COMPUTED TOMOGRAPHIC EVALUATION OF CANINE AND FELINE MEDIASTINAL MASSES IN 14 PATIENTS

A 15-year retrospective analysis of histologically proven canine and feline mediastinal malignancies at the University of Minnesota was conducted to identify patients imaged by computed tomography (CT). The goal of the study was to characterize the CT appearance, to determine if there were any tumor type-specific appearances, and to clarify the role of CT in patients with mediastinal masses. Fourteen patients meeting these criteria were available for evaluation. The masses were characterized based on the presence or absence of contrast enhancement, internal architecture, size, extent of local invasion, the presence of pleural fluid, and the presence of regional vascular invasion. Within the limits of this study and the histopathologic information available, there appeared to be no clinically exploitable relationship between the CT appearance and the histologic characterization of the mass. However, CT does provide reasonably accurate local staging information.     

EFFECTS OF BLADDER DISTENTION ON CANINE AND FELINE RETROGRADE URETHROGRAPHY

Retrograde urethrography with viscous contrast medium was performed in male and female dogs and cats before and after bladder distention. The viscosity of commercially prepared contrast medium was increased by addition of an aqueous lubricant. The diameter of the proximal urethra of female dogs (regions 1 and 2) was larger during urethrography (p<0.05) following bladder distention. The diameter of regions 1 and 2 of the proximal uretha of female cats in lateral recumbency was larger during urethrography (p<0.05) following bladder distention. The diameter of the distal urethra of female dogs and cats was not significantly different before or after bladder distention. The diameter of the prostatic urethra of male dogs was larger (p<0.003) following bladder distention. The diameter of the membranous and penile urethra of male dogs was not significantly different before or after urinary bladder distention. Similarly, the diameter of the urethral lumen in male cats was not significantly different before or after bladder distention. The increased viscosity of the contrast medium due to the aqueous lubricant failed to distend all areas of the male and female canine and feline urethra maximally during urethrography when the bladder was not distended. On the basis of the results of this study, the authors recommend urinary bladder distention with a lubricant-free positive contrast medium to generate intravesical hydrostatic pressure sufficient to induce urethral distention. The degree of bladder distention should be determined by digital palpation.     

COMPUTED TOMOGRAPHIC ANATOMY OF THE CANINE NASAL PASSAGES

A normal German shepherd dog underwent CT imaging with contiguous 10 mm thick images made of the nasal cavity from the caudal limit of the frontal sinuses to the rostral aspect of the nose. Normal structures were identified. This normal anatomic information will be of use in assessing CT images of dogs suspected of having nasal cavity disease.     

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.     

COMPUTED TOMOGRAPHIC QUANTIFICATION OF CANINE ADRENAL GLAND VOLUME AND ATTENUATION

We conducted a retrospective study in presumed normal dogs to determine the adrenal gland attenuation and volume values. Multidetector computer tomography (MDCT 16) analysis of the gland was carried out in 48 adult dogs without evidence of adrenal gland disease that underwent CT examination for acute spinal injuries. The mean nonenhanced attenuation value +/- SD of the left adrenal gland was 36.0 +/- 5.3 HU (range: 22.0-42.0 HU). The mean nonenhanced attenuation value +/- SD of the right gland was 34.3 +/- 7.0 HU (range: 20.4-48.6HU). The mean enhanced attenuation value +/- SD were: left gland 101.5 +/- 10.6HU (range: 86.8-128.0 HU), and right gland 97.4 +/- 12.4 HU (range: 58.9-123.6 HU). The mean CT volume +/- SD were: left gland was 0.60 cm3 (range: 0.20-0.95; SD 0.17), and right gland (0.55cm3, range: 0.22-1.01; SD 0.19). Attenuation values and volume data were related to age, weight, and gender, using ANOVA. There was no statistically significant difference between the left and right side or in adrenal measurements, because of body weight class effects. The animal effect was the most important source of variation for all adrenal measurements. Based on our study, CT is an effective method for assessing adrenal characteristics in the dog. Normative CT data are provided to allow estimation of normal adrenal gland size and volume.     

COMPUTED TOMOGRAPHIC ANATOMY OF THE CANINE INNER AND MIDDLE EAR

A series of high-resolution computed x-ray tomography (CT) images of the normal canine middle and inner ear are presented to serve as a reference for optimal interpretation of clinical CT images of animals with diseases affecting this region.     

