B-mode ultrasonography and ARFI elastography of articular and peri-articular structures of the hip joint in non-dysplastic and dysplastic dogs as confirmed by radiographic examination.

BACKGROUND: Canine hip dysplasia is a common orthopedic disease in veterinary practice. The diagnosis is made by radiographic examinations that evaluate bone alterations associated with hip dysplasia. Although radiographic examination is the gold standard for diagnosis, it does not allow a detailed evaluation of soft tissues such as the joint capsule and periarticular muscles. This study aimed to evaluate the accuracy of B-mode ultrasonography and acoustic radiation force impulse (ARFI) elastography in assessing the joint capsule and periarticular muscles of dogs using the Orthopedic Foundation of Animals (OFA) classification and the distraction index (DI) in the early and late diagnosis of hip dysplasia. This study sought to propose a protocol for the ultrasonographic evaluation of the structures involved in canine hip dysplasia. METHODS: Radiographic and ultrasonographic evaluations were performed on 108 hip joints of 54 dogs. Thirty dogs were older than 2 years and 24 were aged between 4 and 10 months. RESULTS: It was verified that an increase in pectineus muscle stiffness (cutoff value > 2.77 m/s) by elastography in some dysplastic dogs and an increase in the thickness of the joint capsule (cutoff value > 0.9 mm) in B-mode ultrasonography, were associated with a distraction index > 0.5, with both having a positive correlation. In B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease, such as irregularities of the cranial edge of the acetabulum and femoral head, were associated with a distraction index > 0.5 in canines, with a specificity of 94%. In adult dogs, the findings of degenerative joint disease on ultrasound were associated with a diseased OFA classification (P < 0.05). Measurement of the joint capsule > 1.10 mm was diagnostic for dysplasia in unhealthy dogs by OFA. CONCLUSIONS: ARFI elastography has shown that the pectineus muscle may experience changes in stiffness in dysplastic animals. Additionally, changes in joint capsule thickness can be identified in B-mode in young and adult dogs with dysplastic joints, which contributes to the diagnosis of hip dysplasia.

Abdominal perfusion in canine patients with pyometra and sepsis evaluated by Doppler and contrast-enhanced ultrasound.

BACKGROUND: Sepsis is a condition characterized by organic dysfunction, leading to hemodynamic instability and high morbidity and mortality rates in humans and animals. Early identification of perfusion changes and appropriate management of sepsis are crucial for improving patient prognosis. Currently, the Systemic Inflammatory Response Syndrome (SIRS) and Sequential Organ Failure Assessment (SOFA) scores are widely studied for sepsis identification and evaluation of organ dysfunction. However, these scores do not assess gastrointestinal involvement, which is common in this condition. Contrast-enhanced ultrasound (CEUS) and Doppler have been considered promising diagnostic techniques for detecting changes in vascularization and microcirculation in a non-invasive and safe manner, particularly in the gastrointestinal system. This study aimed to evaluate duodenal perfusion using CEUS, as well as abdominal aortic and cranial mesenteric artery blood flow using Doppler ultrasound, and systolic arterial pressure (SAP) in 17 bitches with pyometra and in 10 healthy animals. RESULTS: The variables were compared between the pyometra and control groups, as well between patients with and without sepsis determined by the SOFA or SIRS scores. Pyometra was found to cause a reduction in abdominal aortic blood flow volume, aortic peak systolic velocity, and resistivity index as evaluated by Doppler ultrasound. Patients with sepsis according to the SOFA criteria only presented lower SAP. In contrast, sepsis animals identified by the SIRS score exhibited lower SAP, aortic peak systolic velocity, aortic blood flow volume, and aortic resistivity index and additionally, higher peak intensity of contrast in the duodenal wall. CONCLUSIONS: Pyometra causes a reduction in abdominal aortic blood flow, which is more pronounced in animals with sepsis identified by the SIRS criteria. These animals also exhibited a decrease in systolic blood pressure and an increase in duodenal perfusion, as evident by CEUS. However, these changes were not observed in patients with sepsis identified by the SOFA criteria. The alterations in intestinal perfusion observed in animals with sepsis indicate the presence of inflammation or dysfunction. In this regard, CEUS proves to be a valuable technique for detecting subtle changes in tissue hemodynamics that may not be apparent in conventional exams.

Applicability of ARFI elastography in detecting elasticity changes of the equine superficial digital flexor tendon with induced injury.

