Dual-phase CT Angiography of the Normal Canine Portal and Hepatic Vasculature

A dual-phase computed tomography (CT) angiographic technique was developed to image the hepatic and portal vascular systems using a nonselective peripheral injection of contrast medium. The arterial phase of the dual-phase scan imaged the hepatic arteries and veins, and the portal phase imaged the portal vein as well as its tributaries and branches. There were three steps involved in acquiring the dual-phase scan: a survey helical scan for orientation, a dynamic scan for timing, and finally the dual-phase helical scan. Five normal dogs were imaged using a helical scan technique. The timing of the arterial and portal phases of the scan was calculated using time vs. attenuation graphs generated from a dynamic scan. The median time of appearance of contrast medium in the cranial abdominal aorta was 8.6 s and the median time of appearance of contrast medium in the hepatic artery occurred 0.4 s later. The median time of peak enhancement in the cranial abdominal aorta was 12.0 s. The median time of appearance of contrast medium in the portal vein was 14.6 s and median time of peak enhancement was 33.0 s. The dual-phase scans provided excellent vascular opacification. The hepatic arteries, hepatic veins, cranial and caudal mesenteric veins, splenic vein, gastroduodenal vein, and portal vein branches were all consistently well defined. Dual-phase CT angiography is a minimally invasive technique which provides an excellent three-dimensional representation of portal and hepatic vascular anatomy.     

Effect of catheter size and injection rate of contrast agent on enhancement and image quality for triple‐phase helical computed tomography of the liver in small dogs

Rapid contrast injection is recommended for triple‐phase helical computed tomography (CT) of the liver. However, a large‐gauge catheter is needed for faster contrast injection and this is not practical for small breed dogs or cats. The purpose of this crossover group study was to evaluate applicability of a lower injection rate with a small‐gauge (G) catheter for triple‐phase hepatic CT in small dogs. Triple‐phase CT images were acquired for six beagle dogs using three protocols: an injection rate of 1.5 ml/s with a 24 G catheter, 3.0 ml/s with a 22 G catheter, and 4.5 ml/s with a 20 G catheter. Enhancement of the aorta, portal vein, and hepatic parenchyma was measured in each phase (arterial, portal, and delayed) and image quality was scored subjectively by two observers. Injection duration, time to scan delay, and time to peak enhancement were also recorded. Contrast injection duration decreased with a higher injection rate (n = 6, P ≤ 0.01), but time to peak enhancement and time to scan delay were not significantly affected by injection rates and catheter sizes. Contrast injection rate did not significantly affect aortic, portal, and hepatic enhancement. In addition, separation between each phase and quality of images was subjectively scored as good regardless of injection rate. Findings from the current study supported using an injection rate of 1.5 ml/s with a catheter size of 24 G for triple‐phase hepatic CT in small dogs (weight < 12 kg).     

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.     

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.     

Triple‐phased mesenteric CT angiography using a test bolus technique for evaluation of the mesenteric vasculature and small intestinal wall contrast enhancement in dogs

Computed tomography angiography is widely used for the assessment of various mesenteric vascular and bowel diseases in humans. However, there are only few studies that describe CT angiography application to mesenteric vessels in dogs. In this prospective, experimental, exploratory study, the mesenteric vasculature and enhancement pattern of the intestinal wall were evaluated on triple‐phase CT angiography, and improvement of the visibility of vasculature was assessed on multiplanar reformation, maximum intensity projection, and volume rendering technique. After test bolus scanning at the level of the cranial mesenteric artery arising from the aorta, mesenteric CT angiography was performed in 10 healthy, male, Beagle dogs. Scan delay was set based on time‐to‐attenuation curves, drawn by placing the regions of interest over the aorta, intestinal wall, and cranial mesenteric vein. Visualization and enhancement of mesenteric arteries and veins were evaluated with multiplanar reformation, maximum intensity projection, and volume rendering techniques. The degree of intestinal wall enhancement was assessed on the transverse images in precontrast, arterial, intestinal, and venous phases. Pure arterial images were obtained in the arterial phase. Venous phase images allowed good portal vascular mapping. All CT angiography images were of high quality, allowing for excellent visualization of the anatomy of mesenteric vasculature including the small branches, particularly on maximum intensity projection and volume rendering technique. Distinct contrast enhancement of the intestinal wall was observed in both intestinal and venous phases. Findings indicated that this technique is feasible for the evaluation of mesenteric circulation in dogs.     