COMPUTED TOMOGRAPHIC EVALUATION OF ANATOMIC AND PATHOLOGIC VARIATIONS IN THE FELINE NASAL SEPTUM AND PARANASAL SINUSES

The purpose of this study was to compare the prevalence of nasal septal deviation and variations of the paranasal sinuses in normal and diseased cats. Prevalence of nasal septal deviation was 86.7%, 68.4%, and 71.4% in cats with rhinitis, neoplasia, and normal cats, respectively, with no statistically significant difference (P = 0.244). There was a statistically significant difference (P = 0.01) in the magnitude of nasal septal deviation between cats with and cats without nasal disease, using a cutoff value of 1 mm for maximum distance of deviation from midline. There was a statistically significant difference (P = 0.019) between cats with rhinitis and neoplasia when comparing the presence of a mass (7.7% and 53.8%, respectively), but not when comparing for lysis of the septum. Deviation of the frontal sinus septum occurred in 27.7% of all cats, while the sphenoid septum was oblique and eccentric in 96.6% of all cats. The mean length of the frontal sinus was longer in male cats than female cats. The presence of nasal septal deviation alone cannot be used as a criterion to diagnose nasal disease, but cats with rhinitis or neoplasia have more marked deviation than normal cats. The presence of a mass and lysis of the septum were only seen in cats with nasal disease and a mass is more likely to be seen with neoplasia than rhinitis. Male cats have a longer frontal sinus than female cats. Almost all cats have an oblique, eccentric sphenoid septum.     

COMPUTED TOMOGRAPHIC APPEARANCE OF A NORMAL VARIANT OF THE CANINE TENTORIUM CEREBELLI OSSEUM

A nine-year-old German Shepherd dog presented to the Veterinary Teaching Hospital at North Carolina State University with an eleven-day history of progressive depression, lethargy, inability to walk, blindness and intermittent vomiting. Computed tomography (CT) of the brain was unremarkable; however, bilateral regions of low photon absorption were noted within the tentorium cerebelli osseum. Mean CT numbers of −47.9 Hounsfield units (HU) and −26.4 HU were recorded within the left and right areas, respectively. These areas most likely represent diploë and are presumably a normal variant of the canine skull. A possible explanation for this finding includes a developmental variant where the medial and lateral plates of the tentorium cerebelli osseum fail to fuse, thus leaving a space for diploë accumulation. Use of various combinations of CT windows and numbers can be valuable for characterizing such variants.     

COMPUTED TOMOGRAPHIC FEATURES OF CANINE NONPARENCHYMAL HEMANGIOSARCOMA

The purpose of this retrospective study was to describe pre‐ and postcontrast computed tomographic (CT) characteristics of confirmed nonparenchymal hemangiosarcoma in a group of dogs. Medical records were searched during the period of July 2003 and October 2011 and dogs with histologically confirmed nonparenchymal hemangiosarcoma and pre‐ and postcontrast CT images were recruited. Two observers recorded a consensus opinion for the following CT characteristics for each dog: largest transverse tumor diameter, number of masses, general tumor shape, character of the tumor margin, precontrast appearance, presence of dystrophic calcification, presence of postcontrast enhancement, pattern of postcontrast enhancement, presence of regional lymphadenopathy, and presence of associated cavitary fluid. A total of 17 dogs met inclusion criteria. Tumors were located in the nasal cavity, muscle, mandible, mesentery, subcutaneous tissue, and retroperitoneal space. Computed tomographic features of nonparenchymal hemangiosarcoma were similar to those of other soft tissue sarcomas, with most tumors being heterogeneous in precontrast images, invasive into adjacent tissue, and heterogeneously contrast enhancing. One unexpected finding was the presence of intense foci of contrast enhancement in 13 of the 17 tumors (76%). This appearance, which is not typical of other soft tissue sarcomas, was consistent with contrast medium residing in vascular channels. Findings indicated that there were no unique distinguishing CT characteristics for nonparenchymal hemangiosarcoma in dogs; however, the presence of highly attenuating foci of contrast enhancement may warrant further investigation in prospective diagnostic sensitivity and treatment outcome studies.     

