Detection properties of indium-111 and IRDye800CW for intraoperative molecular imaging use across tissue phantom models.

Significance: Intraoperative molecular imaging (IMI) enables the detection and visualization of cancer tissue using targeted radioactive or fluorescent tracers. While IMI research has rapidly expanded, including the recent Food and Drug Administration approval of a targeted fluorophore, the limits of detection have not been well-defined. Aim: The ability of widely available handheld intraoperative tools (Neoprobe and SPY-PHI) to measure gamma decay and fluorescence intensity from IMI tracers was assessed while varying characteristics of both the signal source and the intervening tissue or gelatin phantoms. Approach: Gamma decay signal and fluorescence from tracer-bearing tumors (TBTs) and modifiable tumor-like inclusions (TLIs) were measured through increasing thicknesses of porcine tissue and gelatin in custom 3D-printed molds. TBTs buried beneath porcine tissue were used to simulate IMI-guided tumor resection. Results: Gamma decay from TBTs and TLIs was detected through significantly thicker tissue and gelatin than fluorescence, with at least 5% of the maximum signal observed through up to 5 and 0.5 cm, respectively, depending on the overlying tissue type or gelatin. Conclusions: We developed novel systems that can be fine-tuned to simulate variable tumor characteristics and tissue environments. These were used to evaluate the detection of fluorescent and gamma signals from IMI tracers and simulate IMI surgery.

Fluorescence and photoacoustic (FL/PA) dual-modal probe: Responsive to reactive oxygen species (ROS) for atherosclerotic plaque imaging.

Accurate and early detection of atherosclerosis (AS) is imperative for their effective treatment. However, fluorescence probes for efficient diagnosis of AS often encounter insufficient deep tissue penetration, which hinders the reliable assessment of plaque vulnerability. In this work, a reactive oxygen species (ROS) activated near-infrared (NIR) fluorescence and photoacoustic (FL/PA) dual model probe TPA-QO-B is developed by conjugating two chromophores (TPA-QI and O-OH) and ROS-specific group phenylboronic acid ester. The incorporation of ROS-specific group not only induces blue shift in absorbance, but also inhibits the ICT process of TPA-QO-OH, resulting an ignorable initial FL/PA signal. ROS triggers the convertion of TPA-QO-B to TPA-QO-OH, resulting in the concurrent amplification of FL/PA signal. The exceptional selectivity of TPA-QO-B towards ROS makes it effectively distinguish AS mice from the healthy. The NIR emission can achieve a tissue penetration imaging depth of 0.3 cm. Moreover, its PA775 signal possesses the capability to penetrate tissues up to a thickness of 0.8 cm, ensuring deep in vivo imaging of AS model mice in early stage. The ROS-triggered FL/PA dual signal amplification strategy improves the accuracy and addresses the deep tissue penetration problem simultaneously, providing a promising tool for in vivo tracking biomarkers in life science and preclinical applications.

A self-powered theranostic DNA nanodevice for amplification of both intracellular microRNA imaging and photodynamic therapy.

While numerous methods exist for diagnosing tumors through the detection of miRNA within tumor cells, few can simultaneously achieve both tumor diagnosis and treatment. In this study, a novel graphene oxide (GO)-based DNA nanodevice (DND), initiated by miRNA, was developed for fluorescence signal amplification imaging and photodynamic therapy in tumor cells. After entering the cells, tumor-associated miRNA drives DND to Catalyzed hairpin self-assembly (CHA). The CHA reaction generated a multitude of DNA Y-type structures, resulting in a substantial amplification of Ce6 fluorescence release and the generation of numerous singlet oxygen (1O2) species induced by laser irradiation, consequently inducing cell apoptosis. In solution, DND exhibited high selectivity and sensitivity to miRNA-21, with a detection limit of 11.47 pM. Furthermore, DND discriminated between normal and tumor cells via fluorescence imaging and specifically generated O21 species in tumor cells upon laser irradiation, resulting in tumor cells apoptosis. The DND offer a new approach for the early diagnosis and timely treatment of malignant tumors.

Deep learning-enabled fluorescence imaging for surgical guidance: in silico training for oral cancer depth quantification.

