Page 440 - Feline diagnostic imaging

(a) (b)

(c) (d)

Figure 26.15 Ultrasonography of the urinary bladder. The bladder should be imaged at moderate distension for optimal visualization
of the bladder wall. (a) When the bladder is fully distended as shown here, the wall will be stretched, causing mild wall thickening to
be missed. In this image, the urethra (white arrow) is also distended. (b) The bladder wall can appear slightly thickened when it is too
empty. (c) When optimally distended, the bladder wall measures approximately 0.2 cm and has 3–4 layers: a hyperechoic serosa, a
hypoechoic central muscular layer, and a hyperechoic inner layer. The mucosa may appear as a hypoechoic fourth inner layer. The apex
of the bladder may be difficult to visualize. (d) Hyperechoic material is suspended in the lumen, likely representing fat in the urine.

(b) ROI Net Kidney counts
Gross 1-3 minutes Size 1-3 minutes % Inj dose
Rt Kidney 25,321 33 17,245 8.07
Lt Kidney 14,183 21 3,924 1.84
Rt BKD 1,468 4
(a)
Lt BKD 1,954 4
Right Kidney Left Kidney
Total GFR 81% 19%
2.65 ml/min/kg 2.16 ml/min/kg 0.49 ml/min/kg

Renogram curves
Right kidney
1,600 Left kidney
Rt BKD 1
1,400 Lt BKD 2
Total ROI Counts 1,200
1,000
800
600
400
GFR Quantification
200
–
0.00 1.00 2.00 3.00 4.00 5.00 6.00
Time in minutes

Figure 26.16 Glomerular filtration rate evaluated with nuclear scintigraphy. (a) Nuclear scintigram of a 15-year-old cat with a left
renal mass. Arrows point to the location of the kidneys. (b) GFR is calculated using time activity curves generated from images
obtained. The overall GFR was reduced but although the left kidney contained a mass and was contributing only 19%, it was still
partly functional.