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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 http://people.upei.ca/lpack/vetrad/ Thoracic Radiology of the Dog Dr. LeeAnn Pack Dipl. ACVR

2 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ Indications Coughing Dyspnea Cardiovascular disease Thoracic trauma Assessment of primary or secondary neoplasia Regurgitation of food Other abnormalities detected on PE

4 http://people.upei.ca/lpack/vetrad/ Technical Factors Potential for movement –Low mAs High inherent contrast –Low kVp INSPIRATION Collimation/centering

5 http://people.upei.ca/lpack/vetrad/ Inspiration vs. Expiration

6 http://people.upei.ca/lpack/vetrad/ 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

7 http://people.upei.ca/lpack/vetrad/

8 Chamber Location

9 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ Cranial Pulmonary Vessels

11 http://people.upei.ca/lpack/vetrad/ 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

12 http://people.upei.ca/lpack/vetrad/

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 http://people.upei.ca/lpack/vetrad/ Air Bronchogram

15 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ Nice Air Bronchograms

17 http://people.upei.ca/lpack/vetrad/ The ABC’s

18 http://people.upei.ca/lpack/vetrad/ A Atelectasis –General anx –Recumbent animals –Dependent lung lobes affected Aspiration pneumonia –Cranial,cranioventral lung lobes affected –Megaesophagus –Post anesthesia

19 http://people.upei.ca/lpack/vetrad/ B Bronchopneumonia –Cranioventral, ventral Bacterial pneumonia –Cranioventral, ventral

20 http://people.upei.ca/lpack/vetrad/ C Contusion –History of trauma –Rib fractures –Distribution varies

21 http://people.upei.ca/lpack/vetrad/ D Dirofilariasis –Most common cause of thromboembolic disease –Increased lung opacity –Mixed interstitial – alveolar –Caudodorsal distribution

22 http://people.upei.ca/lpack/vetrad/ E Edema CARDIOGENIC –Left heart failure –Perihilar, symmetrical NON-CARDIOGENIC –Electrocution –Salt water drowning –Seizures –caudodorsal

23 http://people.upei.ca/lpack/vetrad/ Cardiogenic Edema

24 http://people.upei.ca/lpack/vetrad/ Non Cardiogenic Edema Lateral

25 http://people.upei.ca/lpack/vetrad/ Non Cardiogenic Edema VD’s

26 http://people.upei.ca/lpack/vetrad/ F Foreign Body –Located in bronchus –Affected area depends on affected bronchus

27 http://people.upei.ca/lpack/vetrad/ G Granulomatous Fungal –Eosinophilic Variable distribution

28 http://people.upei.ca/lpack/vetrad/ H Hemorrhage –Distribution variable depending on the cause –Trauma Rib fractures –Coagulopathy Patchy, generalized

29 http://people.upei.ca/lpack/vetrad/ Bronchial Lung Disease

30 http://people.upei.ca/lpack/vetrad/ Bronchial – RR Tracks

31 http://people.upei.ca/lpack/vetrad/ Bronchial

32 http://people.upei.ca/lpack/vetrad/ Donuts

33 http://people.upei.ca/lpack/vetrad/ Bronchial Lung Disease

34 http://people.upei.ca/lpack/vetrad/ Bronchial Lung Disease

35 http://people.upei.ca/lpack/vetrad/ Feline Asthma

36 http://people.upei.ca/lpack/vetrad/ Feline Asthma

37 http://people.upei.ca/lpack/vetrad/ Cardiology Congenital Acquired Small breeds Large breeds Younger Older

38 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ PDA

40 http://people.upei.ca/lpack/vetrad/ PDA

41 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ PS

43 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ AS

45 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ Mitral Insufficiency

47 http://people.upei.ca/lpack/vetrad/ Severe Left Atrial Enlargement

48 http://people.upei.ca/lpack/vetrad/ Splitting of the MSB

49 http://people.upei.ca/lpack/vetrad/ Compression at Carina

50 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ DCM

52 http://people.upei.ca/lpack/vetrad/ DCM

53 http://people.upei.ca/lpack/vetrad/ Pericardial Effusion

54 http://people.upei.ca/lpack/vetrad/ Heartworm Disease Dilated, tortuous pulmonary arteries Right sided heart enlargement Reverse D shape DV radiograph to see caudal vessels

55 http://people.upei.ca/lpack/vetrad/ 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 http://people.upei.ca/lpack/vetrad/ Pleural Effusion – VD vs. DV

57 http://people.upei.ca/lpack/vetrad/ Where Is the Heart?

58 http://people.upei.ca/lpack/vetrad/ Pleural Effusion – CMM Present?

59 http://people.upei.ca/lpack/vetrad/ 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

62 http://people.upei.ca/lpack/vetrad/

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66 Megaesophagus Congenital Acquired Segmental Generalized Radiographic signs Aspiration pneumonia

67 http://people.upei.ca/lpack/vetrad/ Generalized Megaesophagus

68 http://people.upei.ca/lpack/vetrad/ Segmental ME - Surveys

69 http://people.upei.ca/lpack/vetrad/ Segmental ME - Contrast

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71 What Do You See?

72 http://people.upei.ca/lpack/vetrad/ Chest Rads – Same Dog

73 http://people.upei.ca/lpack/vetrad/

74 Thoracic Radiology in the Dog Questions????


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