Significance: Oral cancer surgery requires accurate margin delineation to balance complete resection with post-operative functionality. Current in vivo fluorescence imaging systems provide two-dimensional margin assessment yet fail to quantify tumor depth prior to resection. Harnessing structured light in combination with deep learning (DL) may provide near real-time three-dimensional margin detection. Aim: A DL-enabled fluorescence spatial frequency domain imaging (SFDI) system trained with in silico tumor models was developed to quantify the depth of oral tumors. Approach: A convolutional neural network was designed to produce tumor depth and concentration maps from SFDI images. Three in silico representations of oral cancer lesions were developed to train the DL architecture: cylinders, spherical harmonics, and composite spherical harmonics (CSHs). Each model was validated with in silico SFDI images of patient-derived tongue tumors, and the CSH model was further validated with optical phantoms. Results: The performance of the CSH model was superior when presented with patient-derived tumors ( P -value < 0.05 ). The CSH model could predict depth and concentration within 0.4 mm and 0.4 µ g / mL , respectively, for in silico tumors with depths less than 10 mm. Conclusions: A DL-enabled SFDI system trained with in silico CSH demonstrates promise in defining the deep margins of oral tumors.

Comparing spatial distributions of ALA-PpIX and indocyanine green in a whole pig brain glioma model using 3D fluorescence cryotomography.

Significance: ALA-PpIX and second-window indocyanine green (ICG) have been studied widely for guiding the resection of high-grade gliomas. These agents have different mechanisms of action and uptake characteristics, which can affect their performance as surgical guidance agents. Elucidating these differences in animal models that approach the size and anatomy of the human brain would help guide the use of these agents. Herein, we report on the use of a new pig glioma model and fluorescence cryotomography to evaluate the 3D distributions of both agents throughout the whole brain. Aim: We aim to assess and compare the 3D spatial distributions of ALA-PpIX and second-window ICG in a glioma-bearing pig brain using fluorescence cryotomography. Approach: A glioma was induced in the brain of a transgenic Oncopig via adeno-associated virus delivery of Cre-recombinase plasmids. After tumor induction, the pro-drug 5-ALA and ICG were administered to the animal 3 and 24 h prior to brain harvest, respectively. The harvested brain was imaged using fluorescence cryotomography. The fluorescence distributions of both agents were evaluated in 3D in the whole brain using various spatial distribution and contrast performance metrics. Results: Significant differences in the spatial distributions of both agents were observed. Indocyanine green accumulated within the tumor core, whereas ALA-PpIX appeared more toward the tumor periphery. Both ALA-PpIX and second-window ICG provided elevated tumor-to-background contrast (13 and 23, respectively). Conclusions: This study is the first to demonstrate the use of a new glioma model and large-specimen fluorescence cryotomography to evaluate and compare imaging agent distribution at high resolution in 3D.

In Vivo Imaging of Rodent Retina in Retinal Disease.

High-quality imaging of the retina is crucial to the diagnosis and monitoring of disease, as well as for evaluating the success of therapeutics in human patients and in preclinical animal models. Here, we describe the basic principles and methods for in vivo retinal imaging in rodents, including fundus imaging, fluorescein angiography, optical coherence tomography, fundus autofluorescence, and infrared imaging. After providing a concise overview of each method and detailing the retinal diseases and conditions that can be visualized through them, we will proceed to discuss the advantages and disadvantages of each approach. These protocols will facilitate the acquisition of optimal images for subsequent quantification and analysis. Additionally, a brief explanation will be given regarding the potential results and the clinical significance of the detected abnormalities.

Distribution characteristics of stress on the vertebrae following different ranges of excision during Modified Anterior Cervical Discectomy and Fusion: A correlation study based on finite element analysis.

