Accuracy of four ultrasonography techniques in predicting histopathological classification of canine mammary carcinomas.

Due to the importance of presurgical, noninvasive, and accurate diagnostic tools in mammary carcinoma characterization, this prospective secondary observational cohort study was designed to evaluate and compare the diagnostic accuracy of B-mode, Doppler, contrast enhancement ultrasonography, or acoustic radiation force impulse-elastography in identifying mammary carcinomas types with high degree of malignancy. A total of 246 mammary carcinomas from 141 female dogs were analyzed using B-mode, Doppler, contrast enhancement ultrasonography, and acoustic radiation force impulse ultrasonography prior to their histopathological classification according to types (simple, complex, or special) and grade (I, II, or III). Qualitative and quantitative variables were compared between carcinoma types and grades by Fisher's or analysis of variance. Diagnostic performance was estimated by receiver-operating characteristic analysis, using histopathological classification as a reference. Deformability (acoustic radiation force impulse) had a diagnostic specificity of 100% and sensitivity of 12% in identifying special carcinomas. A width:length ratio greater than 0.53 can be suggestive of special carcinoma, with 80% sensitivity and 76% specificity. Contrast wash-in and peak enhancement times lower than 7.5 and 13.5 s, respectively, were indicative of complex carcinoma at 62% sensitivity and 60% specificity. Contrast wash-in, peak enhancement, and wash-out times greater than 6.5, 12.5, and 64.5 s, respectively; were indicative of grade II and III carcinoma at 68% sensitivity and 62% specificity. In conclusion, B-mode ultrasonography, contrast enhancement ultrasonography, and acoustic radiation force impulse-elastography enabled the identification of some of the characteristics of high-grade mammary carcinoma types and grades in female dogs with limited accuracy. The findings from this study may contribute to oncology research and clinical management canine patients.

Ultrasonography methods for predicting malignancy in canine mammary tumors.

The aim of this study was to evaluate and compare the efficacy of B-mode, Doppler, contrast-enhanced ultrasonography (CEUS), and Acoustic Radiation Force Impulse (ARFI) elastography in predicting malignancy in canine mammary masses. This was a prospective cohort study from 2014 to 2016, which included 153 bitches with one or more mammary masses. A total of 300 masses were evaluated by ultrasonography (B-mode, Doppler, CEUS, and ARFI) and subsequently classified as benign or malignant by histopathology. Each ultrasound parameters studied were compared between benign and malignant masses by Chi-square or Student tests and differences were considered significant when P < 0.01. For the variables that proved significant differences were estimated the cut-off point, sensitivity, specificity, accuracy, and area under curve (AUC) by receiver-operating characteristic curve (ROC) analysis in a logistic regression model using histopathological classification as reference, to assess and compare diagnostic performance of each technique. Out of 300 mammary masses evaluated 246 were classified as malignant and 54 as benign. B-mode measurements showed sensitivity 67.9%, and specificity 67.6% as malignancy predictors on canine mammary masses; Doppler indexes systolic (>21.2 m/s) and diastolic velocity (>4.8 m/s) sensitivity 79.2% and specificity 70.8%; CEUS wash-out time (<80.5 s) sensitivity 80.2% and specificity 16.7%; and ARFI elastography shear velocity (SWV > 2.57 m/s) sensitivity 94.7% and specificity 97.2% In conclusion B-mode and Doppler ultrasound evaluations may assist in malignancy prediction of canine mammary masses with moderate sensitivity and specificity, already the SWV was an great accurate predictor. Therefore, ARFI elastography exam inclusion in veterinary clinic oncology and research is highly recommended, since it allows fast, non-invasive, and complication-free malignancy prediction of canine mammary masses.

Can maternal-fetal hemodynamics influence prenatal development in dogs?

The goals of this study were to report embryonic and fetal ultrasound changes and compare blood flow of uteroplacental and umbilical arteries of normal and abnormal conceptus. Accordingly, from the day of mating or artificial insemination, all fetuses in 60 pregnancies were evaluated weekly. According to the ultrasound findings, the gestational age was determined and the conceptuses were divided into normal or abnormal (embryonic and fetal abnormalities). The two-dimensional ultrasound assessment consists of measuring and evaluating the echogenicity of conceptus and extra-fetal structures. Doppler velocimetry measured the resistivity index (RI) and pulsatility index (PI) of uteroplacental and umbilical arteries. Two-dimensional and Doppler measurements were expressed as mean and standard deviation. Differences between normal and abnormal groups were subject to Mann-Whitney test (P<0.05). Of 264 fetuses, 15.90% showed embryonic abnormalities (resorption) and 5.68% presented fetal abnormalities (congenital abnormalities, fetal underdevelopment and fetal death). We observed a reduced diameter and abnormalities in the contour of gestational vesicle, lack of viability, increased placental thickness, increased fluid echogenicity and increases in RI and PI of uteroplacental arteries of conceptuses with embryonic resorption between the 2nd and 4th weeks. Fetuses with abnormalities showed changes in the flow of uteroplacental and umbilical arteries prior to visualization of two-dimensional alterations and different vascular behavior according to the classification of the change. Results show that ultrasound is efficient for the detection of embryonic and fetal abnormalities. When combined with Doppler ultrasound, it allows early detection of gestational changes, as well as hemodynamic changes, in conceptuses with abnormalities, which may influence their development.

