Computed tomographic features of focal lipogranulomatous lymphangitis for differentiating from malignant intestinal lesions in a dog

An eight-year-old Maltese dog presented with diarrhea and anorexia. Ultrasonography revealed marked focal wall thickening with loss of layering in the distal ileum. Contrast-enhanced computed tomography (CT) revealed a preserved wall layer with hypoattenuating middle wall thickening. In some segments of the lesion, small nodules protruding toward the mesentery from the outer layer were observed. Histopathology revealed focal lipogranulomatous lymphangitis (FLL) with lymphangiectasia. This is the first report to describe the CT features of FLL in a dog. CT features of preserved wall layers with hypoattenuating middle wall thickening and small nodules can assist in diagnosing FLL in dogs.

Diagnostic imaging findings of subcutaneous mast cell tumor in a dog

A 5-year-old Labrador Retriever presented with a subcutaneous mass on the right scapular region with localized calor. On magnetic resonance imaging (MRI), a heterogeneously hypointense mass was seen on T1-weighted images (WI) and hyperintense on T2WI and fat-suppressed T2WI with marginal contrast enhancement on postcontrast T1WI and invasion into the surrounding tissue. Histopathological examination of the mass confirmed subcutaneous mast cell tumor (MCT) infiltrating to the adjacent subcutaneous fat. This is the first report to describe the MRI findings of subcutaneous MCT in veterinary medicine. This study suggests that MRI may help evaluate the extent of invasion of subcutaneous MCT.

Echocardiographic features of accessory mitral valve tissue presenting left ventricular outflow tract obstruction in a dog

In a 3-year-old Samoyed, aortic bulging was found on radiography during a general check-up. On echocardiography, turbulent flow was found in left ventricular outflow tract (LVOT) with high velocity (6.1 m/s). A linear structure was attached to the interventricular septum and connected to the chordae tendineae reaching the papillary muscle. A part of the structure moved during cardiac cycle, similar to mitral motion. This dog was diagnosed with LVOT obstruction caused by accessory mitral valve tissue (AMVT). This is the first report of AMVT in veterinary medicine. AMVT should be considered as a possible cause of LVOT obstruction in dogs.

Echocardiographic features of accessory mitral valve tissue presenting left ventricular outflow tract obstruction in a dog

In a 3-year-old Samoyed, aortic bulging was found on radiography during a general check-up. On echocardiography, turbulent flow was found in left ventricular outflow tract (LVOT) with high velocity (6.1 m/s). A linear structure was attached to the interventricular septum and connected to the chordae tendineae reaching the papillary muscle. A part of the structure moved during cardiac cycle, similar to mitral motion. This dog was diagnosed with LVOT obstruction caused by accessory mitral valve tissue (AMVT). This is the first report of AMVT in veterinary medicine. AMVT should be considered as a possible cause of LVOT obstruction in dogs.

Split-bolus CT urography with synchronous nephrographic and excretory phase in dogs: comparison of image quality with three-phase CT urography and optimal allocation ratio of contrast medium

Background@#Computed tomography urography (CTU), based on the excretion of contrast medium after its injection, allows visualization of the renal parenchyma and the renal collecting system. @*Objectives@#To determine the optimal contrast medium dose allocation ratio to apply in split-bolus CTU in dogs. @*Methods@#This prospective, experimental, exploratory study used 8 beagles. In 3-phase CTU, unenhanced-, nephrographic-, and excretory-phase images were obtained with a single injection of 600 mg iodine/kg iohexol. In split-bolus CTU, two different contrast medium allocation ratios (30% and 70% for split CTU 1; 50% and 50% for split CTU 2) were used. Unenhanced phase image and a synchronous nephrographic-excretory phase image were acquired. @*Results@#Although the attenuation of the renal parenchyma was significantly lower when using both split CTUs than the 3-phase CTU, based on qualitative evaluation, the visualization score of the renal parenchyma of split CTU 1 was as high as that of the 3-phase CTU, whereas the split CTU 2 score was significantly lower than those of the two others. Artifacts were not apparent, regardless of CTU protocol. The diameter and opacification of the ureter in both split CTUs were not significantly different from those using 3-phase CTU. @*Conclusions@#Split-bolus CTU with a contrast medium allocation ratio of 30% and 70% is feasible for evaluating the urinary system and allows sufficient enhancement of the renal parenchyma and appropriate distention and opacification of the ureter, with similar image quality to 3-phase CTU in healthy dogs. Split-bolus CTU has the advantages of reducing radiation exposure and the number of CT images needed for interpretation.

