THE EFFECT OF POSITIONING ON THE RADIOGRAPHIC APPEARANCE OF CAUDODORSAL MEDIASTINAL MASSES IN THE DOG

In this prospective study, the effect of thoracic positioning on the visibility and size of caudal esophageal masses caused by spirocercosis was investigated. Dorsoventral (DV), ventrodorsal (VD) as well as left lateral recumbent (LLR) and right lateral recumbent (RLR) thoracic radiographs of 28 dogs, diagnosed endoscopically with spirocercosis, were evaluated. The radiographic findings were compared with those of esophageal endoscopy. Masses were seen equally well in left vs. right recumbency as well as in DV vs. VD positions but in DV/VD views 86% of masses were detected whereas in lateral views only 50% of masses were identified. In spirocercosis-endemic areas DV and RLR views are advised as they also allow for better visualization of descending aorta aneurysms and to avoid interpreting the potentially normally visible esophagus in LLR in large dogs as a mass.     

THORACIC RADIOGRAPHIC APPEARANCE IN THE NORMAL LLAMA

The goal of this study was to collect quantitative and qualitative radiographic information of the normal adult llama thorax. Standing right-left lateral radiographs of the thorax of 16 normal llamas were made. Normal ratios of cardiac height, width, and height plus width to thoracic vertebrae 3-5 and thoracic height were calculated. Normal values determined for tracheal angle of divergence from the thoracic spine, cardiophrenic and cardiosternal contact are additional potential indicators of cardiac enlargement. Ratios of normal pulmonary artery and vein, caudal vena cava and trachea to the height of the fourth thoracic vertebra should allow identification of pathology of these structures. Observations regarding pulmonary vessels and airways, thoracic spine, sternebrae and portions of the gastrointestinal tract observed on thoracic radiographs are also included. It is proposed that these normal values and observations can be used to better evaluate diseases of the cardiovascular and respiratory systems of adult llamas.     

THE EFFECT OF DORSAL VERSUS VENTRAL RECUMBENCY ON THE RADIOGRAPHIC APPEARANCE OF THE CANINE THORAX

The thorax of nine dogs was radiographed with a vertical beam in both dorsal (VD) and ventral (DV) recumbency. The radiographs were evaluated subjectively and objectively for differences in appearance. To help explain appearance differences, lateral thoracic radiographs were made with the dogs in dorsal and ventral recumbency using a horizontally (laterally) directed x-ray beam. The appearance of thoracic viscera in VD and DV vertical beam radiographs differed. In VD vertical beam radiographs the craniocaudal axis of the heart appeared longer, the heart had a more consistent positional relationship to the thoracic spine, a larger area of the accessory lung lobe was visible, and a greater length of the caudal vena cava was visible. In DV radiographs the caudal lobar pulmonary arteries were more easily identified. The selection of dorsal versus ventral recumbency for thoracic radiography should be based on the clinical status of the patient and the reason(s) for which the radiograph is being made.     

THE EFFECT OF XYLAZINE HYDROCHLORIDE ON THE RADIOGRAPHIC APPEARANCE OF THE STOMACH AND INTESTINE IN THE DOG

Twelve dogs of various breeds, age and weight were injected with xylazine hydrochloride by intravenous and intramuscular routes at various doses. Radiographs of the abdomen were made prior to and at 30, 60 and 90 minutes after injection. The drug produced dilatation of the stomach and the intestines. Radiographic changes were consistent with gastric dilatation and paralytic ileus     

SONOGRAPHIC EVALUATION OF THE CRANIAL MEDIASTINUM IN SMALL ANIMALS

Clinical records, radiographs, and sonograms of 17 animals presented for possible cranial mediastinal disease were reviewed. Radiographs were evaluated for accuracy in detection of mediastinal masses. Sonography of the mediastinum was performed using a parasternal approach with the animals in sternal or lateral recumbency. The mediastinum was evaluated for the presence of a mass or other disease. Masses were characterized by echogenicity, size, number, and margination. Mediastinal vessels were studied to determine if there was vascular invasion or compression. A comparison of radiographic and sonographic assessment in cranial mediastinal disease indicates sonography adds valuable information in the diagnosis of mediastinal disease. Results of ultrasound-guided, fine-needle aspirate were documented and found to be advantageous in establishing a diagnosis in mediastinal masses.     

