RESUMEN
We describe the use of ultrasonography-guided percutaneous splenic injection of agitated saline and heparinized blood for the diagnosis of portosystemic shunts (PSS) in 34 dogs. Agitated saline mixed with 1 ml of heparinized autologous blood was injected into the spleen of 34 sedated dogs under sonographic guidance. The transducer was then sequentially repositioned to visualize the portal vein, the caudal vena cava, and the right atrium through different acoustic windows. It was possible to differentiate between intrahepatic and extrahepatic shunts depending on the entry point of the microbubbles into the caudal vena cava. Portoazygos shunts and portocaval shunts could be differentiated based on the presence of microbubbles in the caudal vena cava and/or the right atrium. In one dog, collateral circulation due to portal hypertension was identified. In dogs with a single extrahepatic shunt, the microbubbles helped identify the shunting vessel. The technique was also used postoperatively to assess the efficacy of shunt closure. All abnormal vessels were confirmed by exploratory laparotomy or with ultrasonographic identification of the shunting vessel. Ultrasound-guided transsplenic injection of agitated saline with heparinized blood should be considered as a valuable technique for the diagnosis of PSS; it is easy to perform, safe, and the results are easily reproducible.
Asunto(s)
Enfermedades de los Perros/diagnóstico por imagen , Sistema Porta/diagnóstico por imagen , Animales , Medios de Contraste , Enfermedades de los Perros/congénito , Perros , Atrios Cardíacos/diagnóstico por imagen , Heparina , Microburbujas/veterinaria , Sistema Porta/anomalías , Cloruro de Sodio , Ultrasonografía/métodos , Ultrasonografía/veterinaria , Venas Cavas/diagnóstico por imagenRESUMEN
Portosystemic shunts (PSSs) allow portal blood to bypass the liver and enter the systemic circulation. Definitive diagnosis requires surgical identification, positive contrast portography, ultrasonography, or scintigraphy. This study was designed as a preliminary step to developing an alternative/adjuvant protocol to these imaging modalities. The main goals were to establish a technique for ultrasound-guided percutaneous trans-splenic injection of agitated saline, to evaluate the feasibility of performing the test to explore the postsplenic portal vasculature highlighted by the microbubbles, and to ascertain whether agitated saline microbubbles cross the sinusoidal barrier. Agitated saline was injected into the spleen of 20 healthy sedated dogs under sonographic guidance. The transducer was then repositioned to visualize the portal vein, the caudal vena cava, and the right atrium through different acoustic windows. Satisfactory results were achieved in all dogs. The microbubbles were visualized in all dogs as small intense echo signals within the portal vein at the level of the porta hepatis immediately after injection. In 18 out of 20 dogs, the echogenic signal of the microbubbles disappeared immediately once within the hepatic parenchyma, whereas in two dogs, the echoes from the microbubbles lasted for several seconds within the intrahepatic portal vasculature. The absence of microbubbles beyond the sinusoidal barrier in all of the healthy dogs included in this study makes trans-splenic injection of agitated saline a candidate as an adjuvant technique for the diagnosis of PSS, being easy to perform and repeat, as well as safe and technically feasible.
Asunto(s)
Sistema Porta/diagnóstico por imagen , Vena Porta/diagnóstico por imagen , Derivación Portosistémica Quirúrgica/veterinaria , Bazo/diagnóstico por imagen , Animales , Perros , Derivación Portosistémica Quirúrgica/métodos , Cintigrafía , Cloruro de Sodio/administración & dosificación , Vena Esplénica/diagnóstico por imagen , UltrasonografíaRESUMEN
We assessed the ability of the resistive index (RI) and pulsatility index (PI) to allow differentiation between normal, reactive, and neoplastic lymph nodes. Forty-seven medial iliac and 54 mesenteric lymph nodes from 83 dogs were evaluated sonographically. A cytologic sample was obtained in each dog that allowed categorization into one of the categories defined above. We found a significant difference in the RI and PI in nonneoplastic vs. neoplastic medial iliac and mesenteric lymph nodes. Values higher than 0.67 for the RI and 1.02 for the PI in medial iliac lymph nodes and higher than 0.76 for the RI and 1.23 for the PI in mesenteric lymph nodes had a high sensitivity and specificity for differentiating benign from neoplastic lymph nodes.
Asunto(s)
Enfermedades de los Perros/diagnóstico por imagen , Ganglios Linfáticos/diagnóstico por imagen , Ultrasonografía Doppler de Pulso/veterinaria , Abdomen , Animales , Enfermedades de los Perros/fisiopatología , Perros , Femenino , Ganglios Linfáticos/fisiología , Ganglios Linfáticos/fisiopatología , Metástasis Linfática/diagnóstico por imagen , MasculinoRESUMEN
Se midió la resistencia hasta la falla de 5 métodos para reparación meniscal. Sesenta meniscos mediales de origen bovino se dividieron en 5 grupos. Se hizo una lesión artificial a 3 mm desde el borde periférico. Las técnicas evaluadas fueron: sutura horizontal con adición de cianoacrilatos (grupo 1), dardos meniscales con cianoacrilato (grupo 2), sutura con técnica horizontal (grupo 3), dardos meniscales (grupo 4), y cianoacrilatos unicamente (grupo 5). Una prueba de tensión hasta la falla se hizo, usando el analizador universal Instron 1122. El promedio de la carga de falla en el grupo 1 fue 110N, en el grupo 2: 89,8N, en el grupo 3: 97N, en el grupo 4: 82.7N y en el último grupo 48.5N. No se encontró diferencia estadisticamente significativa en la carga de falla entre los grupos 2 y 3. La falla para los dardos con cianoacrilato en meniscos bovinos es comparable con la sutura horizontal.