Utility of contrast-enhanced computed tomography in the evaluation of canine insulinoma location.

OBJECTIVES: To determine 1) the sensitivity of contrast-enhanced CT (CECT) for detection of primary canine insulinomas and metastases 2) the sensitivity of CECT to locate canine insulinomas within the pancreas and 3) the CECT attenuation pattern of canine insulinomas and post-contrast phase in which insulinomas have the best visibility. METHODS: A retrospective review was performed of the medical records of 27 canine insulinoma patients. Simultaneous occurrence of blood glucose < 3.5 mmol/L (reference interval: 4.2-5.8 mmol/L) and plasma insulin > 10 mIU/L (reference interval: 1.4-24.5 mIU/L) were considered diagnostic for insulinoma. The dogs had a mean age of 9.0 ± 1.7 (SD) years and comprised 11 males and 17 females. RESULTS: Using CECT-scans, 26/27 insulinomas were successfully detected. However, CECT-scans predicted the correct location of insulinomas within the pancreas in only 14/27 dogs. In 9/13 inaccurately located insulinoma cases, the location error was major. There was no significant difference between triple, double and single-phase CECT-scans with location accuracies of 54%, 50% and 50%, respectively. Also, there was no specific post-contrast phase in which insulinomas could be visualised best. Detection of lymph node metastases with CECT-scans had a sensitivity of 67% (10/15 lymph node metastases). Detection of liver metastases had a sensitivity of 75% (6/8 liver metastases). This study highlights that major location errors mainly occurred if single- or double-phase CECT-scans were used (6/9 cases). CONCLUSION: It is suggested that triple-phase CECT-scans have superior outcome over single- or double-phase CECT-scans in pre-operative imaging of canine insulinomas.

The role of sentinel lymph node mapping in small animal veterinary medicine: A comparison with current approaches in human medicine.

The relevance of regional lymph node (LN) assessment to quantify the metastatic spread of cancer is well recognized in veterinary oncology. Evaluation of LNs is critical for tumour staging. However, sampling the correct LN may not be possible without sentinel lymph node (SLN) mapping. Methods for diagnostic imaging and intraoperative detection of SLNs are well established in human medicine, in particular, the combination of lymphoscintigraphy and intraoperative application of blue dyes. Nevertheless, alternative imaging techniques are available and have gained increasing interest. Successful implementation of these techniques in dogs have been reported in both clinical and experimental studies. This review aims to provide an overview of SLN mapping techniques in human and veterinary medicine.

Diagnostic Imaging of the Hepatobiliary System: An Update.

Recent advances in diagnostic imaging of the hepatobiliary system include MRI, computed tomography (CT), contrast-enhanced ultrasound, and ultrasound elastography. With the advent of multislice CT scanners, sedated examinations in veterinary patients are feasible, increasing the utility of this imaging modality. CT and MRI provide additional information for dogs and cats with hepatobiliary diseases due to lack of superimposition of structures, operator dependence, and through intravenous contrast administration. Advanced ultrasound methods can offer complementary information to standard ultrasound imaging. These newer imaging modalities assist clinicians by aiding diagnosis, prognostication, and surgical planning.

The equine cervical spine: comparing MRI and contrast-enhanced CT images with anatomic slices in the sagittal, dorsal, and transverse plane.