Transcranial Doppler sonographic findings in granulomatous meningoencephalitis in small breed dogs.

Granulomatous meningoencephalitis (GME) is an acute, progressive, and often fatal inflammatory disease of the central nervous system, affecting mainly small and toy dog breeds. A definitive diagnosis of GME can only be achieved through histopathologic examination of samples collected after death. This retrospective study describes transcranial Doppler ultrasonography (TDS) findings in dogs with confirmed clinical histopathology of GME. Eleven dogs were selected for this study. Sonographic findings in B-mode demonstrated diffuse decreased brain parenchyma echogenicity in 9 dogs, ventriculomegaly in 8 dogs, brain atrophy in 4 dogs, and hyperechoic focal lesions in 6 dogs. Color Doppler imaging revealed more obvious vessels of the arterial circle in 10 dogs. Spectral Doppler examination was performed in 10 dogs to detect the 6 major cerebral arteries of interest. The examination showed normal and high resistive index (RI) values in the outlined arteries. The TDS findings were consistent with pathology found on postmortem examination.

RésuméConstatations échographiques Doppler transcrâniennes pour la méningoencéphalite granulomateuse chez les chiens de petite race. La méningoencéphalite granulomateuse (MEG) est une maladie inflammatoire aiguë, progressive et souvent mortelle du système nerveux central qui touche surtout les chiens de petite race. Un diagnostic définitif de MEG peut seulement être obtenu par un examen histopathologique des échantillons recueillis après la mort. Cette étude rétrospective décrit les constatations d'une échographie Doppler transcrânienne (EDT) chez les chiens avec une histopathologie clinique confirmée de MEG. Onze chiens ont été sélectionnés pour cette étude. Les constatations échographiques en mode-B ont démontré une échogénécité diffuse réduite du parenchyme du cerveau chez 9 chiens, une ventriculomégalie chez 8 chiens, une atrophie du cerveau chez 4 chiens et des lésions focales hyperéchogènes chez 6 chiens. Une imagerie Doppler en couleur a révélé des vaisseaux plus évidents du cercle artériel chez 10 chiens. L'examen spectral Doppler a été réalisé chez 10 chiens pour détecter les 6 artères cérébrales majeures d'intérêt. L'examen a montré des valeurs d'indice de résistivité (IR) normales et hautes dans les artères indiquées. Les constatations de l'EDT étaient conformes à celles de la pathologie trouvées à l'examen postmortem.(Traduit par Isabelle Vallières).

Dopplervelocimetric evaluation of portal vein as a diagnostic tool for portosystemic shunt diagnosis in dogs / Avaliação dopplervelocimétrica da veia porta como ferramenta diagnóstica de shunt portossistêmico em cães

The objective of this research was to verify if the study of portal hemodynamic parameters through duplex Doppler ultrasonography (DUS) is able to help to detect portosystemic shunt (PSS) and the shunted vessel origin. It was detected PSS in 20 dogs by abdominal DUS and confirmed atsurgery or necropsy from March of 2004 until March 2007. Main ultrasonographic findings were: identification of a tortuous vessel shunting portal flow being: portocaval shunt (16/20 or 80%), esplenocaval shunt (2/20 or 10%), gastrocaval shunt (1/20 or 5%), portoazigo shunt (1/2o or 5%); 2) elevated portal flow velocity before shunt (17/20 or 81%), 3) lower portal flow velocity after shunt (17/20 or 81%), 4) turbulence in the caudal vena cava (10/20 or 47,5%) and 5) reduced liver size (15/20 or 71%). The others ultrasonographic findings associated with clinical records were similar to that described in literature. With this work we could conclude that hemodynamicassessment of portal vein with DUS may be a useful tool for PSS diagnosis and to detect the shunted vessel origin.

