THE USE OF GATED RADIONUCLIDE VENTRICULOGRAPHY AS A NONINVASIVE METHOD OF EVALUATING RIGHT VENTRICULAR FUNCTION IN DOGS WITH EXPERIMENTALLY INDUCED CONGESTIVE HEART FAILURE

Gated radionuclide ventriculography was evaluated as a noninvasive method of quantifying right ventricular function in dogs with experimentally induced congestive heart failure. Gated radionuclide ventriculography measurements of right ventricular function (right ventricular ejection fraction, right ventricular average emptying rate, and right ventricular average filling rate) were related to standard hemodynamic and echocardiographic measurements. Congestive heart failure was induced by rapid ventricular pacing in eight normal dogs. Hemodynamic, echocardiographic, and gated radionuclide ventriculography measurements were obtained before and after development of biventricular failure. Congestive heart failure resulted in significant changes in all hemodynamic, echocardiographic, and gated radionuclide ventriculography measurements with the exception of systemic arterial pressure. Right ventricular ejection fraction was inversely related to pulmonary artery systolic, diastolic, and mean pressure, and right ventricular average emptying rate was inversely related to the pulmonary artery systolic, diastolic, and mean pressure. Right ventricular ejection fraction was inversely related to left ventricular filling pressure, (pulmonary capillary wedge pressure). Neither the echocardiographic measurements of right ventricular size (right ventricular internal diastolic dimension) nor the right ventricular end-diastolic pressure were related to right ventricular ejection fraction and right ventricular average emptying rate. However, echocardiographic measurements of right ventricular dimension were related to right ventricular filling pressure. The gated radionuclide ventriculography indexes of right ventricular function, right ventricular ejection fraction and right ventricular average emptying rate, are affected by afterload but unaffected by preload, whereas the echocardiographic measurement of right ventricular dimension is related to preload. Gated radionuclide ventriculography provides right ventricular data which is unique from that obtained by standard echocardiographic imaging. Also, gated radionuclide ventriculography has potential value as a noninvasive means of estimating a change in pulmonary artery pressure.     

CORRELATION OF RADIOGRAPHIC, ECHOCARDIOGRAPHIC, AND ELECTROCARDIOGRAPHIC SIGNS OF LEFT HEART ENLARGEMENT IN DOGS WITH MITRAL REGURGITATION

Thoracic radiographs of 40 dogs with mitral regurgitation were evaluated for signs of left heart enlargement and classified into three groups based on the degree of left atrial enlargement (mild = group A, moderate = group B, and severe = group C). Echocardiographic enlargement ratios were calculated for the left atrium (LAE_echo), the left ventricle (LVE_echo), and the aorta (AOE_echo) by dividing the measured dimension with the expected dimension normalized for body weight. The incidence of LVH patterns and p-mitrale was recorded on electrocardiograms. With advanced stages of the disease, there was good agreement of the radiographs and echocardiograms with significant differences of the left atrial enlargement ratio between groups. Nine of the 16 dogs from groups A and B, however, had LAE_echo ratios within the normal range. Sixteen dogs with radiographic signs of left ventricular enlargement had normal LVEecho ratios. These disagreements were interpreted as either cardiac enlargement not manifest in the dimensional change measured by the echocardiogram or as overreading of radiographs. The left ventricular wall thickness did not vary significantly between groups. The incidence of p-mitrale was 30%, but this ECG abnormality, when present, reliably identified enlarged left atrial dimensions. Left ventricular hypertrophy patterns of the ECG did not correlate with either the radiographic diagnosis of left ventricular enlargement or the echocardiographic enlargement ratios.     

ECHOCARDIOGRAPHIC ASSESSMENT OF 537 DOGS WITH MITRAL VALVE PROLAPSE AND LEAFLET INVOLVEMENT

In this work we investigated which mitral valve leaflet was most often involved in mitral valve prolapse with degenerative mitral valve disease and whether there was an association with breed, age, gender, or weight. Five hundred and thirty-seven dogs with mitral valve prolapse-degenerative mitral valve disease were assessed; the cross-breed dog was the most represented breed (248 dogs, 46.2%). Mitral valve prolapse was more common in male dogs, and the average age was 11.3±2.8 years. Prolapse of the anterior leaflet was present in 48.4% of dogs, prolapse of the the posterior leaflet in 7.1%, and bileaflet prolapse was present in 44.5%; this distribution is different than that typically found in humans. There was a significant correlation between severity of mitral regurgitation and severity of mitral valve prolapse or ISACHC class, and between severity of mitral valve prolapse and ISACHC class. There was no relationship between the particular affected leaflet(s) and severity of mitral regurgitation, severity of mitral valve prolapse, or ISACHC class. Our findings suggest that the susceptibility to the mitral valve prolapse-degenerative mitral valve disease is not confined to a specific breeds and that the specific leaflet prolapsing is different in dogs compared with humans.     

