Lecture 33

Question 1

Which radiographic imaging procedures are used for the uterus?

Answer 1

*survey radiographs
-right lateral
-VD

*compression studies

Question 2

What are the normal radiographic findings of the non-gravid uterus?

Answer 2

-usually not seen
-may appear as a very thin linear soft tissue opacity between the bladder and descending colon in obese patients

Question 3

What is shown in this image?

Answer 3

normal non-gravid uterus in an intact female dog

Question 4

What is the radiographic finding in the event of an enlarged, non-gravid uterus?

Answer 4

-tubular structure observable in the abdomen
-originates from caudal abdomen between colon and urinary bladder

Question 5

What is the effect of an enlarged uterus on abdominal organ positioning?

Answer 5

-displaces the bowel in a cranial direction
-uterus can herniate in inguinal, perineal, or abdominal wall location

Question 6

What is shown in this image?

Answer 6

lateral horizontal beam showing mineralized fetal skeleton in thorax and abdomen; displaced uterus from previous trauma

Question 7

What are the potential causes of an enlarged uterus?

Answer 7

-pregnancy/post-partum uterine involution
-pyometra/cystic endometrial hyperplasia/metritis
-hydrometra/mucometra
-hemometra
-uterine masses

Question 8

What is the appearance of an abnormal/enlarged uterus?

Answer 8

-tubular structure that may become tortuous
-smooth margins
-can have effacement in case of peritoneal effusion
-often soft tissue opaque
-can have mineralization with feti
-may see gas due to gas-producing bacteria

Question 9

What are the possible causes of abnormal uterine contents on ultrasound?

Answer 9

-pregnancy
-pyometra
-hemometra
-mucometra
-hydrometra
-post-partum uterus

Question 10

How do uterine ultrasound findings vary based on disease processes?

Answer 10

*echogenic fluid:
-pyometra
-hemometra

*anechoic fluid:
-mucometra
-hydrometra

*thickened wall:
-cysts
-polyps

*fluid with unstructured debris:
-post-partum

Question 11

What is shown in this image?

Answer 11

pyometra

Question 12

What is shown in this image?

Answer 12

hydrometra or mucometra

Question 13

What are the possible etiologies of a thickened uterine wall?

Answer 13

-early pregnancy
-post-partum
-endometritis or cystic endometrial hyperplasia
-pyometra/hemometra/mucometra/hydrometra
-neoplasia

Question 14

What are the ultrasound findings in the event of endometritis/cystic endometrial hyperplasia?

Answer 14

-thickened endometrium
-cysts within the wall
-fluid accumulation within lumen

Question 15

What is shown in this image?

Answer 15

cystic endometrial hyperplasia
-can see cyst within uterine wall

Question 16

What are the ultrasound findings in the event of uterine neoplasia?

Answer 16

-nodules or masses
-variable size and shape
-variable echogenicity
-possible fluid accumulation within the lumen

Question 17

What is shown in this image?

Answer 17

uterine mass
-between the plus signs

Question 18

What are the normal radiographic findings in a gravid uterus?

Answer 18

-two uterine horns observable around 30 days gestation in canine; 25-35 days gestation in feline
-diameter of horns increases with pregnancy progression
-spherical to tubular horns
-smooth margins early; difficult to identify later on
-caudal to mid-abdomen positioning
-mineralization of fetal bones around 45 days gestation in dogs; between 36 to 45 days gestation in cats

Question 19

What is shown in these images?

Answer 19

normal gravid uterus in dogs:
-top: 35 days gestation
-bottom: immediately before parturition

Question 20

When can pregnancy be ruled out via ultrasound?

Answer 20

-30 to 33 days post-breeding in dogs
-15 to 20 days post-breeding in cats

Question 21

When can the gestational chamber be identified via ultrasound?

Answer 21

-20 days after LH surge in dogs
-10 days after breeding in cats

Question 22

When can the embryo and heartbeat be detected via ultrasound?

Answer 22

-23 to 25 days after LH surge in dogs
-16 to 18 days after breeding in cats

Question 23

When can fetal skeletons be detected via ultrasound?

Answer 23

-33 to 39 days after LH surge in dogs
-30 to 33 days after breeding in cats

Question 24

What is shown in this image?

Answer 24

normal fetus
-early mineralization of the skull

Question 25

What are the abnormal ultrasound findings seen in the gravid uterus, associated with fetal death?

Answer 25

-intrafetal or perifetal gas -overlap, malalignment, or collapse of fetal skull bones -collapse of fetal skeleton

Question 26

What is shown in this image?

Answer 26

fetal death in a dog -intrauterine gas surrounding fetus -collapsed fetal skeleton with abnormal posture

Question 27

Which ultrasound findings are helpful for identifying fetal distress and death in a mid- to late-term assessment?

Answer 27

*fetal distress: -heart rate less than twice that of maternal HR *fetal death: -absence of heartbeat -absence of fetal movements

Question 28

What are the radiographic signs of pyometra?

Answer 28

-usually bilateral -enlarged soft tissue opaque tubular structures -between urinary bladder and descending colon -displacement of small intestine cranially

Question 29

What is shown in these images?

Answer 29

pyometra

Question 30

What is shown in these images?

Answer 30

pyometra

Question 31

What are the ultrasound findings in the case of pyometra?

Answer 31

-uterus filled with echogenic fluid -thickened uterine wall -cysts and/or polyps within uterine wall

Question 32

How do uterine masses affect other organs in the abdomen?

Answer 32

-displace colon dorsally -displace bladder ventrally

Question 33

Which radiographic views are used to assess the ovaries?

Answer 33

-right lateral -VD

Question 34

What are the characteristics of normal ovaries on radiographs?

Answer 34

too small to be seen

Question 35

What can cause enlarged ovaries?

Answer 35

-ovarian cysts -granulomas -neoplasia -pedicle abscess

Question 36

What is shown in these images?

Answer 36

enlarged ovary -due to ovarian cysts

Question 37

What are the ultrasound findings in cases of cystic ovaries?

Answer 37

-anechoic -well-circumscribed -thin-walled -distal acoustic enhancement -may appear like large follicles or corpora lutea

Question 38

What is shown in these images?

Answer 38

cystic ovaries

Question 39

What are the ultrasound findings in cases of ovarian tumors?

Answer 39

-nodules or masses -variable size -variable echogenicity -possible cysts and/or mineralization

Question 40

Which conditions are commonly seen in addition to ovarian tumors?

Answer 40

-ascites -pyometra -cystic endometrial hyperplasia

Question 41

What is shown in these images?

Answer 41

ovarian mass -between the plus signs