BACKGROUND: The impact of cervical pathology on performance is of great importance to the horse industry. Accurate diagnosis of cervical disease with imaging modalities, including computed tomography (CT) and magnetic resonance imaging (MRI), requires thorough appreciation of normal cervical anatomy. OBJECTIVES: (1) To describe in detail the anatomy of the equine cervical spine by comparing anatomical sections with corresponding MR and contrast-enhanced CT images in the sagittal, dorsal, and transverse plane. (2) To discuss the ability of MR and contrast-enhanced CT imaging to visualize anatomical structures in the cervical spine. ANIMALS AND METHODS: Three cervical spines of young adults (3-8 years), collected immediately after humane euthanasia, were used. The spine was stabilized on a frame in a natural flexed position with an angle of 20°. MR and contrast-enhanced CT imaging was performed within six hours after euthanasia. Anatomical sections of 1 cm were made in the sagittal, dorsal, and transverse plane and compared with corresponding CT and MR images. The intervertebral disk thickness, facet joint angle, sagittal dural space diameter and ventromedial facet joint projection were quantified. RESULTS: The anatomic location of clinically important structures including the facet joints, spinal cord, cervical nerve roots and intervertebral disks were reliably identified in the anatomical sections and their corresponding MR images. Contrast-enhanced CT images depicted all osseous borders, whereas MR images were superior for soft tissue structures. CONCLUSION AND CLINICAL IMPORTANCE: This study enhances our understanding of normal cervical spine anatomy and the diagnostic usefulness of cervical MRI and contrast-enhanced CT in the horse.

The value of radiographic screening for metallic particles in the equine foot and size of related artifacts on low-field MRI.

Magnetic susceptibility artifacts as a result of metal debris from shoeing are a common problem in magnetic resonance imaging of the equine foot. Our purpose was to determine the suitability of radiography as a screening tool for the presence and location of metallic particles in the equine foot and to predict the size of the resultant magnetic susceptibility artifact. Radiography had 100% sensitivity for detection of metal particles > or = 1 mm diameter. Metal particles of known diameter were placed within the hoof wall of 22 cadaver feet and scanned with a low-field strength MR imaging unit (0.21 T). Magnetic resonance images were characterized by a signal void with a hyperintense rim and adjacent image distortion at the level of the known metal location. T2* weighted sequences were the most and fast spin echo (FSE) sequences the least affected. For all four sequences (T1 gradient echo [GRE]; T2*W GRE; T2 FSE; and short tau inversion recovery FSE), linear relationships were observed between particle and resultant artifact size. Magnetic susceptibility artifact size, location and superimposition on clinically relevant anatomic structures can be predicted radiographically for particles larger than 1 mm. If metal debris cannot be removed, the least artifact-prone FSE sequences should be selected.

Multidetector-row computed tomography: technical basics and preliminary clinical applications in small animals.

Multidetector-row computed tomography (MDCT), a recent breakthrough in computed tomography (CT) technology, is increasingly available in veterinary practice. The main advantage of MDCT over previous CT generations is the ability to acquire thin-section data from a scan volume within a short scan time. The relationship between speed and section thickness has been doubling roughly every 2 year in the past decade, resulting in markedly increased speed of scanning and superb image quality. Datasets obtained from MDCT scanners can be displayed as volume using computer workstations. Given the shorter scanning time and the higher image quality, there is vast potential for new applications of MDCT in small animal imaging. This article provides an overview of the technical basis of MDCT and discusses the current applications of its use in small animals, namely angiographic studies, abdominal, thoracic, and whole-body applications, and in vivo anatomy studies.

PET/CT today and tomorrow in veterinary cancer diagnosis and monitoring: fundamentals, early results and future perspectives.

Functional imaging using positron emission tomography (PET) plays an important role in the diagnosis, staging, image-guided treatment planning and monitoring of malignant diseases. PET imaging complements conventional anatomical imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). The strength of CT scanning lies in its high spatial resolution, allowing for anatomical characterization of disease. PET imaging, however, moves beyond anatomy and characterizes tissue based on functions such as metabolic rate. Combined PET/CT scanners were introduced commercially in 2001 and a number of technological advancements have since occurred. Radiolabelled tracers such as (18)F-fluorodeoxyglucose (FDG) and (18)F-fluorothymidine (FLT) allow visualization of various metabolic processes within cancer cells. Many studies in human oncology evaluating the utility of PET/CT have demonstrated clinical benefits. Few veterinary studies have been performed, but initial studies show promise for improved detection of malignancy, more thorough staging of canine cancer and determination of early response and disease recrudescence.

Localization of the mandibular canal in brachycephalic dogs using computed tomography.

