Magnetic resonance imaging of canine mast cell tumors

Mast cell tumors (MCT) are the most common cutaneous tumors in dogs. Our purpose was to describe the magnetic resonance (MR) imaging characteristics of cutaneous MCT and to identify imaging characteristics that allow differentiation of metastatic from normal lymph nodes. Eight dogs with a total of nineMCT were imaged as were their presumed draining and associated contralateral lymph nodes. The signal intensity of tumors and lymph nodes was compared to adjacent musculature. On T2-W images, 7/9 MCT were hyperintense to muscle and 2/9 were isointense. On T1-W images, 8/9 MCT were isointense and 1/9 were mildly hypointense. All tumors were strongly contrast enhancing; 5/9 were homogeneous and 4/9 heterogeneous in their enhancement patterns. Six lymph node pairs were included in the evaluation (five sentinel lymph nodes with metastases, one without, and six contralateral lymph nodes). Metastatic lymph nodes were significantly larger than their contralateral lymph nodes (P = 0.039). All lymph nodes were isointense on T1-W images and hyperintense on T2-W images. 5/5 metastatic and 2/7 normal lymph nodes were heterogeneously T2-hyperintense. All lymph nodes were moderately to strongly contrast enhancing. 4/5 metastatic and 2/7 normal lymph nodes had heterogeneous enhancement patterns. While heterogeneity was more common in metastatic than in normal lymph nodes, this difference was not significant (P = 0.058 for T2-W images; P = 0.234 for postcontrast images). MR imaging may be useful in the presurgical evaluation and clinical staging of cutaneous MCT.     

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 appearance of masticatory myositis in dogs: 7 cases (1999-2006)

OBJECTIVE: To document computed tomography (CT) features in dogs with masticatory myositis. DESIGN: Retrospective case series. ANIMALS: 7 dogs with an immunologic diagnosis of masticatory myositis and an absence of clinical abnormalities of any skeletal muscles other than the masticatory muscles. PROCEDURES: History; clinical, hematologic, biochemical, immunologic, cytologic, and histologic findings; and pre- and postcontrast CT imaging features of masticatory muscles and head and neck lymph nodes were extracted from medical records. RESULTS: On CT images, changes in size (atrophy or swelling) were common for all masticatory muscles except the digastricus muscles, which were involved only in 1 dog. Pre-contrast attenuation changes, most often hypoattenuation with varied distribution patterns, were seen in masticatory muscles of 4 dogs. Contrast enhancement with a predominantly inhomogeneous distribution pattern was seen in the temporalis, masseter, and pterygoid muscles of all dogs. Head and neck lymph nodes were enlarged in all but 1 dog and had contrast enhancement with predominantly central or homogeneous distribution patterns. Muscle biopsy was performed in 6 dogs, with biopsy specimens obtained from areas that had the most obvious contrast enhancement on CT images. For all 6 dogs, biopsy specimens had histologic features indicative of masticatory myositis. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that CT may be a useful adjunct in the diagnosis of masticatory myositis in dogs, including selection of sites for diagnostic muscle biopsy.     

Evaluation of 18F‐FDG PET/CT as a diagnostic imaging and staging tool for feline oral squamous cell carcinoma

18F‐fluorodeoxyglucose positron emission tomography combined with computed tomography (18FDG‐PET/CT) has been shown to be effective for staging human oral squamous cell carcinoma (SCC) but its application for cats with oral SCC is unknown. Twelve cats with biopsy‐proven oral SCC were imaged with whole body 18FDG‐PET/CT to determine its value as a diagnostic imaging and staging tool and fine needle aspirates were obtained of accessible regional lymph nodes. All tumors were FDG avid and conspicuous on 18FDG‐PET/CT images, with an average of the maximum standardized uptake value 9.88 ± 5.33 SD (range 2.9–24.9). Soft tissue infiltrative tumors that were subtle and ill defined on CT were highly visible and more extensive on FDG‐PET/CT. Tumors invading the osseous structures were more similar in extent on 18FDG‐PET/CT and CT although they were more conspicuous on PET images. Three cytologically confirmed metastases were hypermetabolic on PET, while two of those metastases were equivocal on CT.     

