Page 2331 - Cote clinical veterinary advisor dogs and cats 4th

1155.e2 Radiographic Interpretation, Abdomen

Radiographic Interpretation, Abdomen Client Education
Sheet
VetBooks.ir

views should be evaluated. Use three views
Difficulty level: ♦
(VD, right lateral, and left lateral) when ○ Differentiate focal enlargement caused
by nodules and masses from generalized
Overview and Goal evaluating for gastrointestinal (GI) foreign enlargement caused by hyperplasia, con-
Stepwise interpretation of abdominal radio- bodies. gestion, vacuolar hepatopathy (p. 1025),
graphs to curate a list of differential diagnoses • Use a systematic approach. For example, hepatitis, and infiltrative neoplasia (p. 446).
work cranially to caudally, evaluating each ○ Mineralized biliary tract contents may be
Anticipated Time normally visible organ. Evaluate the peri- seen radiographically.
Anticipated time to evaluate radiographs is 15 toneal and retroperitoneal spaces. Look for Spleen:
minutes. structures not normally seen, such as masses • Normal
or lymphadenomegaly. Continue the systemic ○ Lateral and VD: the proximal extremity of
Preparation: Important approach by evaluating the extraabdominal the spleen is seen as a triangular structure
Checkpoints tissues, such as the spine, the hips, and any in the left craniodorsal abdomen between
Important principles: visible portion of the thorax for incidental the gastric fundus and left kidney.
• Summation: the overlapping area of two but potentially important abnormalities (e.g., ○ In dogs, on the lateral view, the distal
superimposed structures is more opaque vertebral lysis, metastasis in the visible lung extremity of the spleen is usually seen
than their individual opacities (e.g., where fields). along the ventral abdomen and is oblong
kidneys overlap on the lateral view appears Liver: to triangular in shape. On the VD view,
more opaque). • Normal the distal extremity of the spleen varies in
• Silhouetting (border effacement): two struc- ○ Lateral: the liver is a triangular structure location, tethered by the fixed proximal
tures of the same opacity abut one another immediately caudal to the diaphragm extremity. It may be difficult to distinguish
and appear as one continuous opacity with and cranial to the stomach. VD: the from superimposed organs.
no distinct border (e.g., abdominal organs liver lies horizontally across the cranial ○ In cats, the distal extremity of the spleen
surrounded by ascites). abdomen. is not normally seen on the lateral view
• Mass effect: a mass is suspected based on the ○ The gallbladder silhouettes with the sur- but is seen along the left abdominal wall
displacement of surrounding organs. Their rounding liver and is usually not seen. The on the VD view.
direction of displacement is used to deduce feline gallbladder may protrude ventrally • Abnormal
the organ of origin of the mass. from the liver. ○ Canine splenomegaly: spleen reaches the
• Abnormal right kidney or the urinary bladder.
Procedure ○ Characteristics of hepatomegaly: rounded ○ Feline splenomegaly: spleen is seen in the
General: caudal hepatic margin, extension of liver ventral abdomen on the lateral view.
• At least two orthogonal (perpendicular caudal to the costal arch, caudal displace- ○ Differentiate focal enlargement caused by
plane, such as ventrodorsal [VD] and lateral) ment of gastric axis hematomas, nodules, and masses (p. 629)
from generalized enlargement caused by
hyperplasia, congestion or torsion, tick-
borne disease, and infiltrative neoplasia
(p. 936).
○ A torsed spleen is often displaced, enlarged,
and has a curled (C-shaped) appearance
(p. 935).

RADIOGRAPHIC INTERPRETATION, ABDOMEN Splenic mass. Lateral RADIOGRAPHIC INTERPRETATION, ABDOMEN Hydronephrosis. Lateral
radiograph of a 10-year-old schnauzer with lethargy and inappetence. A large, abdominal radiograph of a 15-year-old domestic shorthair cat with weight loss.
irregularly margined mass (black Vs) is seen in the ventral abdomen. This mass The cranially positioned kidney is moderately enlarged with a smooth margin
causes cranial displacement of the stomach (white arrows) and caudododorsal (black Vs) and causes ventral displacement of the colon (arrows). The caudally
displacement of the intestines (thick black arrows). There is decreased serosal detail positioned kidney is small with a flattened cranial pole (white V), an irregular ventral
in the caudoventral abdomen indicative of mild ascites. The location of the mass margin, and renal mineralization (asterisk). Left hydronephrosis and hydroureter
and the displacement it causes is characteristic of a splenic mass. were diagnosed using ultrasound. Chronic infarcts and nephroliths of the right
kidney were also noted.

www.ExpertConsult.com