COMPUTED TOMOGRAPHIC FINDINGS IN 57 CATS WITH PRIMARY PULMONARY NEOPLASIA

Primary pulmonary neoplasia is relatively uncommon in cats and generally has a poor prognosis. In this multicenter, retrospective study of 57 cats with pulmonary neoplasia, the most frequent presenting signs were anorexia/inappetence (39%) and cough (37%). The pulmonary tumors were considered to be incidental findings in 9% cats. In computed tomographic (CT) images, primary pulmonary tumors appeared as a pulmonary mass in 55 (96%) cats and as a disseminated pulmonary lesion without a defined mass in two (4%) cats. Most pulmonary tumors were in the caudal lobes, with 28 (49%) in the right caudal lobe and 17 (30%) in the left caudal lobe. CT features associated with pulmonary tumors included mass in contact with visceral pleura (96%), irregular margins (83%), well‐defined borders (79%), bronchial compression (74%), gas‐containing cavities (63%), foci of mineral attenuation (56%), and bronchial invasion (19%). The mean (range) maximal dimension of the pulmonary masses was 3.5 cm (1.1–11.5 cm). Additional foci of pulmonary disease compatible with metastasis were observed in 53% cats. Pleural fluid was evident in 30% cats and pulmonary thrombosis in 12% cats. The histologic diagnoses were 47 (82%) adenocarcinomas, six (11%) tumors of bronchial origin, three (5%) adenosquamous cell carcinomas, and one (2%) squamous cell carcinoma. In this series, adenocarcinoma was the predominant tumor type, but shared many features with less common tumor types. No associations were identified between tumor type and CT features. Prevalence of suspected intrapulmonary metastasis was higher than in previous radiographic studies of cats with lung tumors.     

COMPARISON OF COMPUTED TOMOGRAPHIC AND PATHOLOGIC FINDINGS IN 17 DOGS WITH PRIMARY ADRENAL NEOPLASIA

The CT appearance of canine adrenal masses has been reported, but associations between imaging features and pathologic features of these lesions have not been investigated in detail. The purpose of this study was to test associations between different types of adrenal neoplasia and their CT and pathologic features. A retrospective cross‐sectional study was performed and inclusion criteria were histologic diagnosis of primary adrenal neoplasia, contrast‐enhanced CT examination of the abdomen and surgical resection of the mass or necropsy examination. For all included dogs, CT images and histopathologic specimens were reviewed independently by two veterinary radiologists and a veterinary pathologist, respectively. Seventeen dogs met inclusion criteria. Diagnoses were adenocarcinoma in nine (53%) dogs, pheochromocytoma in five (29%) dogs, and adenoma in three (18%) dogs. Pheochromocytoma was associated with CT signs of vascular invasion (likelihood ratio = 4.8, 95% CI = 1.3–18.3, P = 0.03) and macroscopic vascular invasion (likelihood ratio = 9.6, 95% CI = 1.4–65.9, P = 0.02). There was excellent agreement between signs of vascular invasion in CT images and vascular invasion at surgery or necropsy (kappa = 0.86, P = 0.001). A peripheral contrast‐enhancing rim in delayed postcontrast CT images was associated with fibrous encapsulation of the tumor (kappa = 0.53, P = 0.05), and a heterogeneous pattern of contrast distribution in delayed postcontrast CT images was associated with adrenal hemorrhage or infarction on histological examination (kappa = 0.45, P = 0.05). Findings indicated that CT enabled assessment of adrenal neoplasia features that reflected their biological behavior and pathological findings, however overlapping characteristics between tumor types limited the potential for reliably distinguishing them based on CT alone.     

COMPUTED TOMOGRAPHY OF PRIMARY INFLAMMATORY BRAIN DISORDERS IN DOGS AND CATS

A retrospective study of 22 animals with histologically confirmed, primary inflammatory brain disease was undertaken to determine the value of computed tomography in such patients. The histologic diagnosis was confirmed at necropsy in 18 patients and by surgical biopsy in four. All affected animals had neurologic deficits; the most common presenting complaint was seizures. Abnormalities were identified on computed tomography images in 21 of the 22 patients. The abnormalities included ventricular changes, falcial deviation, edema, focal changes in parenchymal opacity, focal contrast enhancement, periventricular contrast enhancement, and a ring-like pattern of contrast enhancement. Many lesion types identified in this study, such as falcial deviation, changes in parenchymal opacity, and ring-pattern enhancement, have previously been associated with neoplasia. The abnormalities correlated well with the lesion localization predicted by neurologic examination and confirmed by surgery or necropsy. Although computed tomography findings were often judged to be compatible with inflammatory disease, they did not predict the type of pathologic process. The findings suggest that computed tomography is valuable in the evaluation of animals with primary inflammatory brain disorders, but differentiation of neoplasia from non-neoplastic diseases is not always possible.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE CISTERNA CHYLI IN DOGS