ANATOMIC ATLAS FOR COMPUTED TOMOGRAPHY IN THE MESATICEPHALIC DOG: THORAX AND CRANIAL ABDOMEN

The purpose of this study was to produce a comprehensive anatomic atlas of CT anatomy of the dog for use by veterinary radiologists, clinicians, and surgeons. Whole-body CT images of two mature beagle dogs were made with the dogs supported in sternal recumbency and using a slice thickness of 13 mm. At the end of the CT session, each dog was euthanized, and while carefully maintaining the same position, the body was placed in a walk-in freezer until completely frozen. The body was then sectioned at 13-mm intervals, with the cuts matched as closely as possible to the CT slices. The frozen sections were cleaned, photographed, and radiographed using xeroradiography. Each CT image was studied and compared with its corresponding xeroradiograph and anatomic section to assist in the accurate identification of specific structures. Clinically relevant anatomic structures were identified and labeled in the three corresponding photographs (CT image, xeroradiograph, and anatomic section). In a previous paper, the head and neck of the mesaticephalic (beagle) dog was presented. In this paper, the thorax and cranial part of the abdomen of the dog are presented.     

USE OF A NOVEL BOARD GAME IN A CLINICAL ROTATION FOR LEARNING THORACIC DIFFERENTIAL DIAGNOSES IN VETERINARY MEDICAL IMAGING

When confronted with various findings on thoracic radiographs, fourth‐year veterinary students often have difficulty generating appropriate lists of differential diagnoses. The purpose of this one‐group, pretest, posttest experimental study was to determine if a game could be used as an adjunct teaching method to improve students’ understanding of connections between imaging findings and differential diagnoses. A novel board game focusing on differential diagnoses in thoracic radiography was developed. One hundred fourth‐year veterinary students took a brief pretest, played the board game, and took a brief posttest as a part of their respective clinical radiology rotations. Pretest results were compared to posttest results using a paired t‐test to determine if playing the game impacted student understanding. Students’ mean scores on the posttest were significantly higher than mean pretest scores (P < 0.0001). Thus, results indicate that playing the board game resulted in improved short‐term understanding of thoracic differential diagnoses by fourth‐year students, and use of the board game on a clinical rotation seems to be a beneficial part of the learning process.     

SONOGRAPHIC APPEARANCE OF RENAL NEOPLASIA IN THE DOG

Eight dogs with renal neoplasia were radiographically and sonographically examined. An enlarged, nonopacified kidney was seen on the excretory urogram in four dogs, but differentiation between a solid mass or severe hydronephrosis was not possible. The excretory urogram suggested an avascular lesion in one kidney, but differentiation between solid or cystic disease was not possible. Renal neoplasia was diagnosed in two dogs by excretory urography. Radiographic examination suggested splenic neoplasia in one dog. Solid masses were sonographically diagnosed in all dogs. A metastatic lesion was sonographically diagnosed in the opposite kidney of one dog that was missed on the radiographic examination. Ultrasonography com-plemented radiography as a diagnostic modality in eliciting additional information on renal disease. Sonograms did not allow determination of tumor cell type or whether the tumor was benign or malignant.     

EFFECT OF PERINEURAL ANESTHESIA ON THE ULTRASONOGRAPHIC APPEARANCE OF EQUINE PALMAR METACARPAL STRUCTURES

The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% mepivacaine hydrochloride solution. Ultrasonographic examinations similar to the initial examination then were performed immediately, 1 h and 24 h postinjection. Cross-sectional area and mean pixel value were determined for the superficial and deep digital flexor tendons, the accessory ligament of the deep digital flexor tendon, the suspensory ligament, and the suspensory branches at each level and time period. Subjective ultrasonographic changes also were noted. No significant difference was noted in the cross-sectional area or mean pixel value of any structure at any level or time period compared to baseline. Subjective changes in the tendons and ligaments were not noted. There was mild hypoechoic swelling of the surrounding soft tissues and gas in the region of the injections. Gas could interfere with the evaluation of the origin of the suspensory ligament and the proximal portion of the accessory ligament of the deep digital flexor tendon within the first hour but was not detectable ultrasonographically at 24 h. Based on these findings, if gas interferes with an ultrasonographic examination performed temporally close to perineural anesthesia, a repeat examination at 24 h is recommended.     