BACKGROUND: Modified Anterior Cervical Discectomy and Fusion with specific resection ranges is an effective surgical method for the treatment of focal ossification of the posterior longitudinal ligament (OPLL). Herein, we compare and analyse the static stress area distribution by performing different cuts on an original ideal finite element model. METHOD: A total of 96 groups of finite element models of the C4-C6 cervical spine with different vertebral segmentation ranges (width: 1-12 mm, height: 1-8 mm) were established. The same pressure direction and size were applied to observe the size and distribution area of stress following various ranges of excision of the C5 vertebral body. RESULTS: Different cutting areas had similar stress aggregation points. As the contact area decreased, the stress and the bearing above area increased. The correlation of stress area variation was highest between the 1-2 MPa and 6 MPa-Max regions (Rho = - 0.975). In the surface visualisation model fitting, the width and height were of different ratios in different stress regions. The model with the best fitting degree was the 1-2 MPa group, and the equation fitting (Rho = 0.966) was as follows: Area = 908.80 - 25.92 × Width + 2.71 × Height. CONCLUSION: Modified Anterior Cervical Discectomy and Fusion with different resection ranges exhibited different stress areas. In a specific resection range of the cervical spine (1-12 mm, 0-8 mm), area conversion occurred at a threshold of 4 MPa. Additionally, the stress was concentrated at the contact points between the vertebral body and the rigid fixator.

The first Japanese case of autosomal dominant cutis laxa with a frameshift mutation in exon 30 of the elastin gene complicated by small airway disease with 8 years of follow-up.

BACKGROUND: Cutis laxa constitutes a diverse group of connective tissue diseases, both inherited and acquired, characterized by loose skin and varying systemic involvement, including pulmonary lesions. While cutis laxa has been linked to conditions like emphysema, asthma, and bronchiectasis, the specific pathological and radiological characteristics underlying pulmonary complications related to cutis laxa remain unclear. CASE PRESENTATION: A 36-year-old woman, diagnosed with cutis laxa at birth, presented to our outpatient clinic with severe obstructive ventilatory impairment, evident in pulmonary function tests (expiratory volume in one second (FEV1)/forced vital capacity (FVC): 34.85%; %residual volume [RV]: 186.5%; %total lung capacity [TLC]: 129.2%). Pulmonary function tests also indicated small airway disease (%FEF50%, 7.9%; %FEF75%, 5.7%; and %FEF25-75%, 6.8%). Computed tomography (CT) revealed the lack of normal increase in lung attenuation on expiratory CT scan, with no discernible emphysematous changes. Exome sequencing was performed to confirm the association between the pulmonary lesions and cutis laxa, revealing a frameshift variant in exon 30 of the elastin gene (ELN). Further analysis employing a parametric response map revealed a longitudinal increase in the percentage of functional small airway disease (fSAD) from 37.84% to 46.61% over the 8-year follow-up, despite the absence of overt changes in CT findings, specifically the lack of normal increase in lung attenuation on expiratory CT scan. Over the same follow-up interval, there was a modest reduction of 25.6 mL/year in FEV1 coupled with a significant increase in %RV. Pulmonary function test metrics, reflective of small airway disease, exhibited a continual decline; specifically, %FEF50%, %FEF75%, and %FEF25-75% diminished from 7.9% to 7.0%, 5.7% to 4.6%, and 6.8% to 5.4%, respectively. CONCLUSIONS: This case highlighted an instance of autosomal dominant cutis laxa arising from a frameshift variant in exon 30 of ELN, accompanied by small airway disease. Comprehensive investigation, utilizing quantitative CT analysis, revealed a longitudinal increase in fSAD percentage with a mild reduction in FEV1. These findings indicate that elastin deficiency may not only diminish elastic fibers in the skin but also be implicated in small airway disease by impacting components of the extracellular matrix in the lungs.

Xanthogranulomatous osteomyelitis of pubic bone mimicking neoplasm: a case report and literature review.

BACKGROUND: Xanthogranulomatous osteomyelitis (XO) is a rare disease characterized radiologically by an osteolytic lesion with cortical expansion or disruption. Differentiating this condition from other osteolytic diseases such as primary or metastatic bone neoplasms is imperative. Several case reports have been published on XO, with previous reports predominantly identifying bacteria such as Pseudomonas or Staphylococcus as causative organisms. However, fungal infection-induced XO has not yet been reported. CASE PRESENTATION: We present the case of a 23-year-old woman with a tumor-like osteolytic lesion in the pubic bone. The patient had experienced pelvic pain and intermittent febrile episodes for 2 months. Plain radiography revealed an osteolytic lesion in the right pubic tubercle. Magnetic resonance imaging suggested a cystic bone tumor or tubercular infection. Surgical intervention included curettage of the lesion and irrigation with normal saline. Histopathological examination of the specimen revealed abundant foamy histiocytes with inflammatory infiltrates consistent with XO. Culture of the osteolytic lesion confirmed an Aspergillus species infection and antifungal treatment was initiated. At 1-year follow-up, no evidence of local recurrence was observed. CONCLUSIONS: Although rare, XO requires differentiation from similar conditions and is treated with surgical intervention and targeted medical therapy based on the identified organisms. Clinicians should be mindful that XO can also be induced by fungal infections and that combination antifungal treatments may be beneficial in such cases.