Assessment of neovascularization during bone healing using contrast-enhanced ultrasonography in a canine tibial osteotomy model: a preliminary study

Assessment of neovascularization during bone healing using contrast-enhanced ultrasonography in a canine tibial osteotomy model: a preliminary study

Blood perfusion of skeletal muscle and callus was evaluated using contrast-enhanced ultrasonography (CEUS) in a canine osteotomy model to determine the applicability of CEUS in the assessment of neovascularization during fracture healing and to compare the vascular signals on CEUS between external skeletal fixation and cast-applied dogs. In 6 Beagle dogs, a simple transverse osteotomy was performed at the left tibial shaft and external skeletal fixation (n = 3) or a cast (n = 3) was applied. Radiography, power Doppler ultrasonography (power Doppler), and CEUS were performed until complete union was achieved. On CEUS, vascular changes were quantitatively evaluated by measuring peak intensity (PI) and time to PI in the soft tissue and callus and by counting the vascular signals. Vascular signals from the soft tissue were detected on power Doppler and CEUS on day 2. Significantly more vascular signals were detected by CEUS than by power Doppler. On CEUS, PI in the surrounding soft tissue was markedly increased after the fracture line appeared indistinctively changed on radiography in all dogs. In the cast-applied dogs, vascular signals from the periosteal and endosteal callus were detected on CEUS before mineralized callus was observed on radiography. CEUS was useful in assessing the vascularity of soft tissue and callus, particularly in indirect fracture healing, and provided indications of a normally healing fracture.

Assessment of neovascularization during bone healing using contrast-enhanced ultrasonography in a canine tibial osteotomy model: a preliminary study

Blood perfusion of skeletal muscle and callus was evaluated using contrast-enhanced ultrasonography (CEUS) in a canine osteotomy model to determine the applicability of CEUS in the assessment of neovascularization during fracture healing and to compare the vascular signals on CEUS between external skeletal fixation and cast-applied dogs. In 6 Beagle dogs, a simple transverse osteotomy was performed at the left tibial shaft and external skeletal fixation (n = 3) or a cast (n = 3) was applied. Radiography, power Doppler ultrasonography (power Doppler), and CEUS were performed until complete union was achieved. On CEUS, vascular changes were quantitatively evaluated by measuring peak intensity (PI) and time to PI in the soft tissue and callus and by counting the vascular signals. Vascular signals from the soft tissue were detected on power Doppler and CEUS on day 2. Significantly more vascular signals were detected by CEUS than by power Doppler. On CEUS, PI in the surrounding soft tissue was markedly increased after the fracture line appeared indistinctively changed on radiography in all dogs. In the cast-applied dogs, vascular signals from the periosteal and endosteal callus were detected on CEUS before mineralized callus was observed on radiography. CEUS was useful in assessing the vascularity of soft tissue and callus, particularly in indirect fracture healing, and provided indications of a normally healing fracture.

Clinically Occult Diffuse Large B-Cell Lymphoma of the Middle Turbinate Identified Using ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Case Report

We report a case of clinically occult diffuse large B-cell lymphoma (DLBCL) of the middle turbinate (MT) identified by ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in a 71-year-old man along with imaging findings. DLBCL was presented with a hypermetabolic right MT [maximum standardized uptake values (SUV(max)) = 8.8 gm/dL] on ¹⁸F-FDG PET/CT, while rhinologic examination was normal. CT showed nothing but slightly more intense enhancement of the right MT compared with the opposite side. The disease progressed during next 7 months until follow-up CT demonstrated solidly enhancing mass occupying entire right nasal cavity which was intensely hypermetabolic (SUV(max) = 12.8 gm/dL). Surgical biopsy confirmed the diagnosis. Follow-up CT and 18F-FDG PET/CT performed after chemotherapy demonstrated complete resolution of DLBCL of the right nasal cavity including the right MT. This is thought to be the first case report in the literature concerning clinically occult DLBCL presenting as a hypermetabolic MT on ¹⁸F-FDG PET/CT.