Three-dimensional CT angiography of the canine hepatic vasculature

Eight Beagle dogs were anesthetized and were imaged using a single channel helical CT scanner. The contrast medium used in this study was iohexol (300 mg I/ml) and doses were 0.5 ml/kg for a cine scan, 3 ml/kg for an enhanced scan. The flow rate for contrast material administration was 2 ml/sec for all scans. This study was divided into three steps, with unenhanced, cine and enhanced scans. The enhanced scan was subdivided into the arterial phase and the venous phase. All of the enhanced scans were reconstructed in 1 mm intervals and the scans were interpreted by the use of reformatted images, a cross sectional histogram, maximum intensity projection and shaded surface display. For the cine scans, optimal times were a 9-sec delay time post IV injection in the arterial phase, and an 18-sec delay time post IV injection in the venous phase. A nine-sec delay time was acceptable for the imaging of the canine hepatic arteries by CT angiography. After completion of arterial phase scanning, venous structures of the liver were well visualized as seen on the venous phase.     

Computed Tomography Atlas of the Normal Cranial Canine Abdominal Vasculature Enhanced by Dual‐phase Angiography

This study was performed to provide a detailed atlas of the normal arterial and venous canine vasculature in the cranial abdomen by dual‐phase computed tomographic angiography. Five adult beagles were positioned in dorsal recumbency on a multislice helical CT scanner. An unenhanced survey CT scan from the diaphragm to the pelvic inlet was performed. Bolus‐tracking software was used for the dual‐phase angiogram, and contrast medium was administered in a cephalic vein. The arterial phase was scanned from the mid‐abdomen to the cranial aspect of the diaphragm; the portal phase was scanned a few seconds after the arterial phase in the opposite direction. The DICOM studies from all dogs were analysed. Representative images were selected and anatomic structures labelled. Maximum intensity projections and three‐dimensional images were generated using software techniques. A detailed atlas of the venous and arterial vasculature of the cranial canine abdomen was created with the help of bolus‐tracking dual‐phase computed tomographic angiography (CTA). Practitioners can use this anatomic atlas with its detailed venous and arterial phase CT angiograms of the canine cranial abdomen to compare normal versus abnormal vascular anatomy.     

COMPARISON OF TRANSPLENIC MULTIDETECTOR CT PORTOGRAPHY TO MULTIDETECTOR CT-ANGIOGRAPHY IN NORMAL DOGS

We evaluated transplenic injection of iodinated contrast medium for computed tomography (CT) assessment of the portal vasculature. Specific aims were to: (1) establish a protocol for transplenic transplenic CT portography using a 40-row multidetector scanner; (2) compare transplenic CT portography to dual-phase CT angiography in terms of image quality, opacification of the portal system, and contrast enhancement of the portal vasculature and liver; (3) compare personnel exposure during transplenic CT portography and transplenic portal scintigraphy. Seven juvenile dogs underwent transplenic portal scintigraphy, CT angiography, and transplenic CT portography. Transplenic portal scintigraphy and CT angiography were performed using previously established protocols. For transplenic CT portography, a 20- or 22 gauge needle attached to an extension set was placed into the splenic parenchyma using CT guidance. Iodinated contrast medium (175 mg I/ml) was administered, and CT acquisition was started at the time of the injection. Transplenic CT portography was simple, rapid and provided more intense enhancement of the splenic and portal veins, with a lower contrast medium dose (median dose: 525 mg I for transplenic CT portography, 7700 mg I for CT angiography), but caused inconsistent intrahepatic portal branches and parenchymal opacification due to streamlining and streak artifacts. Despite significantly lower attenuation values in the portal vein, CT angiography provided sufficient enhancement for vessel identification and more consistent parenchymal hepatic enhancement. Personnel radiation exposure rate was higher during transplenic CT portography (0.0725 mSv/min) compared with transplenic portal scintigraphy (0.000125 mSv/min). As transplenic CT portography requires an average injection time of 1 min per study; over 650 [corrected] studies must be performed before reaching the maximum permissible whole body dose of 0.05 [corrected] Sv.     

