ABSTRACT
ABSTRACT: The objective of this study was to verify the applicability of B-mode ultrasonography, ARFI elastography and CEUS in the diagnosis of chronic kidney disease and its Stages in dogs. 24 healthy dogs and 28 with CKD were included. In B-mode, the echogenicity, echotexture and cortico-medullary ratio of the kidneys were verified. By elastography, the shear-wave velocity of the cortical (SWVcort) and medullary (SWVmed) regions were determined and tissue deformity was evaluated. Wash-in, wash-out and peak enhancement (TPic) of the contrast in the renal parenchyma were calculated and homogeneity, presence of filling gaps and distinction of filling phases were evaluated by CEUS. Changes in echogenicity, echotexture and cortico-medullary ratio were observed only in sick patients. There was an increase in SWVcort in CKD, with a cutoff point >2.91m/s. Healthy kidneys were non-deformable and 25% had changes in gray scales. There was an increase in wash-in and TPic, changes in filling characteristics, filling failures and difficulty in distinguishing between the Stages in CEUS in CKD. It was found that dogs with CKD 2, 3 and 4 had greater SWVcort and wash-in values than CKD 1. Elastographic and CEUS changes were observed in dogs with CKD, demonstrating the applicability of ultrasonographic techniques in their diagnosis.
RESUMO: O objetivo deste estudo foi verificar a aplicabilidade da ultrassonografia modo-B, elastografia ARFI e CEUS no diagnóstico da doença renal crônica e seus estágios em cães. Foram incluídos 24 cães saudáveis e 28 com DRC. Pelo modo-B, verificou-se ecogenicidade, ecotextura e relação córtico-medular dos rins. Pela elastografia, foram determinadas as velocidades de cisalhamento das regiões cortical (SWVcort) e medular (SWVmed) e foi avaliada a deformidade tecidual. Calculou-se os temos de wash-in, wash-out e pico de intensidade (TPic) do parênquima renal e avaliou-se homogeneidade, presença de falhas e distinção das fases de preenchimento por contraste por meio de CEUS. Alterações em ecogenicidade, ecotextura e relação córtico-medular foram observadas somente em pacientes doentes. Houve aumento da SWVcort na DRC, com ponto de corte >2.91m/s. Rins saudáveis foram não-deformáveis e 25% apresentou alterações nas escalas de cinza. Houve aumento do wash-in e TPic, alterações nas características de preenchimento, falhas e dificuldade para distinguir as fases de preenchimento do contraste nos rins com DRC. Verificou-se que cães com DRC graus 2, 3 e 4 tiveram valores de SWVcort e wash-in maiores que cães com DRC grau 1. Foram obsrervadas alterações elastográfica e de CEUS em cães com DRC, demonstrando a aplicabilidade destas técnicas ultrassonográficas no seu diagnóstico.
ABSTRACT
The objective of this study was to verify the applicability of B-mode ultrasonography, ARFI elastography and CEUS in the diagnosis of chronic kidney disease and its Stages in dogs. 24 healthy dogs and 28 with CKD were included. In B-mode, the echogenicity, echotexture and cortico-medullary ratio of the kidneys were verified. By elastography, the shear-wave velocity of the cortical (SWVcort) and medullary (SWVmed) regions were determined and tissue deformity was evaluated. Wash-in, wash-out and peak enhancement (TPic) of the contrast in the renal parenchyma were calculated and homogeneity, presence of filling gaps and distinction of filling phases were evaluated by CEUS. Changes in echogenicity, echotexture and cortico-medullary ratio were observed only in sick patients. There was an increase in SWVcort in CKD, with a cutoff point >2.91m/s. Healthy kidneys were non-deformable and 25% had changes in gray scales. There was an increase in wash-in and TPic, changes in filling characteristics, filling failures and difficulty in distinguishing between the Stages in CEUS in CKD. It was found that dogs with CKD 2, 3 and 4 had greater SWVcort and wash-in values than CKD 1. Elastographic and CEUS changes were observed in dogs with CKD, demonstrating the applicability of ultrasonographic techniques in their diagnosis.(AU)
O objetivo deste estudo foi verificar a aplicabilidade da ultrassonografia modo-B, elastografia ARFI e CEUS no diagnóstico da doença renal crônica e seus estágios em cães. Foram incluídos 24 cães saudáveis e 28 com DRC. Pelo modo-B, verificou-se ecogenicidade, ecotextura e relação córtico-medular dos rins. Pela elastografia, foram determinadas as velocidades de cisalhamento das regiões cortical (SWVcort) e medular (SWVmed) e foi avaliada a deformidade tecidual. Calculou-se os temos de wash-in, wash-out e pico de intensidade (TPic) do parênquima renal e avaliou-se homogeneidade, presença de falhas e distinção das fases de preenchimento por contraste por meio de CEUS. Alterações em ecogenicidade, ecotextura e relação córtico-medular foram observadas somente em pacientes doentes. Houve aumento da SWVcort na DRC, com ponto de corte >2.91m/s. Rins saudáveis foram não-deformáveis e 25% apresentou alterações nas escalas de cinza. Houve aumento do wash-in e TPic, alterações nas características de preenchimento, falhas e dificuldade para distinguir as fases de preenchimento do contraste nos rins com DRC. Verificou-se que cães com DRC graus 2, 3 e 4 tiveram valores de SWVcort e wash-in maiores que cães com DRC grau 1. Foram obsrervadas alterações elastográfica e de CEUS em cães com DRC, demonstrando a aplicabilidade destas técnicas ultrassonográficas no seu diagnóstico.(AU)
Subject(s)
Animals , Dogs , Congenital Abnormalities , Ultrasonography , Renal Insufficiency, Chronic , Elasticity Imaging Techniques , Perfusion , KidneyABSTRACT
The testicles are the primary sexual organs of male and their function is to produce sperm and sexual hormones. Disorders of the testicles are common in domestic cats. Therefore, detailed assessment of the testes is of great importance in veterinary medicine. Considering the recent advances in diagnostic imaging in companion animals, this review aims to describe the applicability elastography (qualitative and quantitative), Doppler, contrast-enhanced ultrasonography and B-mode ultrasonography in testes evaluation in cats. B-mode ultrasonography of the testicles combined with haemodynamic analysis in real time by Doppler and contrast enhanced ultrasonography can assist as diagnostic tool in evaluating testicular abnormalities in sick cats. Furthermore, ARFI elastography is a new ultrasound method that evaluates tissue elasticity by elastogram and shear weave. Ultrasonographic study of the testes is a common diagnostic imaging procedure.
Los testículos son los principales órganos sexuales de los machos y su función es producir espermatozoides y hormonas sexuales. Los trastornos de estos órganos son comunes en gatos domésticos. La ultrasonografía convencional, combinada con el análisis hemodinámico en tiempo real por Doppler y ultrasonido contrastado son herramientas diagnósticas importantes para la evaluación de enfermedades testiculares en gatos. Además, La elastografía-ARFI es un método ecográfico actual que evalúa la elasticidad tisular por medio del elastograma y de la velocidad de propagación de las ondas de cizallamiento. El estudio ecográfico de los testículos es un procedimiento de diagnóstico por imágenes común.