Evaluating the predictive efficacy of real-time 3D echocardiography in cardiac resynchronization therapy.

BACKGROUND: The aim of this study is to assess the predictive efficacy of real-time three-dimensional echocardiography (RT-3DE) and QRS wave duration in determining the response to cardiac resynchronization therapy (CRT) and assessing left ventricular systolic function pre- and post-CRT device implantation. METHOD: A total of 51 patients with heart failure undergoing CRT at the Second Affiliated Hospital of Nantong University between January 1, 2013, and October 31, 2020, were enrolled in this study. Traditional two-dimensional echocardiography and RT-3DE were performed pre and post-CRT, with QRS wave width data from electrocardiograms and additional clinical information collected. Patients were categorized into CRT responder (n = 36) and CRT non-responder (n = 15) groups based on their response to CRT device implantation. Comparative analyses were conducted on the general characteristics of both groups, as well as the predictive efficacy of RT-3DE and QRS wave width for CRT responsiveness and left ventricular systolic function. Data on the standard deviation (Tmsv16-SD, Tmsv12-SD, Tmsv6-SD) and maximum difference (Tmsv16-Dif, Tmsv12-Dif, Tmsv6-Dif) of left ventricular end-systolic volume (LVESV) at segments 16, 12, and 6, as well as QRS wave width, were collected and analyzed. RESULTS: The indicators Tmsv6-Dif, Tmsv12-Dif, Tmsv16-Dif, Tmsv6-SD, Tmsv12-SD, Tmsv16-SD, and QRS wave width exhibited significantly higher values in the CRT responder group when compared to the CRT non-responder group (P < 0.05). Among these, Tmsv16-SD demonstrated superior predictive performance for post-CRT response, with a sensitivity of 88.9%, specificity of 80.0%, and a diagnostic cut-off value of 6.19%. This predictive capability exceeded that of the conventional indicator, QRS wave width. CONCLUSION: RT-3DE enables accurate prediction of post-CRT patient response and significantly facilitates quantitative assessment of CRT therapy efficacy.

Conservative treatment in uterine perivascular epithelioid cell tumor of uncertain malignant potential: a case report.

INTRODUCTION: Perivascular epithelioid cell tumors are uncommon mesenchymal tumors. The genital tract is the most common extrarenal location. Preoperative diagnosis is rarely achieved owing to non-specific symptoms and imaging features. Consensus on treatment strategies remains elusive. Case presentation We report the case a 38 year-old north African woman with a primary sterility, who was diagnosed with a uterine Perivascular epithelioid cell tumor of uncertain malignant potential on a resection specimen of an intracavity polypoid mass. Immunohistochemistry confirmed the diagnosis and we opted for conservative surgery to preserve the patient's fertility desires. CONCLUSION: Uterine perivascular epithelioid cell tumor is a rare entity that warrants consideration in the differential diagnosis of uterine tumors. Treatment modalities, follow-up protocols, and prognosis remain ambiguous. Given their unpredictable behavior, accurate diagnosis and long-term monitoring are imperative.

A novel technique for C1-C2 posterior screw insertion using patient-specific guides created by CT-based 3D printing.