TRIPLE‐PHASE HELICAL COMPUTED TOMOGRAPHY IN DOGS WITH HEPATIC MASSES

The purpose of this study was to determine the utility of triple‐phase helical computed tomography (CT) for differentiating canine hepatic masses. Seventy dogs with hepatic masses underwent triple‐phase CT followed by surgical removal of the hepatic masses. Triple‐phase helical CT scans for each dog included precontrast, arterial phase, portal venous phase, and delayed phase studies. The removed hepatic masses were histopathologically classified as hepatocellular carcinoma (n = 47), nodular hyperplasia (n = 14), and hepatic metastatic tumors (n = 9) in dogs. Of the 47 hepatocellular carcinomas, the most common CT findings included a heterogeneous pattern with hyper‐, iso‐, and hypoenhancement in both the arterial and portal venous phases (40/47, 85.1%). Of the 14 nodular hyperplasias, the most common CT findings were a homogeneous pattern with hyper‐ and isoenhancement in both the portal venous and delayed phases (13/14, 92.9%). Of nine hepatic metastatic tumors, the most common CT findings included a homogeneous hypoenhancement pattern in both the arterial and portal venous phases (8/9, 88.9%). In addition, 5 (55.6%) showed homogeneous hypoenhancement patterns in the delayed phase. Findings from our study indicated that triple‐phase CT is a useful tool for preoperative differentiation of hepatocellular carcinoma, nodular hyperplasia, and hepatic metastatic tumors in dogs.     

犬多层螺旋CT肝多期增强扫描技术研究

本试验旨在确定犬肝多期增强扫描造影剂使用剂量、注射速率及最佳延迟时间。选取不同的碘海醇剂量（500、575、650 mg·kg^-1,以I含量计）及速率（2、3 mL·s^-1）对犬进行造影,动态扫描,计算造影前后主动脉、门静脉、肝实质CT增强值,确定最佳造影剂剂量及注射速率。然后采用最佳造影剂剂量和注射速率对不同体型的犬进行造影,动态扫描后绘制时间-密度曲线,统计主动脉、门静脉、肝实质的达峰时间,计算达峰时间和注射时间的差值（Δt_AO/Δt_SP/Δt_L）,确定各期最佳扫描延迟时间。研究结果显示,当采用575 mg·kg^-1、3 mL·s^-1的造影剂剂量和注射速率时得到的主动脉、门静脉、肝实质CT增强值较高,可获得较好的增强效果。通过时间-密度曲线分别计算小、中、大3种体型犬的Δt_AO分别为7、9、4 s,Δt_SP分别为21、23、17 s,Δt_L分别为41、44、34 s,各期最佳扫描延迟时间可用公式“注射时间+Δt_ROI-1/2扫描时间”计算得到。通过临床病例验证,本试验使用的造影剂剂量（575 mg·kg^-1）、注射速率（3 mL·s^-1）及延迟时间（“注射时间+Δt_AO/Δt_SP/Δt_L-1/2扫描时间”）临床效果较好,可应用于犬肝疾病的CT造影检查。     

CONTRAST AGENT Gd‐EOB‐DTPA (EOB·Primovist®) FOR LOW‐FIELD MAGNETIC RESONANCE IMAGING OF CANINE FOCAL LIVER LESIONS

Contrast‐enhanced magnetic resonance (MR) imaging with a new liver‐specific contrast agent gadolinium‐ethoxybenzyl‐diethylenetriamine penta‐acetic acid (Gd‐EOB‐DTPA; EOB·Primovist®) was studied in 14 normal beagles and 9 dogs with focal liver lesions. Gd‐EOB‐DTPA accumulates in normally functioning hepatocytes 20 min after injection. As with Gd‐DTPA, it is also possible to perform a dynamic multiphasic examination of the liver with Gd‐EOB‐DTPA, including an arterial phase and a portal venous phase. First, a reliable protocol was developed and the appropriate timings for the dynamic study and the parenchymal phase in normal dogs using Gd‐EOB‐DTPA were determined. Second, the patterns of these images were evaluated in patient dogs with hepatic masses. The optimal time of arterial imaging was from 15 s after injection, and the optimal time for portal venous imaging was from 40 s after injection. Meanwhile, the optimal time to observe changes during the hepatobiliary phase was from 20 min after injection. In patient dogs, 11 lesions were diagnosed as malignant tumors; all were hypointense to the surrounding normal liver parenchyma during the hepatobiliary phase. Even with a low‐field MR imaging unit, the sequences afforded images adequate to visualize the liver parenchyma and to detect tumors within an appropriate scan time. Contrast‐enhanced MR imaging with Gd‐EOB‐DTPA provides good demarcation on low‐field MR imaging for diagnosing canine focal liver lesions.     

