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Thoracic Radiology of the Dog Dr. LeeAnn Pack Dipl. ACVR.

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Presentation on theme: "Thoracic Radiology of the Dog Dr. LeeAnn Pack Dipl. ACVR."— Presentation transcript:

1 Thoracic Radiology of the Dog Dr. LeeAnn Pack Dipl. ACVR

2 Thoracic Radiology of the Dog Indications Technical factors Normal radiographic anatomy Pulmonary vasculature Alveolar lung pattern ABC’s Bronchial Lung Ds Cardiology –PDA –Pulmonic stenosis –Aortic stenosis –Mitral insufficiency –DCM –Heartworm Disease Pleural Effusion Primary Lung Tumors Pulmonary Nodules Megaesophagus

3 Indications Coughing Dyspnea Cardiovascular disease Thoracic trauma Assessment of primary or secondary neoplasia Regurgitation of food Other abnormalities detected on PE

4 Technical Factors Potential for movement –Low mAs High inherent contrast –Low kVp INSPIRATION Collimation/centering

5 Inspiration vs. Expiration

6 Normal Radiographic Anatomy Heart –2 ½ to 3 ½ intercostal spaces wide on lateral view –< 65% of the width of the thorax on the VD view –“clock face” –Lung lobes

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8 Chamber Location

9 Pulmonary Vasculature Cranial pulmonary vessels –Lateral view –Artery = dorsal, vein = ventral –Diameter of vessels at the 4th ICS should not exceed the diameter of the proximal portion of the 3 rd rib

10 Cranial Pulmonary Vessels

11 Pulmonary Vasculature Caudal pulmonary vessels DV view Artery = lateral, Vein = medial Vessels should not exceed the diameter of the 9 th rib where they cross it

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13 Alveolar Lung Pattern Hallmark = air bronchograms –Consolidation = alveoli filled with fluid/cells Retains shape –Atelectasis = collapse of alveolar lung space Lobe size decreased, mediastinal shift possible

14 Air Bronchogram

15 Alveolar Lung Pattern Lobar sign Summation – superimposed over cardiac silhouette May not see pulmonary vessels in area of pattern due to soft tissue opacity

16 Nice Air Bronchograms

17 The ABC’s

18 A Atelectasis –General anx –Recumbent animals –Dependent lung lobes affected Aspiration pneumonia –Cranial,cranioventral lung lobes affected –Megaesophagus –Post anesthesia

19 B Bronchopneumonia –Cranioventral, ventral Bacterial pneumonia –Cranioventral, ventral

20 C Contusion –History of trauma –Rib fractures –Distribution varies

21 D Dirofilariasis –Most common cause of thromboembolic disease –Increased lung opacity –Mixed interstitial – alveolar –Caudodorsal distribution

22 E Edema CARDIOGENIC –Left heart failure –Perihilar, symmetrical NON-CARDIOGENIC –Electrocution –Salt water drowning –Seizures –caudodorsal

23 Cardiogenic Edema

24 Non Cardiogenic Edema Lateral

25 Non Cardiogenic Edema VD’s

26 F Foreign Body –Located in bronchus –Affected area depends on affected bronchus

27 G Granulomatous Fungal –Eosinophilic Variable distribution

28 H Hemorrhage –Distribution variable depending on the cause –Trauma Rib fractures –Coagulopathy Patchy, generalized

29 Bronchial Lung Disease

30 Bronchial – RR Tracks

31 Bronchial

32 Donuts

33 Bronchial Lung Disease

34 Bronchial Lung Disease

35 Feline Asthma

36 Feline Asthma

37 Cardiology Congenital Acquired Small breeds Large breeds Younger Older

38 Patent Ductus Arteriosis Enlargement of the descending aorta Enlargement also of the: –Main pulmonary artery –Left atrium –Left auricle Vessels enlarged, lungs over-circulated Poodle, pom, collie, GSD, sheltie

39 PDA

40 PDA

41 Pulmonic Stenosis Malformation of the pulmonic valve Enlargement of the main pulmonic aa Right ventricular enlargement Vessels normal to small Beagle, English Bulldog, Samoyed, mastiff, boxer

42 PS

43 Aortic Stenosis Narrowing of the subvalvular region of the left ventricle Aortic arch enlarged Left ventricle enlarged Vessels normal GSD, Newfoundland, Boxer, golden retriever, rott

44 AS

45 Mitral Insufficiency Primary degeneration of the mitral valve leaflets Regurg through the valve  left atrial enlargement Pulmonary veins enlarged Pulmonary edema due to left heart failure

46 Mitral Insufficiency

47 Severe Left Atrial Enlargement

48 Splitting of the MSB

49 Compression at Carina

50 Dilated Cardiomyopathy Cardiac chamber enlargement + systolic ventricular dysfunction ~ impaired cardiac contractility Generalized cardiomegaly Vessels may be enlarged Pleural effusion due to right heart failure Dobe, Great Dane, Newfoundland, Irish Wolfhound

51 DCM

52 DCM

53 Pericardial Effusion

54 Heartworm Disease Dilated, tortuous pulmonary arteries Right sided heart enlargement Reverse D shape DV radiograph to see caudal vessels

55 Pleural Effusion Fluid in the pleural space Exudate, transudate or modified transudate Appearance is sam regardless of the type Usually bilateral Fissure lines, retraction of lungs, silhouetting of heart and diaphragm

56 Pleural Effusion – VD vs. DV

57 Where Is the Heart?

58 Pleural Effusion – CMM Present?

59 Primary Lung Tumors Usually large solitary Caudal lung lobes usually Adenocarcinoma Bronchogenic carcinoma Squamous cell carcinoma Malignant histiocytosis

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61 Pulmonary Nodules

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66 Megaesophagus Congenital Acquired Segmental Generalized Radiographic signs Aspiration pneumonia

67 Generalized Megaesophagus

68 Segmental ME - Surveys

69 Segmental ME - Contrast

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71 What Do You See?

72 Chest Rads – Same Dog

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74 Thoracic Radiology in the Dog Questions????


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