IMAGING DIAGNOSIS—HYPEROSTOSIS ASSOCIATED WITH MENINGIOMA IN A DOG

A 5-year-old neutered male Beagle mix dog had a 5-day history of generalized tonic-clonic seizures. Before the seizures, the dog had a 1-2-month history of progressive right hemiparesis. In computed tomography images, a presumed extraaxial mass with hyperostosis and destruction of the skull covering the mass were identified. Surgical excision was performed and the histopathologic diagnosis was meningioma. Hyperostosis is frequently associated with feline meningioma, but this report documents that hyperostosis may also occur secondary to meningioma in the dog.     

IMAGING DIAGNOSIS—BILATERAL ADRENAL ADENOMAS AND MYELOLIPOMAS IN A DOG

A 10-year-old neutered female Pug was evaluated for a left adrenal mass detected previously by ultrasonography. Using computed tomography, a fat-attenuating, rim-enhancing left adrenal mass and a homogeneous, soft-tissue attenuating, intensely enhancing right adrenal mass were found. A left adrenalectomy and right adrenal biopsy were performed and the final diagnosis was bilateral adrenal adenomas and myelolipomas. Myelolipomas are rare, benign, endocrinologically inactive tumors composed of well-differentiated adipose tissue and a variable amount of hematopoietic cells of both lymphatic and myeloid lineages, which may account for the different appearance on tomographic images.     

IMAGING DIAGNOSIS—PULMONARY INTERSTITIAL EMPHYSEMA IN A DOG

In humans, pulmonary interstitial emphysema is most frequently seen in ventilated preterm newborns with severe lung disease; it is less frequently reported in adults. We report on a mature dog with pneumopathy that underwent computed tomography (CT) imaging to further characterize the lung disease. A bronchiolar pattern and lobar opacification were seen on the CT images. Moreover, gas was detected along the course of the pulmonary vessels, presumably in the interstitium, as seen in pulmonary interstitial emphysema in humans. Sever lung disease and/or hyperventilation during anesthesia could be a possible explanation of pulmonary interstitial emphysema in this dog.     

DIAGNOSTIC IMAGING IN CANINE PHEOCHROMOCYTOMA

The diagnosis of pheochromocytoma is challenging due to the variable presentations of patients affected with this neoplasm. This report describes four dogs with pheochromocytoma in which radiography, ultrasonography and computed tomography (CT) were key diagnostic tools. Computed tomography was the most useful imaging modality for assessment of size, shape and margination of the tumor. CT findings for the pheochromocytoma included a large, irregularly shaped mass in the dorsal midabdomen with multiple foci of low attenuation dispersed in hyperdense, highly vascular tissue. This neoplasm often invades the caudal vena cava and other surrounding organs therefore, although a pheochromocytoma may be identified in the absence of clinical signs, it should not be considered an incidental lesion. The unpredictable growth rate and potential for invasion of major vessels warrants serious consideration. Follow-up ultrasound and CT examinations are recommended for patients with adrenal masses that do not undergo surgical excision.     

IMAGING DIAGNOSIS—SUBLUMBAR PSEUDOMYCETOMA IN A PERSIAN CAT

A 6-year-old Persian cat was examined for constipation, anorexia, and vomiting that was subsequently found to be due to a pseudomycetoma originating from the descending colon and sublumbar region, and causing mechanical obstruction of the colon and rectum. Multiple discrete hyperechoic foci likely representing fungal grains within the lesion gave the mass a coarse echotexture on ultrasound and was supportive of the diagnosis and computed tomography allowed delineation the extent of the mass. A pseudomycetoma is a granulomatous/pyogranulomatous reaction that surrounds dermatophytic fungal hyphae. Definitive diagnosis of a dermatophytic pseudomycetoma requires identification of the etiologic agent by cultivation or immunohistochemical staining. A pseudomycetoma should be included in the differential diagnosis for an abdominal mass in a Persian cat, especially is accompanied by the sonographic findings noted above.     

IMAGING DIAGNOSIS—CANINE MENINGIOANGIOMATOSIS

Meningioangiomatosis is a rare proliferative disorder of the central nervous system. It occurs sporadically in dogs and is characterized by a leptomeningeal plaque that extends from the subarachnoid space along the perivascular spaces into the adjacent parenchyma. We describe the clinical presentation, magnetic resonance (MR) imaging and neuropathologic characteristics of two additional dogs with meningioangiomatosis, and document involvement of the thoracolumbar spinal cord, a site not previously described for this condition. MR imaging findings were different from those previously described, most likely reflecting the degree of vascularity and collagen deposition. The MR imaging features of meningioangiomatosis are not specific.     

IMAGING DIAGNOSIS—NECROTIZING MENINGOMYELITIS AND POLYARTHRITIS

A vaccinated 2-year-old female neutered Weimaraner had bilateral pelvic limb ataxia that progressed over 12 h. The dog became nonambulatory, with signs of pain on palpation of the lumbar spine. The dog also developed multiple joint effusions. On magnetic resonance (MR) imaging, there was a diffuse, asymmetric T2-hyperintensity in the thoracolumbar spinal cord which was characterized by contrast enhancement. Lumbar cerebrospinal fluid (CSF) analysis had an elevated white blood cell count and protein. On the basis of MR images and CSF analysis, a presumptive diagnosis of diffuse myelitis was made. The dog became paraplegic and was euthanized. Postmortem examination confirmed the presence of myelitis with vasculitis and nonerosive polyarthritis.     