COMPUTED TOMOGRAPHY AND POSITIVE CONTRAST COMPUTED TOMOGRAPHIC ARTHROGRAPHY OF THE CANINE SHOULDER: NORMAL ANATOMY AND EFFECTS OF LIMB POSITION ON VISIBILITY OF SOFT TISSUE STRUCTURES

Soft tissue injuries of the shoulder are an important cause of forelimb lameness in dogs. The objectives of this canine cadaver study were to describe normal anatomy of shoulder soft tissue structures using computed tomography (CT) and computed tomographic arthrography (CTA) and to determine the effects of positioning on visualization of shoulder soft tissue structures. Thirteen forelimbs were removed from eight canine cadavers. Two forelimbs were used for contrast dose optimization. For the remaining 11 forelimbs, shoulder CT and CTA were performed using three defined joint angles (140°, 90°, and 70°). For three forelimbs, CT and CTA images were compared with frozen anatomic sections to describe normal anatomy. Ten forelimbs were used for analysis of positioning effects. Soft tissue structures evaluated were the joint capsule, cartilage, ligaments, tendons, and muscles. A visual assessment score was assigned to each structure using a consensus of two observers. The range and mode of scores were calculated and compared for each modality and limb position. The shoulder joint capsule and medial and lateral glenohumeral ligaments were completely visible with CTA. All tendons and muscles were visualized in all the examinations except for the teres minor muscle tendon and the coracobrachialis muscle, which were not visible on all scans. Positioning the limb in an extended position significantly improved visualization of most soft tissue shoulder structures. Shoulder cartilage was best seen with CTA and with neutral or flexed positioning of the shoulder. Findings indicated that both CT and CTA are feasible imaging techniques for visualization of soft tissue structures of the canine shoulder.     

HELICAL COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF THE NORMAL CANINE PANCREAS

Helical abdominal computed tomography (CT) was performed in nine normal beagle-mix dogs. Following cephalic vein injection of ionic iodinated contrast medium via power injector (rate 5 ml/s) dual-phase CT was performed in all dogs. A delayed scan was performed in five dogs between 5 and 13 min after the contrast medium injection. The median time of appearance of contrast medium in the aorta and gastroduodenal artery was 6.3 and 7 s, post start injection and 12 and 12.2 s in the gastroduodenal and portal vein, resulting in a purely arterial pancreatic time window of 5-6s. Pancreatic veins and parenchyma remained enhanced until the end of the dynamic scan (40s). The pancreatic parenchyma showed heterogeneous arterial and homogenous venous contrast enhancement which was slightly hypoattenuating compared to the liver. Delayed scans provided best delineation of the pancreas from the liver. The common bile duct could be identified ventral and to the right of the portal vein joining the dorsomedial aspect of proximal duodenum. Because of the very short time window and variable onset of pure arterial enhancement careful planning of dual-phase studies with previous dynamic CT is recommended. Dual-phase CT angiography enables assessment of the arterial supply, parenchymal perfusion and venous drainage of the canine pancreas.     

HELICAL COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF CANINE PORTOSYSTEMIC SHUNTS

Helical computed tomographic (CT) angiography was performed in 16 dogs with known or suspected portosystemic shunts. Fifteen portosystemic shunts were detected including five single intrahepatic shunts, five single extrahepatic shunts, and five multiple extrahepatic shunts. One dog had a normal CT examination. All diagnoses were confirmed by one or several alternate methods including ultrasound, surgery, necropsy, angiography, and liver biopsy. CT detected the origin of 13 of 15 portosystemic shunts and insertion of 13 of 15 shunts. Limitations included inability to resolve two vessels originating very close to each other, and identification of vessels that traveled parallel to the axial image plane. CT angiography is a promising, minimally invasive method of diagnosing a variety of portosystemic shunts in dogs.     

COMPUTED TOMOGRAPHIC IMAGING OF NASAL DISEASE IN 100 DOGS

One hundred dogs with nasal disease were evaluated by computed tomography (CT). Certain findings were significantly correlated with neoplasia. These included patchy areas of increased density within soft tissue opacity, destruction of part or all of the ethmoid bones, abnormal soft tissue in the retrobulbar spaces, destruction of one or both the lateral maxillae, destruction of the nasal bone or rostral dorsal maxilla, or hyperostosis of the lateral maxilla. Combinations of these findings were even more significant for neoplasia. No single finding or combination of findings was absolutely definitive of neoplasia. The results of this study are useful in indicating that biopsy results should be questioned if one or more of the above factors is present and a diagnosis of inflammation is made.     