Previous lymphangiographic studies have investigated the use of computed tomography (CT) for characterizing the thoracic duct and its tributaries in dogs. However, there is limited published information on the appearance of the canine cisterna chyli using CT. The objective of this retrospective study was to describe the features of the canine cisterna chyli in pre‐ and post‐contrast abdominal CT studies. The presence, location, shape, maximum width, size compared with the aortic diameter (Ao:cisterna chyli ratio) and mean attenuation of the cisterna chyli were recorded from archived abdominal CT scans of 30 dogs. Breed, age, sex and neutering status were also noted. A cisterna chyli was identified in 26 of the dogs (87%). In 22 cases a cisterna chyli could be reliably identified prior to intravenous contrast administration and in all 26 cases in postcontrast images. The cisterna chyli was most commonly located right dorsolateral to the abdominal aorta between L1 and L4. Shape varied on transverse images from crescent‐like to globular and maximum diameters ranged from 5 to 9 mm. The Ao:cisterna chyli ratio varied between 0.29 and 0.71 (mean value—males: 0.32; females: 0.38). On pre‐contrast images the mean Hounsfield units were 21.3HU (range: –3.8 to 64.25). Mild enhancement of the cisterna chyli post‐contrast was observed in 24 dogs (80%). Findings supported the use of pre‐ and post‐contrast abdominal CT as a non‐invasive method for assessing qualitative and quantitative characteristics of the canine cisterna chyli.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF INTRAPELVIC MASSES IN DOGS

In people, the computed tomography (CT) characteristics of intrapelvic masses can be used to distinguish a malignant from a benign mass. As prognosis varies greatly between malignant and benign intrapelvic masses, knowledge of their biological behavior can aid treatment planning before surgery. The purpose of this study was to determine if CT characteristics exist to help differentiate benign from malignant intrapelvic masses in dogs. The CT images of 14 dogs with a histopathologically confirmed intrapelvic mass were evaluated. Postcontrast internal heterogeneity of the mass was the only characteristic significantly associated with malignancy (P=0.005). Preoperative CT examination of intrapelvic masses in dogs can provide prognostic information before invasive surgical treatment.     

COMPUTED TOMOGRAPHIC FINDINGS OF FUNGAL RHINITIS AND SINUSITIS IN CATS

The computed tomographic (CT) findings of fungal rhinitis/sinusitis in cats were characterized. The CT images of 10 cats ranging in age from 7 to 13 years were examined. The mean age was 10.8 years and all were neutered males. Nasal aspergillosis was diagnosed in five cats, cryptococcosis in three cats, hyalohyphomycosis in one cat, and trichosporonosis in one cat. Bilateral disease was present in eight cats, seven had abnormal soft tissue attenuation in two-thirds of the nasal cavity, and six had turbinate lysis. Seven cats had also lysis of the hard palate, nasal septum, or frontal bone. One cat had lysis of the cribriform plate. Five of the nine cats whose lymph nodes were imaged had lymph node enlargement. There was contrast medium enhancement in the nasal cavity in all cats, with either a primarily peripheral rim or heterogeneous pattern. There appears to be an overlap of clinical signs, age, and CT features of cats with nasal neoplasia and those with fungal rhinitis/sinusitis.     

COMPUTED TOMOGRAPHIC PNEUMOCOLONOGRAPHY IN NORMAL DOGS

Objectives of this prospective study were to describe effects of varying technical components that may contribute to an optimal protocol for computed tomographic pneumocolonography (CTP) in dogs, and to develop a standardized methodology for CTP as a future potential diagnostic tool in canine clinical patients with large bowel disease. Eight purpose‐bred intact male hound cross‐research dogs were enrolled and randomized to groups based on variables of pressure/body position (n = 4) and insufflation time (n = 4). For each segment of large bowel (rectum, colorectal junction, descending colon, transverse colon, ascending colon), the adequacy of bowel preparation, % of bowel lumen filled with fecal material, and bowel tortuosity or folding were assessed. Measurements of bowel wall thickness (cm), cross‐sectional bowel lumen diameter (cm), and cross‐sectional bowel luminal area (cm²) were obtained at standardized locations within the large bowel. False discovery rates (FDR) were calculated to adjust for multiple testing. Values of FDR < 0.05 were considered significant. Differences in mean cross‐sectional area and diameter and bowel wall thickness under increasing pressure were not significant after adjusting for multiple testing; some had raw p values <0.05. Ascending colon diameter and ascending colon area significantly increased with insufflation time (FDR < 0.05). No other response variables showed a significant change with insufflation time. The optimal insufflation pressure for maintaining pneumocolon in this study was determined to be 20 mmHg. CTP is a feasible technique to provide consistent distension for imaging of the large bowel and further study on application of CTP in clinical patients is warranted.     