HELICAL COMPUTED TOMOGRAPHIC PORTOGRAPHY IN TEN NORMAL DOGS AND TEN DOGS WITH A PORTOSYSTEMIC SHUNT

Contrast enhanced helical computed tomography (CT) of the liver and portal system is routinely performed in human patients. The purpose of this project is to develop a practical protocol for helical CT portography in the dog. Ten clinically normal dogs were initially evaluated to develop a protocol. Using this protocol, ten dogs with confirmed portosystemic shunts (PSS) were then evaluated. Each patient was anesthetized, and a test dose of sodium iothalamate (400 mg I/ml) at 0.55 ml/kg was injected. Serial images were acquired at the level of T12-13 or T13-L1. The time to maximum enhancement of the portal vein was determined. This time period was used as the period between the second injection (2.2 ml/kg) and the start of the helical examination of the cranial abdomen. Delay times for normal dogs ranged from 34.5 s-66.0 s (median: 43.5 s) or 1.41 s/kg-4.12 s/kg (median: 2.09 s/kg). For patients with a PSS, the delay times were 16.5-70.5 s (median: 34.5 s) or 1.47-19.17 s/kg (median: 3.39 s/kg). The aorta, caudal vena cava, portal vein, shunt vessels, and their respective branches were well visualized on the CT images. Clinical case results were surgically confirmed. The surgeons reported that the information gained from the CT portography resulted in a subjective decrease in surgical time and degree of dissection necessary compared with similar surgeries performed without angiographic information. We believe that helical CT portography in the dog will be a useful adjunct in the diagnosis of PSS. The use of helical CT portography may allow clinicians to give clients a more accurate prognosis prior to surgery and will allow patients with lesions that are not surgically correctable to avoid a costly and invasive procedure.     

DIAGNOSIS OF ARTERIOPORTAL FISTULAE IN FOUR DOGS USING COMPUTED TOMOGRAPHIC ANGIOGRAPHY

Arterioportal fistulae are rare congenital anomalies of the hepatic vasculature. Diagnosis is conventionally made by selective angiography or ultrasonography. This report describes use of a dual-phase computed tomographic (CT) angiographic technique to diagnose arterioportal fistulae in four dogs. Advantages of this method include a noninvasive peripheral injection of contrast medium, ability to diagnose multiple acquired extrahepatic shunts, and observation of hemodynamic changes such as hepatofugal blood flow and reduced circulation to the caudal abdomen. The hepatic vasculature including arteries, veins, and portal veins can be completely evaluated. Dual-phase CT angiography is a safe and minimally invasive method of diagnosing arterioportal fistulae in dogs.     

Idiopathic lymphoplasmacytic rhinitis in dogs: 37 cases (1997-2002)

OBJECTIVE: To determine clinical signs and rhinoscopic, computed tomographic, and histologic abnormalities in dogs with idiopathic lymphoplasmacytic rhinitis. DESIGN: Retrospective case series. ANIMALS: 37 dogs. PROCEDURE: Clinical information was obtained from medical records. Nasal computed tomographic images and histologic slides of biopsy specimens were reviewed. RESULTS: Dogs ranged from 1.5 to 14 years old (mean, 8 years); most (28) were large-breed dogs. Nasal discharge was unilateral in 11 of 26 (42%) dogs and bilateral in 15 of 26 (58%) dogs. In dogs with unilateral disease, duration of clinical signs ranged from 1.5 to 36 months (mean, 8.25 months; median, 2 months), and in dogs with bilateral disease, duration of signs ranged from 1.25 to 30 months (mean, 6.5 months; median, 4 months). Computed tomography (n = 33) most often revealed fluid accumulation (27/33 [82%]), turbinate destruction (23/33 [70%]), and frontal sinus opacification (14/33 [42%]). Rhinoscopy (n = 37) commonly demonstrated increased mucus and epithelial inflammation; turbinate destruction was detected in 8 of 37 (22%) dogs. Bilateral biopsy specimens from all 37 dogs were examined. Four dogs had only unilateral inflammatory changes. The remaining 33 dogs had bilateral lesions; in 20, lesions were more severe on 1 side than the other. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggest that idiopathic lymphoplasmacytic rhinitis is a key contributor to chronic nasal disease in dogs and may be more common than previously believed. In addition, findings suggest that idiopathic lymphoplasmacytic rhinitis is most often a bilateral disease, even among dogs with unilateral nasal discharge.     