ULTRASONOGRAPHIC APPEARANCE OF CHRONIC HYPERTROPHIC PYLORIC GASTROPATHY IN THE DOG

Chronic hypertrophic pyloric gastropathy was diagnosed using ultrasound in six dogs that were presented for chronic vomiting. An evenly thick hypoechoic layer surrounding the pyloric lumen was visualized ultrasonographically in dogs with grades 1 or 2 chronic hypertrophic pyloric gastropathy. This was histologically found to correspond with a thickened muscular layer. Gastric wall thickness was greater than or equal to 9 mm in all six dogs. In dogs with grade 1 or 2 chronic hypertrophic pyloric gastropathy, the hypoechoic muscular layer was greater than or equal to 4 mm.     

THE EFFECT OF OBLIQUITY ON THE RADIOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN DOGS

The temporomandibular joint is formed between the condyloid process of the mandible and the mandibular fossa of the temporal bone. The basic anatomy of this joint was assessed and described in a series of skulls including dolichocephalic, mesaticephalic and brachycephalic breeds. The facial index and rotational angles were measured with the facial index providing a useful method of classifying skull types but the rotational angle being of limited use in assessment of the temporomandibular joint until normal breed values are established. Equipment was designed to allow repeatable positioning of the temporomandibular joint for radiography at a variety of lateral and long axis rotational angles relative to the central x-ray beam. The regions of the joint and anatomic features visualized in each view are demonstrated. 10 degrees rotation was required in either axis to project the joints independently of each other. Lateral rotational angles of 10 to 30 degrees in mesaticephalic and dolichocephalic breeds and 20 to 30 degrees in brachycephalics and long axis rotational views of 10 to 30 degrees depending on the region of interest were considered to be the most useful.     

COMPARISON OF TWO- VS. THREE-VIEW THORACIC RADIOGRAPHIC STUDIES ON CONSPICUITY OF STRUCTURED INTERSTITIAL PATTERNS IN DOGS

Three-view thoracic radiography is often used to evaluate patients for pulmonary metastatic disease. Although use of three views has been reported to be more sensitive than two views for focal lung disease, it also requires increased time, effort, and radiographic exposure of patients and personnel. This study was performed to evaluate the conspicuity of lesions on two-view vs. three-view radiographic procedures to determine the proportion of diagnoses that would change. One hundred three-view radiographic studies of the canine thorax were randomized, and four protocols were reviewed for each study: right lateral and ventrodorsal views, left lateral and ventrodorsal views, both lateral views, and all three views. Radiographs were interpreted as either positive or negative for structured interstitial pulmonary disease, and the certainty of the reading was recorded using a visual analog scale. There was 85-88% agreement between each two-view group and the three-view group, with the kapp statistic ranging from 0.698 to 0.758. There were no differences in certainty of diagnosis among the groups, though within each group there was more certainty for positive diagnoses than negative diagnoses. These findings indicate that three-view studies should be continued when evaluating for possible structured interstitial pulmonary disease, including metastatic disease, as eliminating one view from a three-view study would change the diagnosis in 12-15% of patients.     

RADIOGRAPHIC ASPECTS OF Pneumocystis carinii PNEUMONIA IN THE MINIATURE DACHSHUND

The thoracic radiographic changes of Pneumocystis carinii in 7 miniature Dachshunds were reviewed. The dogs were 7–12 months old and presented with polypnea, exercise intolerance and clinical signs suggestive of immune-incompetence. P. carinii pneumonia was diagnosed in all the dogs using transtracheal aspirate cytology and confirmed at postmortem in 3 dogs that died. Radiographically, diffuse pulmonary changes were present and varied from a mild interstitial and bronchial pattern to an alveolar pattern. Radiographic evidence of cor pulmonale was present in 1 dog. The most severe radiographic changes were seen in 2 of the dogs that died.     

PARTIAL AVULSION OF THE ORIGIN OF THE CRANIAL CRUCIATE LIGAMENT IN A 4 YEAR-OLD DOG

A four year-old intact male Dalmatian was referred to the veterinary teaching hospital at Louisiana State University for acute, non-weight-bearing left hindlimb lameness of three weeks duration. Information supplied by the referring veterinarian indicated the lameness was first diagnosed and treated seven months previously, but recurred three weeks ago. External rotation of the left stifle, mild discomfort upon stifle flexion, mild to moderate muscle atrophy and palpable joint effusion were noted during physical examination. Slight cranial drawer movement with a soft end-point was discovered during manipulation of the left stifle. A triangular bone fragment and thickened, confluent intracapsular soft tissues were observed on radiographs of the stifle. Radiographically, moderate degenerative changes suggested chronicity. This report describes the clinical and radiographic findings of a rarely reported partial avulsion of the origin of the cranial cruciate ligament in a skeletally mature dog.     