COMPUTED TOMOGRAPHIC APPEARANCE OF PRIMARY LUNG TUMORS IN DOGS

Canine primary lung tumors typically appear radiographically as a well‐circumscribed solitary mass in the periphery of a caudal lung lobe. Consolidated and diffuse forms of primary lung tumors have also been described. Nineteen dogs with computed tomographic (CT) images of the thorax and a histological diagnosis of primary lung tumor (17 primary carcinomas and two primary sarcomas) were evaluated retrospectively to characterize the CT findings. All primary lung tumors were bronchocentric in origin with internal air bronchograms. The bronchi were typically narrowed, displaced, and often obstructed by the tumor. Eighteen of 19 (95%) of the tumors were solitary and there was one pneumonic/alveolar form. Most solitary tumors were well circumscribed (17/18), located in the central to periphery of the lung (14/18), and in a cranial or caudal lobe (16/19). Most primary lung tumors (11/17) had mild to moderate heterogeneous contrast enhancement. Five of 19 dogs (26%) had evidence of pulmonary metastasis. Internal mineralization (3/19) and tracheobronchial lymphadenopathy (4/19) were also identified. On CT examination, solitary, well circumscribed, bronchocentric masses with internal air bronchograms are consistent with a primary pulmonary tumor in dogs.     

COMPUTED TOMOGRAPHIC APPEARANCE OF INFLAMMATORY POLYPS IN THREE CATS

This report describes the use of computed tomography (CT) to evaluate the inner ear, tympanic bullae, nasopharyngeal area, and external ear canals of three cats. All cats presented for evaluation of upper respiratory signs or chronic ear infection. Nasopharyngeal masses were present in two cats, and a mass in the external ear canal was present in the third cat. In all three cats, CT was able to define the extent of osseous bulla involvement, which was confirmed at surgery. Computed tomography also defined the extent of the polyp in the nasopharyngeal area in two cats, and in the external ear canal in one cat. Surgical removal of the polyps was accomplished with a combined oral approach and ventral bulla osteotomy in cats 1 and 2. The polyp was removed from cat 3 using a combination of ventral bulla osteotomy and excision of the mass through the external ear canal. Microscopic examination confirmed all masses as nasopharyngeal (inflammatory) polyps.     

COMPUTED TOMOGRAPHIC FEATURES OF PHARYNGEAL NEOPLASIA IN 25 DOGS

Computed tomography (CT) is commonly used to investigate head tumors in dogs, however little information is available for lesions of the pharyngeal area. The purpose of this multicentric, retrospective, cross‐sectional study was to describe the CT findings in a sample of dogs with pathologically confirmed pharyngeal neoplasia and determine whether any CT features allowed differentiation of tumor type. Location of lesions, size and shape, margins, relationship with surrounding structures and vessels, attenuation characteristics and enhancement pattern, regional lymph node changes, and presence of metastasis were recorded by three observers (1 DECVDI). The effect of final diagnosis on each CT feature was tested. A total of 25 dogs were included: 15 with carcinomas, five sarcomas, four melanomas, and one lymphoma. The oropharynx and laryngopharynx were more frequently involved. Among tumor groups, lesions were of similar size, irregularly shaped, had ill‐defined margins, and had moderate‐to‐marked heterogeneous contrast enhancement. Lysis of hyoid bones was recorded in two carcinomas and infiltration of the lingual artery occurred in one case. Marked medial retropharyngeal lymphoadenomegaly was recorded in 11 of 14 carcinomas, in all sarcomas and in two of four melanomas. The single lymphoma case showed ill‐defined thickening of the oropharyngeal and laryngeal wall with retropharyngeal and mandibular lymphadenomegaly. Lung metastases were found in two of five sarcomas and two of four melanomas. Findings from the current study did not support the hypothesis that CT features could be used to predict pharyngeal tumor type in dogs. However, CT was helpful for determining mass extension, lymph node involvement, and distant metastatic spread.     

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.     