Dynamic computed tomographic quantitation of hepatic perfusion in dogs with and without portal vascular anomalies

OBJECTIVE: To compare hepatic, pancreatic, and gastric perfusion on dynamic computed tomography (CT) scans of clinically normal dogs with those of dogs with portal vascular anomalies. SAMPLE POPULATION: Dynamic computed tomography (CT) scans of 10 clinically normal dogs and 21 dogs with portal vascular anomalies. PROCEDURES: Retrospective analysis of dynamic CT scans. Hepatic arterial perfusion, hepatic portal perfusion, total hepatic perfusion, hepatic perfusion index, gastric perfusion, and pancreatic perfusion were calculated from time attenuation curves. RESULTS: Mean +/- hepatic arterial perfusion was significantly higher in affected dogs (0.57 +/- 0.27 mL/min x mL(-1)) than in clinically normal dogs (0.23 +/- 0.11 mL/min x mL(-1)), and hepatic portal perfusion was significantly lower in affected dogs (0.52 +/- 0.47 mL/min x mL(-1)) than in clinically normal dogs (1.08 +/- 0.45 mL/min x mL(-1)). This was reflected in the hepatic perfusion index, which was significantly higher in affected dogs (0.59 +/- 0.34), compared with clinically normal dogs (0.19 +/- 0.07). Gastric perfusion was significantly higher in dogs with portal vascular anomalies (0.72 +/- 0.44 mL/min x mL(-1)) than in clinically normal dogs (0.41 +/- 0.21 mL/min x mL(-1)), but total hepatic perfusion and pancreatic perfusion were not significantly different. Among subgroups, dogs with congenital intrahepatic portosystemic shunts and dogs with arterioportal fistulae had higher hepatic arterial perfusion than did clinically normal dogs. Dogs with congenital intrahepatic portosystemic shunts also had an increase in gastric perfusion and hepatic perfusion index. CONCLUSIONS AND CLINICAL RELEVANCE: Hepatic perfusion variables measured on CT scans revealed differences in hemodynamics between clinically normal dogs and those with portal vascular anomalies.     

Contrast harmonic imaging of canine hepatic tumors

Six adult healthy Beagles were used to investigate the hepatic perfusion dynamics of Levovist, a contrast agent used in contrast harmonic imaging (CHI). In addition, 8 dogs with hepatocellular carcinoma (HCC) and 2 dogs with metastatic hepatic hemangiosarcoma (HSA) were used to characterize both the CHI findings with Levovist. In the Beagles, the start of intravenously injected Levovist into the aorta between the cranial mesenteric and renal arteries and the portal vein at the hepatic hilum were 5.47 +/- 1.52 sec and 16.03 +/- 3.39 sec, respectively. As a characteristic CHI finding in the 8 dogs with HCC, the early arterial phase showed a fine network of blood flow enhanced at the surrounding region and within the tumor in all the 8 dogs (100%), and the post vascular phase demonstrated a defect in the whole tumor and an enhancement of the surrounding hepatic tissues in 7 dogs (87.5%). In the 2 dogs with HSA, characteristic finding in which the early arterial and late vascular phases showed a rim contrast enhancement pattern, and the post vascular phase revealed that the whole tumor lacked contrast enhancement and the surrounding hepatic tissues was clearly enhanced. In dogs, the start of the early arterial and late vascular phases, and the characterizations of the CHI findings in HCC and HSA were suggested to be similar to those in humans. Therefore, CHI is thought to be useful for the diagnosis of HCC and metastatic hepatic HSA in dogs as well as in humans.     

ANGIOGRAPHY OF THE HEPATIC AND PORTAL VENOUS SYSTEM IN THE DOG AND CAT: AN INVESTIGATIVE METHOD*

The investigators studied the hepatic angiographic technics used in human medicine with respect to their applicability for the investigation of circulatory liver diseases in the dog and cat. The technics were performed in 11 normal dogs and 2 normal cats, and the normal radiographic anatomy of the hepatic portal system and its tributaries was described. The potential indications for the angiographic technics were defined and their respective advantages and disadvantages discussed. Splenoportography was a valuable method for outlining the intrahepatic portal vein branches and for percutaneous prehepatic portal vein pressure determination. Percutaneous transhepatic portography was more difficult to perform, but it provided better detail of the intrahepatic portal veins than splenoportography. Transjugular transhepatic portography was the most versatile but also the most cumbersome of all technics tested. Percutaneous kinetic hepatography proved impractical in dogs and cats. The mesenteric tributaries to the hepatic portal system were best outlined by cranial mesenteric arterial portography or by operative mesenteric venous portography. Operative mesenteric venous portography, in contrast to cranial mesenteric arterial portography, was also useful for prehe-patic portal vein pressure determination. Free and wedged hepatic venography provided an opportunity for the functional and morphologic investigation of the hepatic sinusoid circula-tion.     