C1-C2 fixation has been developed for the rigid fusion of atlantoaxial instability. C1 lateral mass screw (C1 LMS)-C2 pedicle screw fixation is used more frequently due to its rigid fixation and high bone fusion rate. However, C1 screw placement is relatively unsafe even with recently developed image-based navigation systems. Patient-specific screw guide templates (PSGT) were developed to improve the accuracy and safety of C1 screw placement. Herein, we investigated the outcomes of the C1-C2 posterior fixation technique using PSGT. This was a retrospective study of six patients who underwent posterior cervical spinal fusion using the PSGT between January 2022 and April 2023. Operative time, estimated blood loss, intraoperative radiation dose, surgical cost, and screw placement accuracy were evaluated and compared with those achieved with preoperative CT-based navigation (navigation group, n = 15). Screw accuracy was assessed using Neo's classification. PSGT showed good results, although the differences were not statistically significant (operation time: 104.3 ± 9.7 min vs 116.4 ± 20.8 min; estimated blood loss: 56.7 ± 72.4 mL vs 123.2 ± 162.3 mL; and radiation dose: 1.8 ± 1.2 mSv vs 2.6 ± 0.8 mSv, respectively). PSGT was particularly better in terms of the accuracy of C1 LMS (PSGT: 100%, navigation: 83.3%). The deviation at the entry point was minimal, and the difference between the sagittal and transversal angles from the preoperative plan was small. We investigated the clinical efficacy of using the PSGT for C1-C2 posterior fixation. PSGT improved the accuracy of C1 LMS insertion.

Spontaneous regression of lumbar disc herniation: four cases report and review of the literature.

Spontaneous regression of lumbar disc herniation refers to shrinkage or disappearance of herniated nucleus pulposus without invasive surgical treatments. This phenomenon has been reported and is supported by improved clinical symptoms and radiographic after conservative treatment, but the underlying mechanism remains unclear. This article reports 4 cases of disc reabsorption and reviews the distribution of several clinical and radiographic factors of disc herniation reabsorption of total 46 patients, including the four from our study, gathered from 28 recent publications. Some of these factors are present with anomalous distributions. But some factors have similar deviations in patients with lumbar disc herniation. Therefore, more research is needed to explore the correlation between those factors and disc reabsorption.

Appendiceal adenocarcinoma associated with Amyand's hernia: a case report.

We encountered a rare case of appendiceal carcinoma associated with Amyand's hernia, which was difficult to diagnose preoperatively. A 74-year-old man presented to our hospital with right lower abdominal pain. A hard mass was palpable in the right lower abdomen, and blood tests showed a slightly elevated inflammatory response. Computed tomography revealed a 7 × 5 cm mass with indistinct borders and heterogeneous internal density extending from the cecum to the right lower abdominal wall. We diagnosed appendiceal abscess, however, percutaneous biopsy which was performed for differential diagnosis with appendiceal carcinoma showed no malignancy. Thereafter, the patient was followed up. Two months later, a blood test showed insignificant changes in the inflammatory response and a high serum carcinoembryonic antigen level (48.6 ng/mL). An ultrasound showed a mass contiguous to the appendix, extending to the abdominal wall, with abundant blood flow signals. Fluorodeoxyglucose-positron emission tomography showed a high accumulation of fluorodeoxyglucose in the mass. Four months after the initial visit, the patient had an open ileocecal resection combined with an abdominal wall resection based on the preoperative diagnosis of appendiceal carcinoma invading the abdominal wall. During laparotomy, an enlarged appendix tip extended from the internal inguinal ring outside the inferior epigastric artery to the abdominal wall. Histopathological examination of the appendiceal tumor revealed well-differentiated adenocarcinoma, T4b (abdominal wall), N0, Ly0, and V0. When a right lower abdominal mass extends from the cecum to the abdominal wall, appendiceal tumors associated with Amyand's hernia should be considered.

Current role of interventional radiology in thyroid nodules.

Thyroid nodules are a prevalent health issue in society. Interventional radiological methods are successfully applied for both the diagnosis and treatment of nodules. Diagnostically, a fine-needle aspiration biopsy and a core needle biopsy can be performed to ascertain the benign or malignant nature of a lesion. In recent years, imaging-guided percutaneous treatment methods have become popular in the treatment of thyroid nodules. Aspiration, ablation, and embolization are techniques employed in the treatment process. In this study, we aimed to discuss the current role of interventional radiology in the diagnosis and treatment of thyroid nodules, which occupy an important place in clinical practice.

Clinical respiratory and radiographic abnormalities in dogs with spontaneous hypercortisolism.