GENDER,WEIGHT, AND AGE EFFECTS ON PREVALENCE OF CAUDAL ABERRANT NASAL TURBINATES IN CLINICALLY HEALTHY ENGLISH BULLDOGS: A COMPUTED TOMOGRAPHIC STUDY AND CLASSIFICATION

English Bulldogs have been reported to demonstrate abnormal growth and development of the nasal turbinates, which contribute to an increase in airway resistance and hence clinical signs of brachycephalic airway syndrome. The purpose of this prospective, cross‐sectional study was to assess the prevalence and severity of caudal aberrant turbinate protrusion via CT studies of English Bulldogs with, according to the owners, none or minimal clinical signs of brachycephalic airway syndrome. An additional objective was to propose a classification scheme for describing the degree of caudal aberrant turbinate protrusion in English Bulldogs and to apply this scheme in assessing the effect of gender, weight, and age on prevalence and severity of turbinate protrusion. The nasal cavities of 40 clinically healthy English Bulldogs were examined. The prevalence of caudal aberrant turbinates in this group was 100%. Using our proposed classification scheme, Grade 1 (minimal) was detected in 7 of 40 (17.5%), Grade 2 (mild) in 28 of 40 (70%), and Grade 3 (moderate) in 5 of 40 (12.5%) English Bulldogs. No significant effect of gender, weight, and age on degree of protrusion was found. In conclusion, this study identified minimal to moderate protrusion of caudal aberrant turbinates toward the nasopharynx in all the sampled English Bulldogs, despite the absence of clinical signs of brachycephalic airway syndrome.     

WHOLE BODY COMPUTED TOMOGRAPHIC CHARACTERISTICS OF SKELETAL AND CARDIAC MUSCULAR METASTATIC NEOPLASIA IN DOGS AND CATS

Muscular metastatic neoplasia has been reported to be rare in domestic animals, however previous studies were based primarily on necropsy findings. The purpose of this retrospective study was to describe whole body computed tomography (CT) characteristics of confirmed muscular metastases in a cohort of dogs and cats presented for oncology evaluation. Medical records of 1201 oncology patients were reviewed. Included animals underwent pre and postcontrast whole body CT, and CT‐guided tru‐cut biopsy or fine needle aspiration of one or more metastatic lesions. Twenty‐one dogs and six cats met inclusion criteria, representing 2.08% of all canine oncology patients and 3.1% of all feline oncology patients. Mean age was 9.6 years. Postcontrast CT characteristics included well‐demarcated, oval‐to‐round lesions with varying enhancement patterns: ring enhancing (n = 16), heterogeneously enhancing (n = 8), or homogeneously enhancing (n = 5). Five animals showed concurrent and varying nodular patterns. In seven cases (five dogs and two cats), one single muscular nodule was observed. In 20 cases, two or more lesions were observed. In two cases, cardiac hypodense nodules were observed in the postcontrast CT, while appearing isodense in the precontrast study. Necropsy confirmed neoplasia in both of them. Locations of muscular metastases included epaxial/paraspinal muscles of the cervical, thoracic, and lumbar spine (n = 18), superficial muscles of the thoracic wall (n = 13), scapular/shoulder region (n = 3), hind limb (n = 3), and abdominal wall muscles (n = 1). Findings supported the use of pre and postcontrast whole body CT for oncologic staging in dogs and cats, especially for primary tumors characterized by a high metastatic rate.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF PRESUMED NORMAL CANINE ABDOMINAL LYMPH NODES

Though identification of lymph nodes is essential in staging cancer patients, little has been reported about the CT features of canine abdominal lymph nodes. The purpose of this retrospective study was to describe the visibility, location, and characteristics of abdominal lymph nodes in abdominal CT studies of dogs considered unlikely to have lymphadenopathy. The relationship between the number of identified lymph nodes and intraabdominal fat ranking, body weight, and slice thickness was also investigated. A total of 19 dogs were included. At least two jejunal lymph nodes and both left and right medial iliac lymph nodes were identified in all dogs. Colic lymph nodes were not identified in any of the dogs. Visualization of all other lymph nodes varied. There were significantly more lymph nodes visible in dogs with more intraabdominal fat (P < 0.0001). No correlation between the number of identified lymph nodes and body weight (P = 0.64) or slice thickness (P = 0.76) was found. Though most of all identified lymph nodes had an elongated shape, a rounded shape was most common in splenic, pancreaticoduodenal, renal, ileocolic and caudal mesenteric lymph nodes. Most lymph nodes had a homogeneous structure before and following the intravenous administration of contrast medium. Some lymph nodes had a slightly irregular structure or were relatively more hyper attenuating in the periphery than centrally before and/or after contrast administration. Mean attenuation before contrast was 37 Hounsfield Units (HU) (range 20–52 HU), and 109 HU after contrast (range 36–223 HU). Findings indicated that the CT visibility, characteristics of different abdominal lymph nodes may be variable in dogs.     