Computed Tomographic Lymphography of the Thoracic Duct by Mesenteric Lymph Node Injection

Objective— To document a novel technique to image the thoracic duct and its tributaries by contrast enhanced computed tomography (CT) lymphography.
Study Design— Clinical report.
Animals— Dogs (n=6) idiopathic chylothorax.
Methods— Ultrasonography was used to guide percutaneous injection of intestinal lymph nodes with nonionic iodinated contrast medium for preoperative CT lymphography of the thoracic duct in 6 dogs with chylothorax. Thoracic CT images were acquired immediately after contrast medium injection. All dogs had subtotal pericardectomy and thoracic duct ligation. Postoperative thoracic duct lymphography was performed in 3 dogs. Superficial cervical lymph node lymphography was performed in 2 dogs to determine cervical lymphatic contribution to thoracic effusions.
Results— Preoperative thoracic duct lymphography using this technique was successful in delineating the cisterna chyli, thoracic duct, and associated lymphatic vessels in all dogs. Immediate postoperative lymphography performed in 2 dogs revealed successful duct ligation in 1 dog and persistent lymphatic leakage in the other. A 1-month postoperative thoracic duct lymphogram performed in 1 dog revealed unsuccessful ligation or recannulation of 1 of 3 redundant vessels seen preoperatively.
Conclusion— Percutaneous CT lymphography results in excellent detection of the thoracic duct and abnormal thoracic duct drainage patterns both pre- and postoperatively. The contribution of superficial cervical lymph node drainage to reoccurrence of effusions can be evaluated.
Clinical Relevance— Percutaneous CT lymphography using ultrasound-guided contrast medium injection should be considered as an alternative to conventional open abdominal approaches to radiographic or CT lymphography.     

Anatomical study of the gastrointestinal tract of a pudu (Pudu puda) using contrast-enhanced abdominal computed tomography

The pudu (Pudu puda), which is the smallest deer in the world and inhabits central and southern Chile and Argentina, is a ruminant and a browsing herbivore. The aim of this study was to provide a reference for interpretation of the normal anatomy of the pudu's gastrointestinal tract as imaged by abdominal computed tomography (CT). For the study, one adult female pudu was used. After a 24-h fast, the pudu was anaesthetized and positioned in sternal recumbency at the CT table. Image acquisition began immediately after intravenous injection of contrast media (MD-76(?); 370 mgI/ml) into the cephalic vein. Injection of contrast material was administered as a biphasic protocol. First, a manual bolus of contrast material was injected at a rate of 4 ml/s. Then, an additional continuous infusion injection (0.1 ml/min) was performed for adequate opacification of vascular structures. Transverse images of 5 mm thickness and 5 mm interval were obtained with a fourth-generation CT scanner, from the ninth thoracic vertebra (T9) until the first sacral (S1) vertebrae. CT images were labelled and compared with anatomical reference images for ruminants. Structures that were identified in the abdominal cavity included the stomach with its four compartments (rumen, reticulum, omasum and abomasum), the small and large intestines, liver, spleen, kidneys and some major blood vessels (aorta, caudal vena cava). The distal loop of the ascending colon, the transverse colon, the pancreas and lymph nodes could not be identified. The resulting CT images provide a reference for normal cross-sectional abdominal anatomy of the adult pudu.     

Computed Tomography and Cross‐Sectional Anatomy of the Metatarsus and Digits of the One‐humped Camel ( Camelus dromedarius) and Buffalo ( Bos bubalis)

The purpose of the present study was to provide a detailed computed tomography (CT) and cross‐sectional anatomic reference of the normal metatarsus and digits for the camel and buffalo, as well as to compare between metatarsus and digits in these animals to outstand a basis for diagnosis of their diseases. Advantages, including depiction of detailed cross‐sectional anatomy, improved contrast resolution and computer reformatting, make it a potentially valuable diagnostic technique. The hind limbs of 12 healthy adult camel and buffalo were used. Clinically relevant anatomic structures were identified and labelled at each level in the corresponding images (CT and anatomic slices). CT images were used to identify the bony and soft tissue structures of the metatarsus and digits. The knowledge of normal anatomy of the camel and buffalo metatarsus and digits would serve as initial reference to the evaluation of CT images in these species.     

Malignant B-cell lymphoma of the Harder's gland in a rabbit

A 22-month-old, female rabbit was presented with a 1-day history of acute unilateral exophthalmos. Ultrasonography and computed tomography (CT) of the orbit revealed an orbital mass. Retrobulbar lymphoma was diagnosed following fine-needle aspiration biopsy (FNAB). Thoracic radiographs were normal, and ultrasonography of the abdomen showed focal hypoechoic thickening of the bowel wall and hypoechoic enlarged lymph nodes. The rabbit was euthanized and histopathology identified the retrobulbar mass as B-cell malignant lymphoma of the Harder's gland. Mesenteric lymph nodes, caecum, and both kidneys were also affected. This is the first documented case of malignant lymphoma of the Harder's gland in a rabbit.     