The objective of this study was to characterize respiratory clinical signs, other than panting and respiratory distress, as well as thoracic radiographic abnormalities, in dogs with hypercortisolism. Although there have been case reports and studies evaluating the results of pulmonary scintigraphy, no studies have yet reviewed respiratory clinical signs and radiograph results in dogs with hypercortisolism. This study addresses this gap. A case series was evaluated and the dogs' clinical histories were obtained, including clinical signs and physical examination. Digital thoracic radiographs were analyzed to consider such parameters as the diameter of the main bronchi, lung patterns, and the size of the pulmonary trunk. The most common respiratory symptoms were snoring (61.9%), coughing (57.1%), and fatigue (52.4%). Physical examination revealed a high frequency of changes on lung auscultation (95.2%). The body condition score (BCS) was high in 95% of dogs and a significant correlation was observed between the presence of cyanosis and changes in lung auscultation, both of which present similar risk factors. Furthermore, body weight showed a moderate correlation with respiratory rate (RR = 0.571). Radiographic changes were evident in 47.5% of dogs, with the bronchial pattern being the most common (70%). Based on these results, it was observed that respiratory and radiographic abnormalities are frequent in dogs with spontaneous hypercortisolism and a high body condition score was relevant for exacerbating clinical respiratory signs, such as cyanosis and tachypnea.

L'objectif de cette étude était de caractériser les signes cliniques respiratoires, autres que le halètement et la détresse respiratoire, ainsi que les anomalies radiographiques thoraciques, chez les chiens atteints d'hypercortisolisme. Bien qu'il existe des rapports de cas et des études évaluant les résultats de la scintigraphie pulmonaire, aucune étude n'a encore examiné les signes cliniques respiratoires et les résultats radiographiques chez les chiens atteints d'hypercortisolisme. Cette étude comble cette lacune. Une série de cas a été évaluée et les antécédents cliniques des chiens ont été obtenus, incluant les signes cliniques et l'examen physique. Des radiographies thoraciques numériques ont été analysées pour prendre en compte des paramètres tels que le diamètre des bronches principales, les schémas pulmonaires et la taille du tronc pulmonaire. Les symptômes respiratoires les plus courants étaient le ronflement (61,9 %), la toux (57,1 %) et la fatigue (52,4 %). L'examen physique a révélé une fréquence élevée de changements à l'auscultation pulmonaire (95,2 %). Le score d'état corporel (BCS) était élevé chez 95 % des chiens et une corrélation significative a été observée entre la présence de cyanose et les modifications de l'auscultation pulmonaire, qui présentent toutes deux des facteurs de risque similaires. De plus, le poids corporel a montré une corrélation modérée avec la fréquence respiratoire (RR = 0,571). Des changements radiographiques étaient évidents chez 47,5 % des chiens, le schéma bronchique étant le plus courant (70 %). Sur la base de ces résultats, il a été observé que les anomalies respiratoires et radiographiques sont fréquentes chez les chiens atteints d'hypercortisolisme spontané, et qu'un score d'état corporel élevé était pertinent pour l'exacerbation des signes respiratoires cliniques, tels que la cyanose et la tachypnée.(Traduit par Docteur Serge Messier).

Peritoneal pericardial diaphragmatic hernia with an incidental finding of suspected right ventricular wall aneurysms in a dog.

A 3-year-old neutered male standard poodle mix dog was presented because of acute onset vomiting, increased respiratory effort, hyporexia, and progressive lethargy. On physical examination, intermittent tachycardia, tachypnea with mildly increased respiratory effort, and bilateral ventral muffled lung sounds were noted. Thoracic and abdominal computed tomography with contrast revealed a peritoneal pericardial diaphragmatic hernia (PPDH) with herniation of the liver and gallbladder, moderate abdominal lymphadenopathy, and mild pleural effusion. The dog underwent an emergency laparotomy and median sternotomy. Right ventral PPDH with a herniated, necrosed, and nonviable quadrate liver lobe and gallbladder; 2 suspected right ventricular (RV) aneurysms; and generalized mesenteric and portal lymphadenopathy were present. The affected liver lobe and gallbladder were removed; suspected aneurysms were managed by placing 2 purse-string sutures around the lesions and anchoring a pericardial flap over the aneurysms. The dog developed a ventricular arrhythmia postoperatively. Due to the arrhythmia and intraoperative findings of suspected aneurysms, echocardiography was performed and revealed focal RV systolic dysfunction, left ventricular systolic dysfunction, mild left ventricular dilation, and a hyperechoic area on the RV free wall, consistent with the purse string. An angiotensin-convertingenzyme (ACE) inhibitor was prescribed for left ventricular dilation. The dog was discharged 4 d postoperatively and was doing well 12 mo postoperatively. To our knowledge, this is the first report of a PPDH and suspected concurrent RV wall aneurysm in a dog successfully treated with a purse string and pericardial flap. Key clinical message: An RV aneurysm is extremely rare yet can be life-threatening in small animals. Early detection and treatment may minimize the risk of aneurysm rupture and sudden death.