Echocardiographic features of indirect Gerbode defect in a cat / 대한수의학회지

This report describes the echocardiographic features of an indirect Gerbode defect in a young cat. Echocardiography revealed high-velocity, turbulent systolic flow directed from left ventricle to right ventricle through a ventricular septal defect. The flow immediately entered the right atrium through a tricuspid septal leaflet. The indirect-type Gerbode defect was confirmed through necropsy. When a high-velocity turbulent flow in the RA without pulmonary hypertension is observed on echocardiography, Gerbode defect should be considered.

A Case Report of Gynecomastia Due to Rosuvastatin

Gynecomastia is a common benign disease characterized by the progressive enlargement of the glandular tissue of the male breast due to an imbalance between the levels of estrogen and androgen in the blood. The etiology may vary and may be physiological, pharmacological, pathological, or even idiopathic. Among men, drug-induced gynecomastia may account for 10% to 20% of cases. The literature contains six case reports of rosuvastatin-induced gynecomastia. Withdrawal of statin or switching to a less potent statin can lead to symptom improvement and avoidance of unnecessary tests and patient anxiety. A 62-year-old male patient developed unilateral gynecomastia after 13 months of rosuvastatin therapy. After switching to a different statin (pravastatin), his symptoms improved within 2 months. Thus, clinicians should be aware of the possibility of occurrence of gynecomastia when statins are prescribed.

Remnant parietal serosa detection in a cat with true diaphragmatic hernia using computed tomography / 대한수의학회지

A 4-year-old cat was referred for a suspected pulmonary mass. True diaphragmatic hernia presence was diagnosed via computed tomography (CT). There was a thin membrane covering the diaphragmatic defect. The membrane was thinner than the diaphragm. After contrast injection, the membrane was less enhanced than that of the normal diaphragm. The membrane was identified as a remnant of the parietal pleura. In addition, contrast-enhanced CT images provided clarity in viewing the herniated liver and falciform fat. A thinner membrane, covering the diaphragmatic defect, and attached to the thicker normal diaphragm, is considered a unique CT feature of true diaphragmatic hernia.

Electromagnetic tracking-based ultrasound/computed tomography fusion imaging in dogs: preliminary application to ocular and periocular regions

In ultrasound/computed tomography (CT) fusion images, ultrasound allows visualization of the target in real time. CT provides a navigation for ultrasound scanning and improves the overview in areas of limited visualization with ultrasound. This study was performed to investigate the feasibility of ultrasound/CT fusion based on an electromagnetic tracking technique using external fiducial markers for canine ocular and periocular regions. In 7 Beagle dogs, contrast-enhanced CT images of the head were obtained with placing external fiducial markers over the frontal region and both sides of the forepaws of the dog. Ultrasonography was performed under a magnetic field by installing a position sensor in the linear probe, without changing the dog's position. The positions of the external fiducial markers were adjusted and matched, based on the CT images. The execution time of co-registration and the distance between the regions of interest and the co-registration points, the frontal bone, cornea, retina, and optic nerve, were estimated. Approximately 60% of external fiducial markers were properly recognized in all dogs. After adjustment, all external fiducial markers were precisely matched. The co-registration execution time was less than 1 min. The distances between the regions of interest and co-registration points were less than 3 mm in all dogs. The electromagnetic tracking technique using external fiducial markers was a simple and applicable method for fusion imaging of a canine head using real-time ultrasonography and CT. This technique can be useful for interventional procedures of retrobulbar and periorbital lesions.

Remnant parietal serosa detection in a cat with true diaphragmatic hernia using computed tomography

A 4-year-old cat was referred for a suspected pulmonary mass. True diaphragmatic hernia presence was diagnosed via computed tomography (CT). There was a thin membrane covering the diaphragmatic defect. The membrane was thinner than the diaphragm. After contrast injection, the membrane was less enhanced than that of the normal diaphragm. The membrane was identified as a remnant of the parietal pleura. In addition, contrast-enhanced CT images provided clarity in viewing the herniated liver and falciform fat. A thinner membrane, covering the diaphragmatic defect, and attached to the thicker normal diaphragm, is considered a unique CT feature of true diaphragmatic hernia.