ASSESSMENT OF RESPIRATION‐INDUCED DISPLACEMENT OF CANINE ABDOMINAL ORGANS IN DORSAL AND VENTRAL RECUMBENCY USING MULTISLICE COMPUTED TOMOGRAPHY

Respiratory‐induced organ displacement during image acquisition can produce motion artifacts and variation in spatial localization of an organ in diagnostic computed tomography (CT) examinations. The purpose of this prospective study was to quantify respiratory‐induced abdominal organ displacement in dorsal and ventral recumbency using five normal dogs. All dogs underwent CT examinations using 64 multidetector row CT (64‐MDCT). A “3‐dimensional (3D) apneic CT exam” of the abdomen was acquired followed by a “4‐dimensional (4D) ventilated CT exam.” The liver, pancreas, both kidneys, both medial iliac lymph nodes, and urinary bladder were delineated on the 3D‐apneic examination and the organ outlines were compared to the maximum alteration in organ position in the 4D‐ventilated examination. Displacement was measured in dorsal‐to‐ventral (DV), right‐to‐left (RL), and cranial‐to‐caudal (CC) directions. Respiratory‐induced displacement of canine abdominal organs was not predictable and showed large variability in the three directions evaluated. For most canine abdominal organs, dorsal recumbency provided overall the least amount of displacement among all directions evaluated except for liver and urinary bladder. For liver, a large variability was found for all directions and a statistically significant difference was found only in the RL direction with ventral recumbency exhibiting less displacement (P = 0.0099). For the urinary bladder, ventral recumbency also provided less displacement but this was statistically significant only in the RL direction (P < 0.0001). Findings from this study indicated that dorsal recumbency may be preferred for minimizing respiratory motion artifacts in whole abdomen studies, but ventral recumbency may be preferred for liver and urinary bladder studies when respiration cannot be controlled.     

QUANTITATIVE ULTRASONOGRAPHY FOR ASSESSMENT OF BONE MINERAL DENSITY IN THE CANINE RADIUS AND TIBIA

Quantitative ultrasound allows noninvasive assessment of cortical bone density. Potential applications include monitoring of fracture healing, rehabilitation, and skeletal diseases. The objectives of this study were to determine the three most accessible portals to obtain speed of sound measurements of the radius and tibia with an Omnisense multisite quantitative ultrasound device and to determine probe-dependent intra- and interoperator variability for speed of sound measurements of the radius and tibia in six healthy hounds. The radius was most accessible at the cranial proximal metaphysis, the cranial middiaphysis, and medial distal metaphysis. Speed of sound measurements were possible at these sites on the radius with acceptable intra- and interoperator variation (1.6–4.6%). Measurements differed significantly when performed with different probes at the cranial proximal radial metaphysis. The tibia was most accessible at the cranial proximal metaphysis, the medial middiaphysis, and medial distal metaphysis. The medial middiaphyseal and mediodistal tibial sites allowed measurements with lowest intra- and interoperator variation (<3.5%). A smaller probe allowed tibial measurements with lowest interoperator variation. Measurements did not differ significantly at each tibial site when different probes were used. Measurements did not differ significantly between observers when measuring with the same probe at each specific site on radius and tibia. A medium-size probe allowed for most time-efficient measurements and the least number of failed measurements on the radius and tibia. Speed of sound can be consistently measured by different observers on the radius and tibia in healthy hounds.     