For some surgical procedures in veterinary dentistry including exodontia, orthognathic surgery, orthopedic surgery, oncologic surgery, and for the placement of dental implants, it is important to know the accurate location of the neurovascular structures within the mandibular canal. The aim of this research was to determine the course of the mandibular canal in the mandible and its relationship with other anatomical structures in brachycephalic dogs using computerized tomography. Mandibles from 10 brachycephalic cadaver dogs were evaluated. Measurements were taken in relation to the lingual, vestibular alveolar crest, and ventral surfaces. These measurements indicated that the mandibular canal descends slightly from the mandibular foramen to the molar area, decreasing the distance of the mandibular canal from the mandibular ventral border. The mandibular canal is slightly closer to the lingual surface than the vestibular surface except in the molar tooth region. The mandibular canal continues in a rostral direction occupying the ventral region of the mandibular body, reaching its maximum distance from the alveolar crest at the level of the first molar and fourth premolar teeth. In the third and fourth premolar tooth region, the mandibular canal maintains a similar distance between the vestibular and lingual borders; then, at the level of the second premolar tooth, the distance of the mandibular canal from the lingual and ventral border increases before its termination at the mental foramen. The study reported here documents the feasibility of using CT to determine the location of the mandibular canal in relation to bony and dental parameters. Although the difference in mandible size of the group of brachycephalic dogs reported here resulted in broad ranges of measurements, it is clear that the MC course may vary between individual dogs.

Primary anastomosis of segmental external auditory canal atresia in a cat.

External auditory canal atresia (EACA) may arise as a congenital deformity, or as sequel to external auditory canal trauma. Diagnosis of EACA was made in this 3-year-old cat by video otoscopy and computed tomography. Successful treatment of congenital segmental EACA was achieved, using end-to-end anastomosis. Primary anastomosis should be considered for treatment of both acute and chronic separation of the annular and auricular cartilages, as well as congenital EACA in the cat.

Post-traumatic peripheral arteriovenous fistula manifesting as digital haemorrhages in a cat: diagnosis with contrast-enhanced 3D CT imaging.

Arteriovenous fistulae (AVF) are defined as congenital or acquired abnormal direct communications between an artery and a vein leading to abnormal blood circulation. This report describes an unusual manifestation of acquired peripheral AVF in a cat for which the diagnosis was confirmed by computed tomographic (CT) imaging and three-dimensional (3D) reconstruction. A 10-year-old female spayed domestic shorthaired cat was presented with a 2-month history of nonhealing, crusting, erosive and ulcerative skin lesions on the dorsal right forepaw. Severe chewing and biting, but not lameness, had been reported. Systemic abnormalities were not noted. Histopathology revealed increased numbers of thin-walled and slightly grouped vascular profiles in the superficial and mid-dermis, which were often markedly dilated and partially obscured by prominent hyaline deposits. There were a few pyknotic nuclear fragments and haemorrhages in vascular walls as well as multifocal luminal thrombosis with or without recanalization. Differential diagnoses included progressive angiomatosis with trauma or AVF with secondary regional venous hypertension. Computed tomographic images were acquired using a 16-slice Siemens Somotom Sensation CT scanner, and 3D images were created using the Voxar 3D software. Image reconstruction revealed tortuous aberrant vasculature on the medial aspect of the radius and around the carpus compared to normal vascularization on the contralateral limb. These changes were suggestive of the diagnosis of acquired peripheral AVF. The differential diagnosis for localized, nonhealing, haemorrhagic, crusted, erosive or ulcerative distal extremity skin lesions in cats should include acquired AVF, and diagnosis may be confirmed with contrast-enhanced CT imaging.

Validation of a technique to assess radial torsion in the presence of procurvatum and valgus deformity using computed tomography: a cadaveric study.