Computed tomographic‐lymphography as a complementary technique for lymph node staging in dogs with malignant tumors of various sites

Locoregional lymph nodes are routinely examined in order to define the spatial extent of neoplastic disease. As draining patterns of certain tumor types can be divergent from expected anatomical distribution, it is critical to sample the lymph nodes truly representing the draining area. The aim of this bicenter prospective pilot study was to describe the technique of computed tomographic (CT)‐lymphography for primary draining lymph node mapping in tumor staging in dogs. Forty‐five dogs with macro‐ or microscopic tumors in specified localizations were evaluated. Depending on body weight, 0.8–2 ml contrast agent (iohexol) was injected into four quadrants around the tumor, and CT‐images were obtained at 1, 3, 6, 9, and 12 minutes post‐injection. Attenuation of chosen regions of interest (Hounsfield units (HU)) and patterns of enhancement were assessed for 284 lymph nodes in the precontrast study with median HUs of 31.1 (Interquartile range (IQR) = 18.4) and for 275 in the intravenous postcontrast study with 104.3 HU (IQR = 31.2) (paired Wilcoxon test, P < 0.001). In the CT‐lymphography study, 45 primary draining lymph nodes with a significantly higher median HU value of 348.5 (IQR = 591.4) (one‐sample t‐test, P < 0.001) were identified. Primary draining lymph nodes were found to be clearly visible after 1–3 minutes after local injection, often concurrent with a good visibility of the lymphatic vessel system. The herein described technique of peritumorally injected CT‐contrast agent followed by subsequent CT‐lymphography for primary draining lymph node mapping works well in a majority of cases in all investigated sites and warrants further validation for different tumor entities.     

Computed tomographic anatomy of the temporomandibular joint in the young horse

Reasons for performing study: The equine temporomandibular joint (TMJ) and its surrounding structures can be difficult to investigate in cases with a clinical problem related to the region. Little previous attention has been given either to a computed tomographic (CT) imaging protocol for the joint or an interpretation of the structures displayed in CT images of the normal joint. Objectives: To provide a CT atlas of the normal cross‐sectional anatomy of the equine TMJ using frozen and plastinated sections as anatomical reference. Methods: Eight TMJs from 4 immature pure‐bred Spanish horses were examined by helical CT. Scans were processed with a detailed algorithm to enhance bony and soft tissue. Transverse CT images were reformatted into sagittal and dorsal planes. Transverse, sagittal and dorsal cryosections were then obtained, photographed and plastinated. Relevant anatomic structures were identified in the CT images and corresponding anatomical sections. Results: In the CT images, a bone window provided excellent bone detail, however, the soft tissue components of the TMJ were not as well visualised using a soft tissue window. The articular cartilage was observed as a hyperattenuating stripe over the low attenuated subchondral bone and good delineation was obtained between cortex and medulla. The tympanic and petrous part of the temporal bone (middle and inner ear) and the temporohyoid joint were seen in close proximity to the TMJ. Conclusions: Helical CT provided excellent images of the TMJ bone components to characterise the CT anatomy of the normal joint. Potential relevance: Detailed information is provided that may be used as a reference by equine veterinarians for the CT investigation of the equine TMJ and serve to assist them in the diagnosis of disorders of the TMJ and related structures (middle and inner ear). The study was performed at an immature stage and further studies of mature individuals are required in order to confirm that the clinical interpretation is not affected by changes occurring with age.     

Computed tomographic anatomy of the canine temporal bone

This study aims to identify and describe structures of the temporal bone in normal dogs that can be depicted using computed tomography (CT). Five normal dogs of different breeds and both sexes ranging from 0.5 to 8 years were used as the study material. CT images of 2 mm thickness without abnormalities in the temporal bone were reviewed and analysed in bone and soft tissue settings. All images were compared with corresponding E 12 plastic-embedded cross sections of 3 mm thickness, which were acquired from anatomic cross sections of frozen beagles. The sections were provided from the Department of Pathobiology (Institute of Anatomy). CT is able to image all relevant bony structures within the temporal bone. Concerning soft tissue structures, CT allows their localization by using bony markers, i.e. the internal acustic meatus for the cranial nerves VII and VIII or the canals for the internal carotid artery and the temporal sinus. The provided reference images are meant to improve orientation within the complex anatomy of the temporal bone. On condition that slice thickness is equal to or smaller than 2 mm and bony setting is supplied, CT is able to visualize all relevant structures within the temporal bone. However, in clinical settings the combined look on air, liquids and bone as well as the contrast enhancement of soft tissues might prefer magnetic resonance imaging to CT.     