O objetivo desta pesquisa foi verificar se o estudo dos parâmetros hemodinâmicos, por meio da ultrassonografia duplex Doppler (USD), é capaz de auxiliar na detecção do desvio portossistêmico (DPS) e na origem do vaso desviado. Por meio da USD abdominal, foram detectados, no período de março de 2004 a março de 2007, casos de DPS em 20 cães, os quais foram confirmados pela cirurgia ou necropsia. Os principais achados ultrassonográficos foram: 1) identificação de um vaso tortuoso, desviando o fluxo portal, sendo: desvioportocaval (16/20 ou 80%), desvio esplenocaval (2/20 ou 10%), desvio gastrocaval (1/20 ou 5%), desvio portoázigos (1/20 ou 5%); 2) velocidade de fluxo portal elevada antes do desvio (17/20 ou 81%); 3) velocidade de fluxo portal diminuída após o desvio (17/20 ou 81%); 4) fluxo turbulento na veia cava caudal (10/20 ou 47,5%); e 5) fígado de tamanho diminuído (15/20 ou 71%). Os outros achados ultrassonográficosassociados com dados clínicos foram semelhantes aos descritos na literatura. Com este trabalho, pode-se concluir que a avaliação hemodinâmica da veia portal com USD pode ser uma ferramenta diagnóstica útil na detecção do DPS e naorigem do vaso desviado.

Parâmetros Doppler velocimétricos das artérias renais e da aorta abdominal em gatos da raça persa / Doppler velocimetric parameters of aorta and renal arteries of Persian cats

Foi realizado um estudo prospectivo com 50 unidades renais de gatos adultos jovens da raça persa, as quais foram examinadas ao ultrassom Doppler. Os animais foram selecionados como sadios por meio de exames laboratoriais e de pressão arterial sistólica. Foram mensurados os seguintes parâmetros: a velocidade de pico sistólico máximo (VPS), a velocidade diastólica mínima (VDF) e os índices de resistividade (IR) das artérias renais (AR) e da aorta (AO). Para a AR esquerda, foram obtidos VPS 40,96±9,08cm s-1 e IR 0,55±0,07 e, para a AR direita, VPS 41,39±9,89cm s-1 e IR 0,52±0,07. Não foi observada diferença estatisticamente significante entre os lados. Assim, ao serem consideradas ambas as AR, obteve-se a média de VPS 41,17±9,40cm s-1 e IR 0,53±0,07. A média do diâmetro da AR foi de 0,15±0,02cm. Para a aorta, obteve-se VPS 53,17±13,46cm s-1 e média de diâmetro de 0,38±0,04cm. Correlacionando-se os valores de VPS da AR e da AO, obteve-se um índice mínimo de 0,38 e máximo de 1,52, com média de 0,82±0,30.

Prospective study was made performing Doppler ultrasonographic exams of fifty kidneys belonging to Persian adult cats. The animals were classified as healthy by laboratorial exams and measurement of arterial systolic pressure. Maximal systolic blood flow velocity (VPS), minimal diastolic blood flow velocity (VDF) and resistivity index (IR) of renal arteries (AR) and aorta (AO) of each animal were evaluated. The results are: left renal artery VPS 40.96±9.08cm s-1 and IR 0.55±0.07; right artery VPS 41.39±9.89cm s-1 and IR 0.52±0.07. It was not observed any statistical significant difference among the sides. Considering both renal arteries it was calculated VPS 41.17±9.40cm s-1 and IR 0.53±0.07. Renal arterial diameter was 0.15±0.02cm. The aorta VPS obtained was 53.17±13.46cm s-1 and the diameter was 0.38±0.04cm. Correlation velocities of renal artery and aorta resuled in a relation 0.38 as minimal and 1.52 as maximal, with 0.82±0.30.

Princípios físicos do Doppler em ultra-sonografia: [revisão] / Physical principles of Doppler ultrasonography: [review]

A ultra-sonografia Doppler é um método relativamente recente dentro da rotina veterinária que fornece informações em tempo real da arquitetura vascular e dos aspectos hemodinâmicos dos vasos sanguíneos examinados em diversos órgãos vitais. Pode determinar a presença, a direção e o tipo de fluxo sanguíneo. Esta revisão de literatura compila as informações sobre os princípios físicos da ultra-sonografia Doppler. A ampliação do conhecimento desta tecnologia possibilita a melhor compreensão das aplicações e limitações deste método diagnóstico, que tem se tornado rotina na medicina veterinária de pequenos animais.

Doppler ultrasonography is a relatively new diagnostic tool in veterinary medicine that provides real time details about vascular architecture and hemodynamic aspects of examinated blood vessels in several internal organs. Doppler can identify the presence, direction and type of blood flow. This literature review provides information about the physical principles of Doppler ultrasonography. The enlargement of expertise about this technology lead to a better comprehension of its use and limitations as a diagnostic technique, which already becomes usual in veterinary medicine of small animals.