The objectives of this prospective, experimental study were to describe changes in the stiffness of the equine superficial digital flexor tendon (SDFT) after induced injury, deep digital flexor tendon (DDFT), accessory ligament (AL-DDFT), and suspensory ligament (SL) during 90 days of healing using acoustic radiation force impulse (ARFI) elastography. Eight healthy horses were selected. Preinjury B mode and ARFI evaluations were performed bilaterally in the palmar metacarpal region. Injury was induced only on the left forelimb (G2) by a single injection of collagenase in SDFT, 15 cm distal to the accessory carpal bone. The right forelimb was used as a control (G1). Evaluations were performed at eight timepoints: one before injury (T0) and seven (T1-T7) after injury (3, 15, 30, 40, 60, 75, and 90 days post-induction). Tendinopathies were visualized as hypoechoic areas with loss of parallel tendon fiber pattern. Injured SDFTs presented mainly cool colors (soft) from T1 to T3, and from T4, there was an increase in warm colors (hard), close to the appearance of tendons of G1. In the first four timepoints, there was a decrease in stiffness compared to G1 (P < 0.001). On T1 and T2, a cutoff value <6.21 m/s to determine tendinopathy of the SDFT was established (75.8% sensitivity and 92.03% specificity). Stiffness changes in the DDFT, AL-DDFT, and SL of injured limbs occurred at different timepoints. Tendinopathy significantly altered the stiffness of the injured tendon and the adjacent tissues. ARFI made it possible to detect these changes, helping to monitor the reparation of this injury.

Accuracy of B-mode ultrasound and ARFI elastography in predicting malignancy of canine splenic lesions.

The objective was to evaluate the accuracy of B-mode ultrasonography and ARFI elastography in detecting malignancy in canine splenic lesions. Thirty-seven spleens with abnormalities (16 benign and 21 malignant) from dogs of different breeds and ages were evaluated. Echogenicity, echotexture, organ length and height were evaluated using B-mode. By ARFI elastography, tissue stiffness was evaluated qualitatively (elastogram) and quantitatively (measuring the shear wave velocity-SWV). Lesions were classified as diffuse, focal or multifocal (cranial, medial or caudal portion) and comparisons of the SWV between the injured and non-injured areas were performed. In the B-mode, no features were associated to malignancy (P > 0.05). In the elastogram, 35 spleens were non-deformable and 2 deformable, having no association with malignancy. The greater SWV was observed in malignant lesions (3.4 ± 0.6 m/s), followed by areas free from alterations (2.1 ± 0.3 m/s) and benign lesions (1.7 ± 0.5 m/s), with difference between groups (P < 0.0001). It was found that a SWV > 2.6 m/s indicates malignancy of canine splenic lesions (sensitivity of 95%, specificity of 100%, PPV of 100%, NPV of 94% and accuracy of 97%), concluding that ARFI elastography is a promising technique for differentiating malignancy in these lesions.

Malignancy prediction of cutaneous and subcutaneous neoplasms in canines using B-mode ultrasonography, Doppler, and ARFI elastography.

BACKGROUND: Cutaneous and subcutaneous neoplasms are highly prevalent in dogs, ranging from benign to highly aggressive and metastatic lesions. The diagnosis is obtained through histopathology, however it is an invasive technique that may take a long time to obtain the result, delaying the beginning of the adequate treatment. Thus, there is a need for non-invasive tests that can help in the early diagnosis of this type of cancer. The aim of this study was to verify the accuracy of B-mode ultrasonography, Doppler, and ARFI elastography to predict malignancy in cutaneous and subcutaneous canine neoplasms. In addition, we aim to propose an ultrasonography evaluation protocol and perform the neoplasms characterization using these three proposed techniques. RESULTS: Twenty-one types of specific neoplasm were diagnosed, and using B-mode, we verified the association between heterogeneous echotexture, invasiveness, presence of hyperechoic spots, and cavity areas with malignancy. An increased pulsatility was verified in malignant neoplasms using Doppler (cut-off value > 0.93). When using the elastography, malignancy was associated with non-deformable tissues and shear wave velocity > 3.52 m/s. Evaluation protocols were proposed associating 4, 5, 6, or 7 malignancy predictive characteristics, and characterization was done for all tumors with at least two cases. CONCLUSIONS: We concluded that ultrasonography methods are promising and effective in predicting malignancy in these types of tumors, and the association of methods can increase the specificity of the results.

Ultrasonography of the nuchal translucency of healthy and abnormal English Bulldog fetuses.

The aim of this study was to measure the nuchal translucency (NT) of canine fetuses to establish reference values ​​for healthy gestational processes and to verify its effectiveness in the diagnosis of congenital abnormalities. On day 34 of gestation, the NT of three fetuses from each of the 26 English bulldog female dogs was measured. The first fetus was the one located immediately cranial to the bladder, the second was selected from the left side of the abdomen, and the third from the right side. The reference values for healthy animals were offset using descriptive statistics. The diagnostic ability of the test to identify fetal malformations was studied using receiver operating characteristic curve analysis. Of the 26 litters, only 18 had healthy fetuses, 4 had fetuses with anasarca, 3 had fetuses with abdominal wall defects, and 1 had both types of abnormalities. The NT was higher in canine fetuses that presented anasarca in the litter than in normal litters (1.8 ± 0.77 mm vs. 1.4 ± 0.48 mm; P = 0.0249), with a cut-off value of NT > 1.45 mm (sensitivity = 61.54%, specificity = 70.18%). NT greater than 1.45 mm seems to be a diagnostic tool for the identification of anasarca during gestation of bulldogs. Considering the unprecedented use of this parameter in canine species and the limitations found during the study, further studies will be needed in order to use it on clinical practice.