ASSESSMENT OF THE REPEATABILITY OF FELINE ECHOCARDIOGRAPHY USING CONVENTIONAL ECHOCARDIOGRAPHY AND SPECTRAL PULSE-WAVE DOPPLER TISSUE IMAGING TECHNIQUES

The objective of this study was to determine the intraoperator, intraobserver, and interobserver repeatability in a series of conventional echocardiographic parameters and in some of the newer measurements of diastolic function, including color M-mode flow propagation velocity, isovolumic relaxation time and pulsed-wave Doppler tissue imaging velocities. Four healthy cats were each scanned five times over a 3-day period. The repeatability of these echocardiographic analyses was compared using Bland-Altman analysis (intraoperator repeatability). After a minimum of 5 weeks, one scan was randomly selected from each cat, and was remeasured by the original observer and the results compared using a standard paired Student's t-test (intraobserver repeatability). One scan from each cat was then randomly selected and two observers, with similar levels of experience, measured each of these scans. The repeatability of these echocardiographic analyses was compared using Bland-Altman analysis (interobserver repeatability). The conventional two-dimensional (2D), M-mode and spectral Doppler measurements were repeatable in both their acquisition and measurement by a single investigator; there was a greater degree of variation between the two observers. The predominant (S', E', and A') pulsed-wave Doppler tissue imaging velocities from the left apical four-chambered view, generally had a coefficient of variation of approximately 20% (range 9.62-34.08%). However, with pulsed-wave Doppler tissue imaging, velocities recorded during the isovolumic phases, the velocity of the tricuspid annulus, and the radial fiber velocity within the interventricular septum, frequently had coefficients of variation in excess of 20% and should therefore be interpreted with caution.     

ASSESSMENT OF LOCATION OF THE CELIAC AND CRANIAL MESENTERIC ARTERIES RELATIVE TO THE THORACOLUMBAR SPINE USING MAGNETIC RESONANCE IMAGING

Exact localization of thoracolumbar lesions can be harder with magnetic resonance (MR) imaging than with radiography. The celiac and cranial mesenteric arteries are easily seen on MR images and are always included in sagittal thoracolumbar studies. This study was undertaken to establish whether their location was sufficiently consistent to enable them to be used as anatomic landmarks. It was found that their location varied considerably, and there was no useful relationship to breed, gender, age, or body weight. They are therefore unreliable for use in establishing initial localization of a spinal lesion although they can be helpful when comparing multiple image planes.     

IMAGING ASSESSMENT OF THE MODIFIED DOUBLE CONTRAST BARIUM ENEMA USING CARBOXYMETHYLCELLULOSE ON RADIOGRAPHY AND ULTRASONOGRAPHY IN DOGS

A modified double contrast barium enema using carboxymethylcellulose was evaluated in beagle dogs and compared with dogs receiving a conventional barium enema. The experimental group was divided into three groups (1, 2, and 3) and given 30 ml/kg of different volume ratios of a barium vs. carboxymethylcellulose mixture. Each group underwent sonography following radiography. The volume ratio of one part barium to three parts carboxymethylcellulose was judged to be the optimal mixture, resulting in a general distribution of contrast and bowel radiolucency on radiographs and adequate postradiography sonography. The modified barium enema using carboxymethylcellulose is useful for assessing the general morphology and mucosal layers of the colon simultaneously on radiographs and ultrasonographs.     

ASSESSMENT OF A RADIOTHERAPY PATIENT IMMOBILIZATION DEVICE USING SINGLE PLANE PORT RADIOGRAPHS AND A REMOTE COMPUTED TOMOGRAPHY SCANNER

Radiation treatment requires a precise procedure for interfraction repositioning of the patient. The purpose of this study was to determine the accuracy of our fixation device in treatment position and to evaluate the setup accuracy with two different methods. The positioning data of 19 canine patients with tumors in the head region (oral, nasal, cerebral) treated with photon or proton irradiation were included in this study. The patients were immobilized by means of an individualized fixation device. Focus was set upon interfraction displacement with systematic and random components. In one method, treatment position was evaluated using single plane port radiographs and megavoltage x-rays. In the other method, two orthogonal CT-topograms were acquired to evaluate the precision of positioning of the patient in the immobilization device. Systematic and random displacements were calculated and presented as mean values with corresponding 95% confidence intervals. In spite of a difference between both methods, the positioning seemed to be accurate within the expected range. It seems that a safety margin of 3.7 mm would be enough for both methods to take into account systematic and random position variability in the fixation device, thereby preventing geometric inaccuracies of treatment delivery. The reported immobilization protocol provides accurate patient immobilization for photon and conformal proton radiation therapy.