OBJECTIVE: To validate a technique to assess radial torsion with and without procurvatum and valgus deformity using computed tomography (CT). STUDY DESIGN: Anatomic study. ANIMALS: Radii (n=3) from normal dogs. METHODS: Three cadaveric radii were scanned using CT (3 mm slices). Transverse image sections were assessed at the distal and proximal physeal scar parallel to the joint surface in both sagittal and dorsal planes. Anatomic landmarks of the radius were identified and torsion was measured. A hinged Ilizarov circular external skeletal fixator was constructed to create known procurvatum, valgus, and torsional deformities. RESULTS: Between observers results were highly correlated for calculation of torsion (r=0.972, r(2)=0.9448, P<.00001). Mean baseline torsion of the radius in the construct was 4.88 degrees . At 20 degrees procurvatum and valgus, mean calculated torsion was 5.07 degrees (confidence interval [CI]=4.6-5.6 degrees ). At 20 degrees procurvatum and valgus with 22.5 degrees -induced torsion, mean measured torsion was 25.4 degrees (expected=27.38 degrees ; CI=22.7-28.1 degrees ). At 40 degrees procurvatum and valgus and 45 degrees -induced torsion, mean measured torsion was 51.1 degrees (expected=49.88 degrees ; CI=-49.2 to 53.0 degrees ). CONCLUSION: Assessment of radial torsion by CT is reproducible and accurate in the presence of procurvatum and valgus antebrachial angular limb deformities in the dog. CLINICAL RELEVANCE: Despite complex presurgical planning, current measurements only allow for measurement of valgus and procurvatum deformities in the sagittal and dorsal planes, this method allows for more precise measurements of radial torsion in the transverse plane.

Use of computer tomography for imaging of Crassicauda grampicola in a Risso's dolphin (Grampus griseus).

A mature male Risso's dolphin (Grampus griseus) stranded along the coasts of Friuli Venezia Giulia, northeast Italy, in May 2001. Parasitic infection with Crassicauda grampicola is often found in the tympanic bullae and pterygoid sinuses in many of the Risso's dolphins examined from the same area. For this reason, it was decided to perform computed tomography of the head to assess this imaging technique for the diagnosis of crassicaudosis in dolphins. A full postmortem examination confirmed the pathologic findings of the computed tomography scan. This technique can be considered a useful adjunct in the diagnosis of cranial crassicaudosis in live dolphins.

Morphometry of the thoracic spine in German shepherd dog: a computed tomographic study.

Computed tomographic images of the thoracic spine of 13 German shepherd dogs were examined in order to determine the thoracic spine morphometry. Examinations were carried out in the transverse plane both intervertebral and mid-vertebral levels of the each thoracic vertebrae. The dorsoventral and interpedicular diameters of the spinal canal, the dorsoventral and transverse diameters of the vertebral body, the dorsoventral and transverse diameters of the spinal cord and also the cross-section area of the spinal canal were measured. The maximum values were found to be at the level of C7-T1. The shapes of the spinal canal and cord were circular in middle part, the shape became transverse oval in the cranial and caudal parts of the thoracic spine. The most significant correlation between the diameters was found to be in male dogs, except between dorsoventral diameters of the spinal canal and that of the vertebral body and between dorsoventral diameters of the spinal canal and transverse diameters of the vertebral body.

Primary T-cell lymphoma of the central nervous system in a dog.

Primary T-cell lymphoma is a rare form of CNS neoplasia. Diagnosis may be aided by use of cytologic examination of CSF. Primary CNS T-cell lymphoma should be considered in a patient with multiple cranial nerve abnormalities, even if results of imaging studies are considered normal.

Intraosseous approach to the nasolacrimal duct for removal of a foreign body in a dog.

A Labrador retriever was evaluated because of chronic mucopurulent discharge from the left eye. A foreign body was identified in the nasolacrimal duct by use of dacryocystorhinography. Attempts to alleviate the inflammation by use of flushing and administration of antimicrobials were unsuccessful. At surgery, the infraorbital foramen was used as a landmark for a skin incision, because the nasolacrimal duct courses dorsal and parallel to the infraorbital canal. An air drill was used to remove the portion of the maxillary bone overlying the nasolacrimal duct, which exposed the intraosseous portion of the duct and allowed removal of a plant-material foreign body. The incision in the duct was allowed to heal by second intention, and the dog recovered without complications.