COMPUTED TOMOGRAPHIC ASSESSMENT OF BODY FAT IN BEAGLES

Obesity is the most common nutritional disorder in small animals. To establish a computed tomographic (CT) method for assessment of visceral and subcutaneous fat content in the dog, CT analysis was performed in normal and obese beagles. Fat area was measured by the level detection method at varied attenuation ranges and compared with body fat content estimated by the deuterium oxide dilution method. Fat area measured at L3 using the attenuation range of -135/-105 Hounsfield unit had the best correlation with body fat content (r = 0.98). Regional fat distribution was almost the same between normal and obese dogs, with more fat accumulation at L1-S1 than T10-T13. Moreover, visceral and subcutaneous fat area could be estimated separately. This CT method may contribute to both the clinical diagnosis and the study of canine obesity, especially for studies in the relationship between body fat distribution and obesity-associated diseases.     

CONTRAST-ENHANCED COMPUTED TOMOGRAPHIC IMAGING OF THE AUDITORY TUBE IN MESATICEPHALIC DOGS

Computed tomography after contrast medium injection was performed in three mesaticephalic canine cadavers to image the auditory tube. Cadavers were positioned in lateral recumbency for imaging. A myringotomy incision was made in the left tympanic membrane of each dog, and contrast medium was infused into the ear canal and middle ear through a balloon-tip catheter. With this method, contrast medium filled the left bulla and auditory tube in all three cadavers. Computed tomography following contrast medium injection was effective for evaluation of the canine auditory tube. Future studies are required to determine the usefulness, as well as the safety, of this procedure in the evaluation of the auditory tube in other breeds of dogs as well as dogs with otitis     

COMPUTED TOMOGRAPHIC FEATURES OF SKULL OSTEOMYELITIS IN FOUR YOUNG DOGS

Computed tomography (CT) features of four immature to young adult dogs with osteomyelitis of the skull are described. Trauma or bite wounds were the cause of infection and Staphylococcus aureus was the most common pathogen. CT features were a combination of soft tissue thickening, bone lysis, and bone proliferation. Bone lysis was extensive in some dogs with a moth-eaten appearance and involved the calvarium, base of the skull, the frontal sinuses, and the temporomandibular joint. In other dogs it was more focal with thinning of the bone rather than complete lysis. Bone proliferation also varied in appearance from irregular palisading or spiculated to expansion and septation of the frontal bone. Sequestrum formation was seen in one dog. Widespread infection in one dog involved the tympanic bullae and the temporomandibular joint. Lysis of the calvarium resulted in bacterial meningitis in two dogs. One dog was euthanized and three were treated with surgical curettage of the affected bone and antibiotic therapy which resulted in resolution of the clinical signs in one dog whereas two dogs had recurrent disease. CT was very helpful for characterizing extent and localization of the infection. Despite the aggressive CT features, osteomyelitis should be considered especially in young animals with a history of trauma or bite wounds. The pathophysiology of skull bone infections is discussed.     

COMBINATION OF COMPUTED TOMOGRAPHIC IMAGING CHARACTERISTICS OF MEDIAL RETROPHARYNGEAL LYMPH NODES AND NASAL PASSAGES AIDS DISCRIMINATION BETWEEN RHINITIS AND NEOPLASIA IN CATS

Feline nasal diseases are a diagnostic challenge. The objective of this retrospective, cross‐sectional study was to determine whether computed tomography (CT) imaging characteristics of the medial retropharyngeal lymph nodes (MRPLN), alone or in combination with CT imaging characteristics of the nasal passages, could aid in differentiation between rhinitis and nasal neoplasia. Cats were recruited from record archives at two veterinary facilities during the period of 2008–2012. Selection criteria were presentation for chronic nasal discharge, contrast‐enhanced CT of the head that included the MRPLN, and rhinoscopic nasal biopsy resulting in diagnosis of rhinitis or neoplasia. For each CT scan, two board‐certified veterinary radiologists recorded MRPLN size, attenuation, heterogeneity, contrast‐medium enhancement, margination, shape, presence of a lymph node hilus, perinodal fat, turbinate lysis, paranasal bone lysis, and nasal mass. Both readers were unaware of patient information at the time of CT interpretation. Thirty‐four cats with rhinitis and 22 cats with neoplasia were included. Computed tomographic characteristics significantly associated with neoplasia included abnormal MRPLN hilus (OR 5.1), paranasal bone lysis (OR 5.6), turbinate lysis (5.6), mass (OR 26.1), MRPLN height asymmetry (OR 4.5), and decreased MRPLN precontrast heterogeneity (OR 7.0). The combined features predictive of neoplasia were a nasal mass with abnormal hilus (OR 47.7); lysis of turbinates/paranasal bones with abnormal MRPLN hilus (OR 16.2). Findings supported the hypothesis that combining CT features of the nasal passages and MRPLN aided in differentiating rhinitis from neoplasia in cats.     