ASSOCIATION BETWEEN MALIGNANCY AND SONOGRAPHIC HETEROGENEITY IN CANINE AND FELINE ABDOMINAL LYMPH NODES

Abdominal lymph node enlargement is frequently noted sonographically. Certain sonographic features can be used to suggest whether lymphadenopathy is more likely benign or malignant. Specific changes in size, shape, echogenicity, and Doppler flow patterns have an association with malignancy. In this retrospective case-control study, the association between abdominal lymph node heterogeneity and malignancy was evaluated. Twenty-three canine and 18 feline patients with ultrasonographically heterogeneous abdominal nodes were evaluated for presence of benign or malignant lymphadenopathy. Controls were animals with lymph node enlargement of uniform echogeneity. Twenty-one (91%) of heterogeneous canine lymph nodes were malignant, and there was a significant association between heterogeneity and malignancy in canine abdominal lymph nodes (P= 0.024). Seven (63%) heterogeneous feline lymph nodes were malignant, with no significant association between heterogeneity and malignancy (P = 0.537).     

PATHOLOGIC BASIS FOR RIM ENHANCEMENT OBSERVED IN COMPUTED TOMOGRAPHIC IMAGES OF FELINE NASOPHARYNGEAL POLYPS

In postcontrast computed tomographic (CT) images, feline nasopharyngeal polyps typically demonstrate enhancement of the peripheral rim. Computed tomographic images and histologic specimens of a case series of 22 cats with surgically removed nasopharyngeal polyps were reviewed retrospectively in an attempt to elucidate the origin of rim enhancement. Polyps were present in the tympanic cavity in 15 (68%) cats (three with extension into the nasopharynx), only in the nasopharynx in four (18%) cats, and only in the external ear canal in the remaining three (14%) cats. All polyps had variable degrees of epithelial injury. Hemorrhage and inflammatory infiltration were significantly more marked in the superficial stroma whereas edema was significantly more marked in the core stroma. In noncontrast CT images (n = 22), the tympanic bulla was thickened in all 15 cats with a polyp in the tympanic cavity and enlarged in eight (53%) of these cats. In postcontrast CT images (n = 15), an outer zone of relatively increased attenuation compatible with a rim was observed in 11 (73%) polyps. The magnitude and extent of rim enhancement in CT images was positively correlated with the histologic grade of inflammation in the superficial stroma and negatively correlated with the grade of edema in the superficial stroma. It appears that inflammation is the major determinant of contrast medium accumulation in feline nasopharyngeal polyps, and the tendency for inflammation to affect predominantly the superficial layers explains the frequent observation of a rim in postcontrast CT images.     

64‐MULTIDETECTOR COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF THE CANINE CORONARY ARTERIES

Canine coronary artery angiography (CTA) was performed in four anesthetized healthy dogs using 64‐multidetector computed tomography. Esmolol, a β‐1 adrenergic receptor antagonist, and sodium nitroprusside, an arteriolar and venous dilator, were administered to enhance visualization of the coronary arteries by reducing heart rate and creating vasodilation. The left main coronary artery with its three main branches and the right coronary artery were visualized and subdivided in 13 segments for evaluation. Optimal reconstruction interval, expressed as percentage of the R‐to‐R interval, was determined at 5% in 2.9%, 35% in 1%, 75% in 21.2%, 85% in 43.3%, and 95% in 31.7% of the segments. Overall image quality was good in 41.3% of the segments and excellent in 14.4%. There was blur in 98.1%, motion in 17.3%, and stair step in 6.7% of the evaluated segments, but these artifacts did not interfere with anatomic depiction of the arteries. Cross‐sectional anatomy of the coronary arteries as evaluated from the coronary CTA agreed well with gross anatomic evaluation and published information. The use of esmolol did not lead to the target heart rate of 60–65 beats/min. Nitroprusside had no significant effect on visualized length or diameter of the coronary artery branches. Coronary CTA is useful for the anatomic depiction of coronary artery branches in the dog.