Variation of canine vertebral bone architecture in computed tomography

Focal vertebral bone density changes were assessed in vertebral computed tomography (CT) images obtained from clinically healthy dogs without diseases that affect bone density. The number, location, and density of lesions were determined. A total of 429 vertebral CT images from 20 dogs were reviewed, and 99 focal vertebral changes were identified in 14 dogs. Focal vertebral bone density changes were mainly found in thoracic vertebrae (29.6%) as hyperattenuating (86.9%) lesions. All focal vertebral changes were observed at the vertebral body, except for a single hyperattenuating change in one thoracic transverse process. Among the hyperattenuating changes, multifocal changes (53.5%) were more common than single changes (46.5%). Most of the hypoattenuating changes were single (92.3%). Eight dogs, 40% of the 20 dogs in the study and 61.6% of the 13 dogs showing focal vertebral changes in the thoracic vertebra, had hyperattenuating changes at the 7th or 8th thoracic vertebra. Our results indicate that focal changes in vertebral bone density are commonly identified on vertebral CT images in healthy dogs, and these changes should be taken into consideration on interpretation of CT images.

Minimally Invasive Mitral Valve Repair in a Woman with Marfan Syndrome and Type B Dissection

We report the case of a patient with mitral regurgitation complicated by type B dissection and Marfan syndrome (MFS) who was managed successfully with minimally invasive mitral valve repair. Without type A aortic dissection or aortic root dilation, MFS patients may develop mitral valve regurgitation, as in this case, and need valve surgery to improve their symptoms and long-term survival. However, it is not clear that a full sternotomy and prophylactic aortic surgery are necessary. Although retrograde perfusion to the dissected aorta is controversial, our approach minimizes the risk of future anticipated aortic surgery in MFS patients.

Minimally Invasive Mitral Valve Repair in a Woman with Marfan Syndrome and Type B Dissection / 대한흉부외과학회지

We report the case of a patient with mitral regurgitation complicated by type B dissection and Marfan syndrome (MFS) who was managed successfully with minimally invasive mitral valve repair. Without type A aortic dissection or aortic root dilation, MFS patients may develop mitral valve regurgitation, as in this case, and need valve surgery to improve their symptoms and long-term survival. However, it is not clear that a full sternotomy and prophylactic aortic surgery are necessary. Although retrograde perfusion to the dissected aorta is controversial, our approach minimizes the risk of future anticipated aortic surgery in MFS patients.

Quantitative evaluation of renal parenchymal perfusion using contrast-enhanced ultrasonography in renal ischemia-reperfusion injury in dogs

This study evaluated whether renal perfusion changes can be noninvasively estimated by using contrast-enhanced ultrasonography (CEUS) in renal ischemia-reperfusion injury and investigated the correlation between renal perfusion measured by CEUS and necrosis and apoptosis of renal tubular epithelial cells. In six dogs with experimentally induced renal ischemia-reperfusion injury, changes in time to peak intensity, peak intensity, and area under the curve were measured on CEUS. Peak intensity and area under the curve of the renal cortex began to decrease on day 1 (about 20% lower than baseline) and reached the lowest levels (about 50% of baseline) on day 4. They then gradually increased until day 10, at which time peak intensity was about 87% and area under the curve was about 95% of baseline; neither fully recovered. Both parameters were strongly correlated with the necrosis scores on histopathologic examination on day 4 (r = −0.810 of peak intensity and r = −0.886 of area under the curve). CEUS allowed quantitative evaluation of perfusion changes in acute renal ischemia-reperfusion injury, and CEUS results were correlated with renal tubular damage on histopathologic examination. Thus, CEUS could be a noninvasive, quantitative diagnostic method for determining progress of renal ischemia-reperfusion injury.

Single-Suture Neochorda-Folding Plasty for Mitral Regurgitation

The single-suture neochorda-folding plasty technique is a modification of existing mitral valve repair techniques. In the authors' experience, its simplicity, reliability, and versatility make it a useful technique for mitral valve repair, especially when a minimally invasive approach is used.

Cervicofacial Actinomycosis with Orbit Involvement

Actinomycosis is caused by filamentous Gram positive anaerobic bacteria from the Actinomycetaceae family, and known as a rare cause of the infection at the eyeball. We report magnetic resonance findings of a 60-year-old Korean man with cervicofacial actinomycosis, including cellulitis in the eye and central nervous system actinomycosis. On orbital magnetic resonance imaging, gadolinium-enhanced T1-weight images showed multiple abnormal enhancing lesions in head and neck including right eye, and some include low signal intensities which considered as abscesses. The lesions was diagnosed as actinomycosis by incisional biopsy, and since then was cured by using antibiotics of penicillin family.