (kV), 80 and 120, and two different helical pitches, 0.562 and 1.75, were evaluated. The signal intensity of the pulmonary parenchyma (SI_lung), signal intensity of background (SI_backgr), contrast, noise, signal‐to‐noise ratio (SNR), and contrast‐to‐noise ratio (CNR) were calculated. Three evaluators ranked the images for sharpness of liver margins, motion, helical, and windmill artifacts. CT was successfully completed in 20 of 22 cats. No artifacts directly related to the device were detected. Overall, 75 of 80 (94%) examinations were judged to have absent or minimal motion artifact. A statistically significant difference was found for SNR (P=0.001) and CNR (P=0.001) between all protocols. The higher pitch protocols had significantly lower noise and higher SNR and CNR, lower motion artifact but greater helical artifacts. A protocol using 80 kV, 130 mA, 0.5 s, and 0.562 pitch with 1.25 mm slice thickness, and 0.625 mm slice reconstruction interval is recommended. The VetMousetrap^? appears to provide the opportunity for diagnostic CT imaging of the thorax of awake cats.     

Ultrasonographic examination of important aspects of the bovine shoulder--physiological findings

The left and right shoulder region of 19 healthy cattle and the left and right shoulders of six bovine cadavers were examined ultrasonographically using a 7.5 MHz linear and a 3.5 MHz convex transducer. The lateral shoulder muscles were successfully imaged in all cases; the joint space appeared as a funnel shaped interruption of the hyperechoic bone surfaces of the distal part of the scapula and the proximal and lateral part of the humeral head. In healthy cattle, the synovial cavities of the scapulohumeral joint, the bicipital bursa and the infraspinous bursa could not be clearly defined. After experimental filling with water, the synovial cavities could be differentiated as discrete anechoic zones. In this study, the normal ultrasonographic appearance of the soft tissue structures and bone surfaces of the scapula and proximal humerus is presented, providing basic reference data for the ultrasonographic evaluation of the bovine shoulder region.     

LOW‐FIELD MAGNETIC RESONANCE IMAGING APPEARANCE OF POSTARTHROSCOPIC MAGNETIC SUSCEPTIBILITY ARTIFACTS IN HORSES

An awareness of magnetic susceptibility artifacts is important for interpreting prepurchase and postoperative magnetic resonance imaging (MRI) studies in horses. These artifacts occur when a metallic or a paramagnetic substance creates a local magnetic field deformity. Aims of the current experimental study were to determine prevalence of these artifacts after arthroscopy in a sample of nonlame horses, and to describe effects of time and type of pulse sequence on low‐field MRI signal intensity and detection of the artifacts. Ten, nonlame Standardbred horses were prospectively recruited. All horses underwent arthroscopy of both metacarpophalangeal joints for purposes unrelated to the study. Serial low‐Field MRI examinations were performed on each horse and each joint (before, and 6 and 12 weeks postsurgery). In two horses, more detailed longitudinal evaluations were performed with additional MRI examinations. Magnetic susceptibility artifacts were detected postoperatively at the surgical access sites in eight metacarpophalangeal joints at both 6 and 12 weeks after surgery (40% prevalence). Neither of the two longitudinally followed horses had artifacts at any time. Artifacts were only detected on gradient echo (GRE) sequences. Findings indicated that magnetic susceptibility artifacts can be present in postarthroscopy MRI studies in horses and can persist up to 12 weeks after arthroscopy. For this sample of horses, the artifacts did not interfere with evaluation of the joint. Further longitudinal studies are needed to determine the full duration of magnetic susceptibility artifact persistence in affected tissues.     

DETERMINATION OF CANINE PROSTATIC VOLUME USING TRANSABDOMINAL ULTRASONOGRAPHY

The prostate gland from cadavers of 12 intact adult male dogs euthanized less than 3 hour were used to compare prostatic volume measured by ultrasonography to volume measured by water displacement, and to determine specific gravity of the canine prostate. Prostate glands were scanned by transabdominal ultrasonography with a 4-7 MHz curved linear array transducer. The greatest craniocaudal (L), transverse (W), and dorsoventral (D) diameters of the prostate were recorded. Prostatic volume was calculated using formulas for an ellipsoid and for a box. Prostate glands were removed, and the prostate weight was measured and prostatic volume was measured by water displacement. The mean +/- SD specific gravity of the prostate was 1 +/- 0.05 (range = 0.90 to 1.09) g/cm. There were positive correlations (R2 = 0.94) between prostatic volume calculated from ultrasound measurement and measured volume. Measured prostatic volume (VM) can be predicted using the formula: VM = [1/2.6 (L x W x D)] + 1.8 (cm3).     

UROCYSTOLITH DETECTION: COMPARISON OF SURVEY, CONTRAST RADIOGRAPHIC AND ULTRASONOGRAPHIC TECHNIQUES IN AN IN VITRO BLADDER PHANTOM

Urocystoliths of 9 mineral types from 437 canine patients submitted to the University of Minnesota Urolith Bank were imaged in a urinary bladder phantom. Imaging techniques simulated were survey radiography, pneumocystography, double contrast cystography (two iodine concentrations) and real-time ultrasonography (3.5 MHz, 5.0 MHz, 7.5 MHz). Imaging techniques were compared for accuracy of urocystolith detection, accuracy of urocystolith enumeration, and tendencies for over or undercounting. Across urocystolith mineral types, the false negative rates (no urocystoliths detected in a given case) for survey radiographs range from 2 to 27%. Pneumocystographic techniques are one-half as likely to yield false negative results as are survey radiographic techniques. Underestimates of urocystolith numbers and false negatives are likely using 80 mg iodine/ml double contrast cystography because calcium-based urocystoliths are isopaque in this contrast medium dilution. The 200 mg iodine/ml double contrast cystographic techniques are unlikely to yield false negative diagnoses even for very small (< or = 1.0 mm) urocystoliths and is comparable to pneumocystography for detection and slightly better for enumeration. The likelihood of an ultrasonographic false negative for urocystoliths decreases with increasing MHz. Under optimal conditions using a 7.5 MHz mechanical sector transducer, the false negative rates were comparable to double contrast cystography, but rates increased notably with lower MHz transducers.     

Ultrasonographic Examination of the Scrotal Content in the Rabbit

This study was performed to describe a practical technique for ultrasound examination of the scrotal content of the rabbit. The scrotal content of normal rabbits and those with induced lesions (i.e. needle biopsy of the testis and epididymal ligation) were viewed using a portable scanner connected to a 5 or 7.5 MHz real time, B-mode linear array transducer. The effect of frequency (5 and 7.5 MHz), pad material placed under the testicle (rubber, plastic and carton) and the presence of a water sack between the probe and organ were examined to optimize the technique. The best image quality was obtained using a 5-MHz probe when the testicle was fixed on a rubber pad and covered by a water sack. Testicular parenchyma was imaged as homogeneous and moderately echoic. Caput and cauda epididymis were identified as homogeneous and less echoic compared with the testis parenchyma. Variations in the testicular echotexture that occur secondarily to epididymal ligation and testis biopsy could be screened readily. In conclusion, real-time ultrasonography, performed as described in this study, may provide a valuable tool to screen scrotal contents and to identify certain pathological conditions that affect fertility in the rabbit.