THE CANINE LATERAL THORACIC RADIOGRAPH

Selected structures seen on right and left lateral thoracic radiographs of 12 dogs were evaluated for differences in position, size, and shape. The size and position of the cardiac silhouette were different when thoracic radiographs made in left and right lateral recumbency were compared. These changes were, however, considered insignificant. The position of the right cranial lobe bronchus relative to the left varied in right lateral recumbency and left lateral recumbency. The right cranial lung lobe was better aerated when dogs were positioned in left lateral recumbency.
Lesions seen in the caudal portion of the left cranial lung lobe or the right middle lobe were masked when the affected lobe was dependent, and enhanced when the affected lung lobe was non-dependent. It is believed that this difference occurred due to compression of the dependent lung with greater aeration of the non-dependent lung.     

IMAGING DIAGNOSIS—CONGENITAL LOBAR EMPHYSEMA IN A DOG

A 14‐week‐old female West Highland White Terrier developed acute dyspnea. Radiographically there was an enlarged, hyperlucent caudal portion of the left cranial lung lobe and a diffuse, severe interstitial‐to‐alveolar pattern in the remaining lung lobes that was accentuated caudodorsally. Computed tomography confirmed the presence of the emphysematous lobe and further showed it to have focal lobar bronchial collapse. Lung lobe resection was performed, and the diagnosis was congenital lobar emphysema secondary to bronchial cartilage hypoplasia.     

A REVIEW OF IMAGING TECHNIQUES FOR CANINE CAUDA EQUINA SYNDROME

There are many imaging modalities available for evaluating the canine lumbosacral region. These include conventional radiography, stress radiography, myelography, epidurography, transosseous and intravenous venography, discography, linear tomography, computed tomography, and magnetic resonance imaging. Myelography, epidurography and discography are commonly used, but often lack sensitivity. Myelography is of little value when evaluating the cauda equina because the dural sac is elevated from the vertebral canal floor and frequently ends before the lumbosacral junction. Epidurography will identify a ventrally located compressive lesion and discography can delineate the dorsal extent of the diseased disc; however, both are sometimes difficult to interpret. Therefore, more than one of these imaging techniques must be used in order to make a diagnosis. Computed tomography and magnetic resonance imaging have become valuable in evaluating the lumbosacral region in dogs. These modalities have proven to be both sensitive and specific for determining cauda equina compression in both humans and in dogs.     

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.     

IMAGING DIAGNOSIS—COMPLEX INTRAHEPATIC PORTOSYSTEMIC SHUNT IN A DOG

An unusual form of congenital intrahepatic portosystemic shunt was identified in a 3½-month-old female Labrador Retriever with neurologic signs. Ultrasonography and contrast-enhanced computed tomography were used to characterize the shunt morphology. An unusual, looping right-divisional shunt connected back to the portal vein that formed an ampula in the right-central portion of the liver. An irregularly shaped window-like opening connected the combined right-divisional loop and aneurysmal portal vein, and the caudal vena cava, while this vascular pool gradually fused more cranially. Imaging features of this complex vascular anomaly, which has not been previously reported, are presented.     

THORACIC METASTASES OF CANINE MAMMARY GLAND TUMORS

The absence or presence of metastases on thoracic radiographs in 55 female dogs with mammary gland tumors was assessed by comparing the results of a single radiographic examination, using dorsoventral and left lateral views, with clinical and histologic follow-up data. Radiographic abnormalities found in dogs with thoracic metastases were classified as well-defined pulmonary nodules, ill-defined pulmonary nodules, and involvement of pleural effusion. No obvious difference in the effect on the right or left lung lobes was found. The sensitivity, specificity and accuracy for the detection of thoracic metastases were 65%, 97%, and 87%, respectively.     

NON-CARDIAC THORACIC ULTRASOUND IN 75 FELINE AND CANINE PATIENTS

The purpose of this study was to describe the ultrasonographic appearance of non-cardiac diseases of the small animal thorax. Ultrasound images from a total of 75 animals (26 cats and 49 dogs) were compared to cytologic, histopathologic, and necropsy findings. Clinical diagnoses included neoplasia of the mediastinum, pleura, or lungs (43); idiopathic mediastinal cyst (3); diaphragmatic or peritoneopericardial hernia (4); lung lobe torsion (1); pulmonary eosinophilic infiltrates (1); and idiopathic, chylous, congestive heart failure, or lymphangiectasia associated pleural effusion (14). In the remaining 9 patients, a definitive diagnosis was not obtained. Ultrasound-guided fine needle aspirate was performed in 56 patients; 1 of these also had an ultrasound-guided tissue core biopsy. Of the fine needle aspirates, 51 (91%) were diagnostic. Ultrasound examination, particularly when accompanied by guided tissue sampling, can be a valuable tool in the diagnosis of non-cardiac intrathoracic lesions.     