Hernie diaphragmatique péritonéale péricardique avec découverte fortuite d'anévrismes suspects de la paroi ventriculaire droite chez un chienUn chien croisé caniche standard mâle castré âgé de 3 ans a été présenté en raison de vomissements aigus, d'efforts respiratoires accrus, d'hyporexie et de léthargie progressive. À l'examen physique, une tachycardie intermittente, une tachypnée avec effort respiratoire légèrement accru et des bruits pulmonaires étouffés ventraux bilatéraux ont été notés. Une tomodensitométrie thoracique et abdominale avec contraste a révélé une hernie diaphragmatique péritonéale péricardique (HDPP) avec hernie du foie et de la vésicule biliaire, une lymphadénopathie abdominale modérée et un épanchement pleural léger. Le chien a subi une laparotomie d'urgence et une sternotomie médiane. Une HDPP ventrale droite avec un lobe hépatique carré et une vésicule biliaire herniés, nécrosés et non viables; 2 anévrismes du ventricule droit (VD) suspectés; et une adénopathie mésentérique et portale généralisée étaient présents. Le lobe hépatique et la vésicule biliaire affectés ont été retirés; les anévrismes suspectés ont été gérés en plaçant 2 sutures en bourse autour des lésions et en ancrant un lambeau péricardique sur les anévrismes. Le chien a développé une arythmie ventriculaire postopératoire. En raison de l'arythmie et des résultats peropératoires d'anévrismes suspectés, une échocardiographie a été réalisée et a révélé un dysfonctionnement systolique focal du VD, un dysfonctionnement systolique du ventricule gauche, une légère dilatation du ventricule gauche et une zone hyperéchogène sur la paroi libre du VD, compatible avec la bourse. Un inhibiteur de l'enzyme de conversion de l'angiotensine (ECA) a été prescrit pour la dilatation du ventricule gauche. Le chien a obtenu son congé 4 jours après l'opération et se portait bien 12 mois après l'opération. À notre connaissance, il s'agit du premier rapport d'une HDPP et d'un anévrisme concomitant suspecté de la paroi du VD chez un chien traité avec succès par une suture en bourse et un lambeau péricardique.Message clinique clé :Un anévrisme du ventricule droit est extrêmement rare, mais peut mettre la vie en danger chez les petits animaux. Une détection et un traitement précoces peuvent minimiser le risque de rupture d'anévrisme et de mort subite.(Traduit par Dr Serge Messier).

Emphysematous splenic torsion in a German shepherd dog.

A 9-year-old castrated male German shepherd dog was presented because of a 2-day history of lethargy and anorexia. Abdominal distention and free peritoneal fluid were noted on physical examination, which prompted radiographs revealing a large, soft tissue and stippled gas opaque structure in the right cranial abdomen. Computed tomography was used to further describe the structure and assess for comorbidities in the dog. Both CT and abdominal radiographs supported a diagnosis of emphysematous splenic torsion. The enlarged spleen was surgically extracted, along with sections of necrotic omentum. Four days after the procedure, the dog developed a portal vein thrombus and secondary abdominal effusion, which ultimately led to the decision for humane euthanasia. Veterinarians should know the different imaging modalities used to diagnose splenic torsion and the possible postoperative complications following treatment.