COMPARISON OF THORACIC ULTRASONOGRAPHY AND RADIOGRAPHY FOR THE DETECTION OF INDUCED SMALL VOLUME PNEUMOTHORAX IN THE HORSE

Small volume pneumothorax can be challenging to diagnose in horses. The current standard method for diagnosis is standing thoracic radiography. We hypothesized that thoracic ultrasonography would be more sensitive. Objectives of this prospective, experimental study were to describe a thoracic ultrasound method for detection of small volume pneumothorax in horses and to compare results of radiography and ultrasound in a sample of horses with induced small volume pneumothorax. Six mature healthy horses were recruited for this study. For each horse, five 50 ml air boluses were sequentially introduced via a teat cannula into the pleural space. Lateral thoracic radiographs and standardized ultrasound (2D and M‐mode) examinations of both hemithoraces were performed following administration of each 50 ml air bolus. Radiographs and ultrasound images/videos were analyzed for detection of pneumothorax by four independent investigators who were unaware of treatment status. Sensitivity, specificity, positive predictive values, negative predictive values, and agreement among investigators (Kappa test, κ) were calculated for radiography, 2D and M‐mode ultrasound. Comparisons were made using a chi‐squared exact test with significance set at P < 0.05. Two‐dimensional (84%) and M‐mode (80%) ultrasound were more sensitive than radiography (48%) for pneumothorax detection (P = 0.02 and P = 0.04, respectively). Specificity and positive predictive values were similar for all three imaging modalities (P = 1). Agreement between investigators for pneumothorax detection was excellent for 2D ultrasound (κ = 1), very good for M‐mode ultrasound (κ = 0.87), and good for radiography (κ = 0.79). Findings from this experimental study supported the use of thoracic ultrasonography as a diagnostic method for detecting pneumothorax in horses.     

ULTRASOUND APPEARANCE OF NORMAL LUNG BORDERS AND ADJACENT VISCERA IN THE HORSE*

B-mode ultrasound was utilized to define the borders of the lungs and surrounding viscera in a normal horse. Characteristic reverberation artifacts produced by the air-filled lung allowed accurate definition of the lung borders. The liver on the right and the spleen on the left were the predominant parenchymal organs identified. These two organs were seen adjacent to the lung and medial to the diaphragm. Recognition of the liver and spleen is important in evaluating equine pleural effusion.     

THE EFFECT OF ANESTHESIA ON THE RADIOGRAPHIC APPEARANCE OF THE COXOFEMORAL JOINTS

The effect of anesthesia on the radiographic appearance of the coxofemoral joints was evaluated by taking pelvic radiographs of thirty dogs. Each dog was radiographed twice, once under general anesthesia and once without anesthesia. The radiographs were submitted to the Orthopedic Foundation for Animals independently of one another to be evaluated for signs of hip dysplasia. Results suggest there was no statistical difference between the two groups of dogs. Twenty five dogs received the same reading. Three dogs received readings that were worse by one grade while under anesthesia and two dogs received readings that were one grade better while under anesthesia. This study failed to demonstrate any changes due to anesthesia on the radiographic appearance of the coxofemoral joints. Anesthesia may, however, be beneficial for proper positioning and to decrease unnecessary patient, and personnel exposure to radiation.     

EFFECT OF ANESTHESIA,POSITIONING, TIME,AND FEEDING ON THE PROVENTRICULUS: KEEL RATIO OF CLINICALLY HEALTHY PARROTS

Healthy, adult Hispaniolan Amazon parrots (Amazona ventralis) were imaged on three occasions to determine the effects of anesthesia, patient rotation, feeding, and short/long‐term temporal factors on the proventriculus:keel ratio. Increasing rotation up to 15° from right lateral resulted in increased inability to measure the proventriculus in up to 44% of birds, meaning that the proventriculus:keel ratio could not be calculated from those radiographs. There was a significant difference between the proventriculus:keel ratio for individual parrots when quantified 3 weeks apart. Despite this difference, all ratios remained within normal limits. No significant effect was identified due to anesthesia, feeding, fasting, or repeated imaging through an 8‐h period. Interobserver agreement for measurability and correlation for the proventriculus:keel ratio values was high. It is recommended that the proventriculus:keel ratio be calculated from anesthetized parrots to attain images in true lateral recumbency. Ratio fluctuations within the normal range between radiographs obtained on different dates may be observed in normal parrots.