OPTIMIZED CANINE DENTAL COMPUTED TOMOGRAPHIC PROTOCOL IN MEDIUM‐SIZED MESATICEPAHLIC DOGS

The purpose of this study was to develop an optimized imaging protocol for canine dental imaging using single‐detector row CT and multidetector row CT. Two medium‐sized mesaticephalic cadaver dog heads were scanned using varying slice thickness, sequential vs. helical scanning mode, sequential CT table increment, pitch, image reconstruction algorithm, and an additional moderate edge enhancement filter. For each series, two reviewers scored dental roots as not visible (score: 0), partially visible (score: 1) or completely visible (score: 2). Sharpness of the dento‐alveolar margin was scored as blurry (score: 0), sharp (score: 1) or very sharp (score: 2). Consensus reader scores were compared among CT protocols. For single‐detector row CT, complete visualization of all tooth roots was only achieved with 1 mm slice thickness and image interval sequential or helical series (pitch of 1 or 2) using a high‐frequency image reconstruction algorithm with or without additional edge enhancement. For four‐detector row CT, complete visibility of all tooth roots was recorded in all series. For single‐detector row CT, all medium frequency algorithm series yielded blurry margin scores and all other series yielded sharp margin scores. For four‐detector row CT, sequential and helical 0.5 mm thickness images yielded very sharp dento‐alveolar margin scores, whereas the 1 mm series yielded only sharp margin scores. Authors concluded that the optimal dental imaging protocol was a sequential mode 1 mm slice thickness and interval with a high‐frequency image reconstruction algorithm and an additional moderate edge enhancement filter.     

ANATOMY OF THE CANINE ORBITAL REGION

Computed tomography (CT) was used to study the normal anatomy of the orbital region in one Beagle. Direct transverse and reformatted dorsal, sagittal, and oblique plane images were used to distinguish various soft tissue structures. Intraorbital fat provided a natural contrast against which extraocular muscles and nerves could be discerned. The noninvasive nature and the multiplanar imaging capabilities of CT provided a means by which the orbital contents could be precisely localized and differentiated from one another.     

IMAGING DIAGNOSIS—SPONTANEOUS INTRAMURAL CANINE DUODENAL HEMATOMA

A 9‐year‐old neutered female Pug with a 2‐week history of pancreatitis was presented for dyspnea, icterus, and intractable vomiting. Sonographically, the gallbladder, intrahepatic bile ducts, and common bile duct were distended. The pancreas was hypoechoic with hyperechoic peripancreatic fat. A mildly heterogeneous intramural mass was present in the muscularis layer of the descending duodenum. A presumptive diagnosis of pancreatitis and smooth muscle tumor of the duodenum leading to common bile duct obstruction was made. The dog died despite supportive care. Necropsy examination confirmed the presence of pancreatitis and an intramural duodenal hematoma.     

IMAGING DIAGNOSIS—ULTRASOUND-GUIDED ETHANOL SCLEROTHERAPY FOR A SIMPLE RENAL CYST

Solitary renal cysts are benign and in the majority of instances asymptomatic and do not require treatment. Nevertheless, treatment may be required if abdominal discomfort or pain, hypertension, infection or renal outflow obstruction occur. Under these circumstances, percutaneous management of the cyst is the easiest and fastest procedure, and no major complications are generally encountered. In this report we describe a patient with a solitary renal cyst treated successfully by a single injection of ethanol into the cyst. The sonographic appearance of the cyst changed from a well-defined hypoechoic structure to an ill-defined hyperechoic region. Canine renal cysts may be successfully managed in some instances by a single ethanol injection.     

COMPUTED TOMOGRAPHIC ANATOMY OF THE CANINE PANCREAS

Barium sulfate was administered into the coeliac artery of 5 canine cadavers to allow for contrast computed tomography of the pancreas. Contiguous, 2-mm-thick slices were acquired. Multiplanar and three-dimensional reformatting were performed to clarify the anatomic relationship. After imaging, the cadavers were frozen, cross sections obtained, and plastinated. These were compared to the computed tomography images. Five plain and contrast enhanced computed tomographic series of normal live controls were acquired and evaluated retrospectively. In the study of the canine cadavers the pancreas became opacified and appeared homogenous with irregular contour. In normal live controls, acquiring an image at the end of expiration allowed a detailed view of the pancreatic parenchyma in the non-alterated pancreas, but pancreatic and bile ducts could not be seen. Adjacent to the hepatic hilus the pancreatic body appeared as a dorsoventrally flattened structure bordering on the ventral surface of the portal vein, both in cadavers and normal live controls. The right lobe extended caudodorsally to the right abdominal wall and aligned with the cranial part of the duodenum. The left lobe was adjacent to the gastric body in all dogs although it was separated from the gastric fundus by the dorsal extremity of the spleen in normal live controls. Neither kidney was suitable as an anatomic marker for localization of the pancreas, unlike traditional references in textbooks. We recommended using the portal vein to localize the pancreatic body, the descending duodenum for the right lobe, and the dorsal extremity of the spleen as well as the gastric fundus for the left lobe.