COMPUTED TOMOGRAPHIC FINDINGS IN 15 DOGS WITH EOSINOPHILIC BRONCHOPNEUMOPATHY

Eosinophilic bronchopneumopathy is a disease characterized by the infiltration of the lung and bronchial mucosa by eosinophils. The aim of the present study was to describe the CT findings in a large series of dogs with confirmed diagnosis of eosinophilic bronchopneumopathy. Computed tomographic scans of 15 dogs with confirmed diagnosis of eosinophilic bronchopneumopathy were evaluated retrospectively by two boarded radiologists who reached a consensus. Abnormalities were identified in 14/15 (93%) dogs, including pulmonary parenchymal abnormalities in 14/15 (93%) dogs, bronchial wall thickening in 13 (87%) dogs, which was considered marked in eight (53%), plugging of the bronchial lumen by mucus/debris in 11 (73%) dogs, and bronchiectasis in nine (60%) dogs. Pulmonary nodules were identified in 5/15 (33%) dogs including one dog with a mass. All dogs with a nodular lung pattern had additional abnormalities. Lymphadenopathy was present in 10 dogs (67%). Lesions associated with eosinophilic bronchopneumopathy are variable and heterogeneous and encompass a wider variety of computed tomographic features than reported previously. Computed tomographic images were abnormal in the majority of affected dogs, hence CT is a useful modality to characterize the nature and distribution of thoracic lesions in dogs with eosinophilic bronchopneumopathy.     

A COMPARISON OF RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC FINDINGS IN 31 DOGS WITH MALIGNANT NASAL CAVITY TUMORS

Nasal cavity radiographs and CT images from 31 dogs with nasal cavity cancer were compared. All dogs had abnormal clinical signs relating to -nasal cancer and histologic confirmation of malignant nasal cavity neoplasia. No dog had cyto reductive surgery prior to imaging. All radiographic and CT examinations were abnormal. CT was more accurate than radiographs in identifying unilateral versus bilateral nasal cavity disease and tumor extension into adjacent structures such as the cranial cavity, hard palate, and pterygopala-tine fossa. The improved accuracy of CT in these respects was not of benefit in the confirmation of nasal cavity disease because radiographs were abnormal in every instance. However, CT may be useful for more accurate tumor staging, predicting possible treatment-related complications, and planning of surgery and radiation therapy. It was also determined that one dorsally located radiation therapy portal bounded laterally by the medial ocular canthi, as described in previous reports, would not have been adequate for encompassing all abnormal tissue in 28 of the 31 dogs evaluated.     

THE COMPUTED TOMOGRAPHIC APPEARANCE OF ACUTE THORACOLUMBAR INTERVERTEBRAL DISC HERNIATIONS IN DOGS

The appearance of herniated intervertebral disc material in the thoracolumbar vertebral canal was evaluated in 23 dogs using computed tomography (CT). The images were then compared with the myelographic and surgical findings. The normal spinal cord, outlined by epidural fat over intervertebral disc spaces, was of intermediate attenuation on transverse CT images. Herniated disc material was identified in all animals as a heterogeneous hyperattenuating extradural mass. The attenuation of the disc material increased with the degree of mineralization. In seven dogs, the herniated material was only slightly more attenuating than the spinal cord. In these dogs, small fragments of mineralized disc material and significant hemorrhage were found in the epidural space at surgery. In dogs with a long standing history of disc herniations, disc material identified in the vertebral canal had a more hyperattenuating and homogeneous appearance than recently herniated disc material. We conclude that mineralized, herniated disc material and hemorrhage can be identified quickly and safely in dogs using CT.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF MULTILOBULAR TUMOR OF BONE INVOLVING THE CRANIUM IN 7 DOGS AND ZYGOMATIC ARCH IN 2 DOGS

Computed tomography (CT) images of nine dogs with a multilobular tumor of bone of the head were reviewed. The CT characteristics of the neoplasms involving the calvarium (n = 7) were rounded, well defined with a fine granular, nonhomogeneous bone opacity usually in the occipital region. Cranial vault invasion (5 of 7) was commonly found with a significant portion of the mass within the vault. The neoplasms involving the zygomatic arch (n = 2) were also generally rounded and well defined but with a more coarse granular appearance. The common CT findings were best seen when the images were viewed in a bone window.