Torsion splénique emphysémateuse chez un berger allemandUn berger allemand mâle castré de 9 ans a été présenté en raison d'une léthargie et d'une anorexie depuis 2 jours. Une distension abdominale et du liquide péritonéal libre ont été notés lors de l'examen physique, ce qui a donné lieu à des radiographies révélant une grosse structure opaque de tissus mous et de gaz dans l'abdomen crânial droit. Un examen par tomodensitométrie a été utilisée pour décrire plus en détail la structure et évaluer les comorbidités chez le chien. La tomodensitométrie et les radiographies abdominales ont toutes deux confirmé un diagnostic de torsion splénique emphysémateuse. La rate hypertrophiée a été extraite chirurgicalement, ainsi que des sections d'épiploon nécrotique. Quatre jours après l'intervention, le chien a développé un thrombus de la veine porte et un épanchement abdominal secondaire, ce qui a finalement conduit à la décision d'une euthanasie. Les vétérinaires doivent connaître les différentes modalités d'imagerie utilisées pour diagnostiquer la torsion splénique et les complications postopératoires possibles après le traitement.(Traduit par Dr Serge Messier).

Hysterosalpingography findings in infertile Sudanese women: a cross-sectional study on tube blockage.

Introduction: infertility is a significant public health concern in Africa and Hysterosalpingography (HSG) is an affordable option for initial treatment. This study aimed to provide information about the incidence of abnormal pathology and tubal findings in HSG of Sudanese women who experienced infertility. Methods: this prospective cross-sectional study included 100 infertile patients who were requested for HSG, including age, duration of infertility, body mass index (BMI), medical history, and HSG findings collected after performing the radiographic test, which was diagnosed by an experienced radiologist. Results: one hundred infertile women (46% and 54%) experienced primary and secondary infertility, respectively. Mean age was (31.1 ± 5.2, 27.5 ± 6.0) years, and BMI was (25.1 ± 3.3, 25.7 ± 2.9) Kg/cm2 for primary and secondary infertility respectively. Abnormal findings prevalence was (29/46, 63%) and (30/54, 56%). The incidence of fallopian tube abnormality was (52/100, 52% (25/46, 54.3%), and (27/56, 50%) for primary and secondary infertility, respectively. Forty-one percent of participants had normal hysterosalpingograms. Pelvic surgery was the highest risk factor in 24% of the participants. Age and medical history were significantly associated with the infertility type (P < 0.05). Conclusion: infertile patients who underwent hysterosalpingography (HSG) were predominantly older, with secondary infertility being slightly more common, underscoring the importance of early diagnostic evaluation and care. Fallopian tube abnormalities were the most common cause of infertility, with tube blockage affecting nearly half of the participants. Additionally, this study revealed that prior pelvic surgery significantly increased the risk of infertility.

Presence of pneumatosis intestinalis in a dog with multicentric lymphoma.

A 13-year-old neutered male Lagotto Romagnolo dog had ultrasonographic and computed tomographic findings of pneumatosis intestinalis after presentation to the emergency department because of progressive diarrhea and hyporexia. Further investigations produced a diagnosis of multicentric lymphoma, and treatment with chemotherapy was commenced. Clinical remission of lymphoma was achieved and coincided with resolution of pneumatosis intestinalis on subsequent computed tomographic imaging. Key clinical message: Consider underlying pathology such as neoplasia in cases of pneumatosis intestinalis after excluding surgical emergent causes.

Présence d'une pneumatose intestinale chez un chien atteint d'un lymphome multicentriqueUn chien Lagotto Romagnolo mâle castré de 13 ans a présenté des résultats échographiques et tomodensitométriques de pneumatose intestinale après sa présentation au service des urgences en raison d'une diarrhée progressive et d'une hyporexie. Des examens complémentaires ont permis de poser un diagnostic de lymphome multicentrique et un traitement par chimiothérapie a été débuté. Une rémission clinique du lymphome a été obtenue et a coïncidé avec la résolution de la pneumatose intestinale sur l'imagerie par tomodensitométrie ultérieure.Message clinique clé :Envisager une pathologie sous-jacente telle qu'une néoplasie dans les cas de pneumatose intestinale après avoir exclu les causes d'origine chirurgicale.(Traduit par Dr Serge Messier).