Morfologia duplex Doppler dos principais vasos sanguíneos abdominais em pequenos animais / Duplex Doppler morphology of major abdominal blood vessels in small animals

A ultra-sonografia duplex Doppler é capaz de fornecer informações anatômicas e hemodinâmicas em tempo real. O conhecimento do espectro Doppler normal de cada vaso sanguíneo é importante na sua identificação, pois cada vaso possui um sinal Doppler específico. Reconhecer as alterações de morfologia do espectro somente é possível mediante o conhecimento das variações na normalidade. O objetivo deste artigo foi revisar as informações publicadas em literatura que descrevem o padrão Doppler normal dos principais vasos sanguíneos abdominais de pequenos animais.

Duplex Doppler ultrasonography is able to provide real time anatomic and hemodynamic information. The complete knowledge of the normal Doppler spectrum of each blood vessel is important to their identification, since each vessel has a specific Doppler sign. Recognizing the changes in the morphology of Doppler spectrum is only possible based on previous knowledge of its variations. This is a literature review about Doppler pattern of the major abdominal blood vessels in small animals.

Ultra-sonografia dúplex-Doppler na avaliação morfológica e hemodinâmica das artérias aorta e mesentérica cranial em cães / Duplex-Doppler ultrasonography for morfologycal and hemodynamic evaluation of aorta and cranial mesenteric arteries in dogs

O conhecimento dos sinais normais ao ultra-som Doppler de cada vaso sanguíneo é fundamental na sua identificação. Existem poucos artigos na literatura veterinária que tratam do aspecto normal dos vasos abdominais nos cães. Com o objetivo de verificar a viabilidade técnica da aplicação do US-Doppler na avaliação da aorta abdominal e da artéria mesentérica cranial; vinte cães normais foram submetidos a este exame sem sedação. Foi descrito e avaliado o padrão de mapeamento dúplex-Doppler colorido destes vasos e os resultados comparados com aqueles descritos em literatura. Embora encontradas algumas limitações técnicas, verificamos que o US-Doppler pode ser aplicado com sucesso como meio não invasivo para a detecção de alterações no fluxo sanguíneo mesentérico em cães sem a necessidade de submete-los a contenção química.

The knowledge of the normal Doppler signs of each blood vessel is important in their identification. There are few reports in veterinary literature that describe the normal aspect of abdominal blood vessels in dogs. The aim of this paper was verify technical viability of US Doppler use to assessment of the abdominal aorta and cranial mesenteric arteries; twenty clinically normal unsedated dogs were examinated. It was described and assessed characteristic duplex color Doppler spectrum of each blood vessel and the results were compared with that found in literature. Although some technical limitations were found, US Doppler could be successfully used as a noninvasive method to detect mesenteric blood flow changes in dogs without chemical contention.

Feocromocitoma em cão: nota prévia / Pheochromocytoma in a dog: short communication

Os feocromocitomas são tumores das células da região medular adrenal, considerados raros, cujo diagnóstico geralmente é feito post mortem. Estes promovem taquicardia, hipertensão e outras manifestações clínicas atribuídas ao aumento da quantidade de catecolaminas circulantes. Este trabalho relata o caso de um cão, SRD), fêmea de 15 anos de idade, atendido no Hospital Veterinário da UniABC, cuja queixa principal era prurido intenso e compulsivo, insônia e perda de peso considerável (12 Kg em menos de 3 meses). Ao exame clínico observouse midriase bilateral, ulcerações cutâneas com exposição de musculatura torácica bilateral. A ultrasonografia revelou a presença de duas formações sólidas ovaladas, de contornos definidos, localizadas próximo a grandes vasos e margem cranial de rim esquerdo, aspecto hipoecogênico heterogêneo com áreas anecogênicas em seu interior, compatível com formação neoplásica em adrenal e provável metástase em linfonodo regional. O eletrocardiograma apresentou onda "t' alternante compatível com aumento das catecolaminas circulantes. Foram removidas duas massas globosas de 2 e 4 cm de diâmetro, que se encontravam localizadas cranialmente ao rim esquerdo, sobre as artérias renal e aorta. Macroscopicamente visualizouse regiões circunscritas de coloração marrom. A pressão arterial média durante a cirurgia foi de 150 mmHg e no momento da laparorrafia caiu para 60 mmHg. Durante a primeira semana pós cirúrgica a proprietária relatou que o cão passou a dormir, ficou mais tranquila e o prurido diminuiu. O diagnóstico de feocromocitoma foi definido com os exames complementares e concluído após a remoção cirúrgica e exame histopatológico.