USE OF CONTRAST HARMONIC ULTRASOUND FOR THE DIAGNOSIS OF CONGENITAL PORTOSYSTEMIC SHUNTS IN THREE DOGS

Contrast harmonic ultrasound was used to determine macrovascular and perfusion patterns in three dogs with congenital extrahepatic solitary portosystemic shunts (PSS). With coded harmonic angiographic ultrasound, the size and tortuosity of the hepatic arteries were subjectively increased. Single pulse intermittent low-amplitude harmonic perfusion imaging provided contrast enhancement time-intensity curves from regions of interest in the liver. Mean (+/- standard deviation) peak perfusion times of dogs with PSS were significantly shorter (p = 0.01; 7.0 +/- 2.0 s) than reported in normal dogs (22.8 +/- 6.8 s). The contrast inflow slope for the dogs with PSS (14.6 +/- 3.7 pixel intensity units [PIU] was significantly (p = 0.05) larger than reported for normal dogs (3.6 +/- 1.4 PIU/s). These results indicate that combined coded harmonic angiographic and contrast harmonic perfusion sonography can be used to detect increased hepatic arterial blood flow as an indicator of PSS in dogs.     

PULMONARY ANGIOGRAPHY USING 16 SLICE MULTIDETECTOR COMPUTED TOMOGRAPHY IN NORMAL DOGS

We report a canine computed tomography (CT) pulmonary angiography technique using multidetector CT (MDCT). CT pulmonary angiography using a 16 slice MDCT was performed on five healthy, anesthetized beagles. A helical acquisition with pitch of 1.4 was used. The time delay for the angiographic study was determined using a bolus‐tracking program. A dose of 400 mg I/kg of nonionic contrast medium (Iohexol 300 mg I/ml) was administered to each dog via a cephalic catheter using an angiographic power injector at a rate of 5 ml/s. In two dogs a second study, using a contrast medium dose of 200 and 600 mg I/kg was performed. Arterial enhancement of transverse and reformatted images was classified subjectively as excellent, good, or poor, and assessed objectively by measuring Hounsfield units at the right main pulmonary artery. Angiographic studies were evaluated by two radiologists to determine the number of subsegmental arterial branches visualized. The median number of subsegmental arterial branches identified was five (range: 2–7). Based on the time attenuation curve obtained by the bolus‐tracking program, there was consistent enhancement of the right main pulmonary artery beginning at 6 s and peaking at 8 s in 4/5 dogs. The contrast medium dose of 400 mg I/kg produced good to excellent vascular enhancement in the same 4/5 dogs. A dose of 200 mg I/kg resulted in poor enhancement. CT pulmonary angiography using MDCT and an automated bolus‐tracking program allows rapid, consistent evaluation of the pulmonary vasculature using a single dose of 400 mg I/kg of contrast medium.     

Hepatic lesions associated with intrahepatic arterioportal fistulae in dogs

Seven cases of hepatic arterioportal fistulae in young dogs (mean age 6 months) are described. All cases were presumed to be congenital in origin. The onset of clinical signs, which frequently included gastrointestinal and neurological disturbances, was usually sudden. All dogs had clinical evidence of portal hypertension in the form of ascites, and all developed multiple extrahepatic portacaval venous shunts consequential to portal hypertension. The neurological disturbances were likely the result of portacaval shunting. The arterial and venous vessels involved in the fistulae had markedly altered wall structure. Hepatic regions adjacent to the fistulae frequently evidenced marked bile duct proliferation. Hepatic parenchymal atrophy, relative collapse of distributing portal veins, dilatation of hepatic arterial branches and proliferation of hepatic arterioles were seen throughout the liver; these changes closely resembled those present with portacaval shunting in the absence of hepatic arterioportal fistulae. The importance of recognizing that hepatic arterioportal fistulae and multiple extrahepatic portacaval shunts usually coexist and separately influence the morphological appearance of the liver is stressed.