Retrospective analysis of use of fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) for detection of metastatic lymph nodes in dogs diagnosed with appendicular osteosarcoma

The purpose of this retrospective analysis was to determine if fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) could potentially be an accurate staging tool for detecting metastatic lymph nodes in dogs with appendicular osteosarcoma based on the quantitative measurement of the maximum standard uptake value (SUV_max) of lymph nodes. A total of 53 dogs were identified that presented for staging via ¹⁸F-FDG PET/CT for primary appendicular osteosarcoma. Patients were categorized according to lymph node status of having either metastatic or non-metastatic nodes based on cytological or histological analysis. Maximum standard uptake (SUV_max) values of the sampled lymph node(s) were recorded and 3/77 (3.9%) of sampled lymph nodes were confirmed metastatic. A Mann-Whitney test revealed a statistical difference in the SUV_max of the metastatic versus non-metastatic lymph nodes [median: 6.6 to 95% confidence interval (CI): 2.56 to 14.37 versus 2.18 95% CI: 2.32 to 3.17, respectively, P-value = 0.05]. This retrospective analysis revealed a significant difference in the SUV_max as measured on ¹⁸F-FDG PET/CT between metastatic lymph nodes and non-metastatic lymph nodes in canine patients afflicted with appendicular osteosarcoma, in spite of the small numbers analyzed. While these results are promising, they should be interpreted with caution and further studies are justified.     

Contrast‐enhanced computed tomography may be helpful for characterizing and staging canine gastric tumors

In humans, computed tomography (CT) is a widely performed technique for the diagnosis and staging of gastric tumors. The purpose of this retrospective case series study was to describe CT findings in a group of dogs with confirmed gastric tumors. For each included dog, the following CT parameters were recorded: gastric tumor location, tumor shape, gastric involvement pattern, tumor enhancement pattern in early and late phases, presence and location of lymphadenopathy, gastric tumor attenuation values, attenuation values of enlarged lymph nodes, maximum short‐axis diameter (mm) of enlarged lymph node, maximum long‐axis diameter (mm) of enlarged lymph node, and short‐axis diameter to long‐axis diameter ratio (short axis/long axis). A total of 16 dogs met inclusion criteria and had the following final diagnoses: five lymphoma, six adenocarcinoma, three inflammatory polyps, and two leiomyoma. In the early‐ and delayed‐phase postcontrast images, the mean CT attenuation value for lymphoma was lower than that of other gastric tumors. Lymphadenopathy was widespread in lymphomas and regional in adenocarcinomas. Lymphadenopathy was not detected in leiomyomas. Lymph node measurements in lymphoma were larger than lymph node measurements in adenocarcinoma. Although there were overlapping findings for the different types of gastric tumors, contrast‐enhanced CT provided helpful information for characterizing gastric tumors based on the following criteria: early and late enhancement patterns, the site of origin of the mass lesion, and extent of local invasion and distant metastases. Lymphoma should be considered for canine gastric tumors with low mean attenuation values during early‐ and delayed‐phase postcontrast images, and widespread, bulky, and rounded lymphadenopathy.     

QUANTITATIVE METHODS FOR INDIRECT CT LYMPHOGRAPHY

In this investigation, we applied quantitative CT methods to characterize contrast enhanced lymph nodes opacified using iodinated contrast media for indirect CT lymphography. lodinated nanoparticles were injected into the buccal submucosa and SQ into the metatarsus and metacarpus of four normal swine (1.0–4.0 ml/site, 76 mg I/ml). Attenuation (HU), volume (cm³), iodine concentration (mg I/cm³), total iodine uptake (mg I), contrast-to-noise ratio (CNR), and percent injected dose (%ID) were estimated in opacified inguinal, cervical and parotid/mandibular lymph nodes using manual image segmentation techniques on 24 hour post-contrast CT images. Lymph node volumes estimated by multiple slice ROI analysis were compared with estimates obtained by post-excisional weight measurements. HU and iodine concentration increased 5–20 fold in opacified nodes (p < 0.01) and CNR increased more than four-fold (p < 0.001). %ID ranged between 3.5 and 11.9% and did not appear dose related. ROI estimated lymph node volumes approximated volumes calculated from weight measurements. (R²= 0.94, p < 0.0001). We conclude that interstitially injected iodinated nanoparticles increase attenuation and conspicuity of targeted nodes on CT images. Quantitative methods could play an important clinical role in more accurate metastasis detection.