Secret Papers Flashcards

Question

* How do different anesthetic protocols affect uptake of ¹⁸FDG by the brain in PET/CT imaging? * What is the mechanism by which certain protocols will result in higher OR lower SUV?

Answer 1

* Standard uptake value (SUV) for the **frontal and occipital lobes** was significantly higher than in the **cerebellum and brainstem** in all dogs regardless of protocol * Dogs receiving medetomidine/pentobarbital and medetomidine/tiletamine-zolazepam * Occipital \> temporal, cerebellum * Also had significantly higher **whole brain SUVs** than the propofol/isoflurane group * Propofol and iso are known to depress glucose metabolism * Medetomidine suppresses insulin release --\> hyperglycemia LEE, M.I.N.S.U., KO, J., LEE, A.H.R.A., et al. (2010) EFFECTS OF ANESTHETIC PROTOCOL ON NORMAL CANINE BRAIN UPTAKE OF 18F-FDG ASSESSED BY PET/CT. Veterinary Radiology & Ultrasound 51, 130–135

Answer 2

* Which view was most sensitive for the detection of pulmonary metastatic disease? **RLV** * Which was least sensitive? **VDV** * What was the least sensitive combination of two views? **LLV + VDV** Lang, J., Wortman, J.A., Glickman, L.T., et al. (1986) SENSITIVITY OF RADIOGRAPHIC DETECTION OF LUNG METASTASES IN THE DOG. Veterinary Radiology & Ultrasound 1–5

Answer 3

* Low incidence of T2w-***hyper***intensity of the vertebral body (11%) * This was found in the dogs with a more acute history of spinal pain and ataxia * Almost all of the rest of the dogs in this study had clinical signs for \>3 weeks * This likely reflects acute/recent infection Carrera, I., Sullivan, M., MCCONNELL, F., et al. (2011) MAGNETIC RESONANCE IMAGING FEATURES OF DISCOSPONDYLITIS IN DOGS. Veterinary Radiology & Ultrasound 52, 125–131

Answer 4

* Ratios based on skull type * Brachycephalic dogs: 3.1 * Dolichocephalic dogs: 2.8 * Mesaticephalic dogs: 2.97 * Smaller dogs had larger ratios * NO significant difference based on age or sex Lobacz, M.A., Sullivan, M., Mellor, D., et al. (2012) EFFECT OF BREED, AGE, WEIGHT AND GENDER ON RADIOGRAPHIC RENAL SIZE IN THE DOG. Veterinary Radiology & Ultrasound 53, 437–441

Answer 5

* Solitary mass lesion that could be intra- or extra-axial, and often difficult to definitively determine. Intra-cranial or spinal. * Primarily T2w hyperintense, T1w iso- to hypointense (but also could be anything) * Primarily marked CE with a few that had minimal or no CE * Indistinct margins, mass effect, extensive peri-lesional edema * 2/11 had a dural tail sign * Main differentials: meningioma and glioma * Novel form: bilaterally symmetric T2w-hyperintensity throughout the frontal lobes, caudate nuclei, internal capsule +/- wispy CE. Severe atrophy of affected regions on recheck MRI Bentley, R.T., Heng, H.G., Thompson, C., et al. (2015) MAGNETIC RESONANCE IMAGING FEATURES AND OUTCOME FOR SOLITARY CENTRAL NERVOUS SYSTEM COCCIDIOIDESGRANULOMAS IN 11 DOGS AND CATS. Veterinary Radiology & Ultrasound 56, 520–530 Spoor, E., Stainback, L., Plummer, S., et al. (2019) A novel form of intracranial coccidioidomycosis is present in dogs and exhibits characteristic clinical and magnetic resonance imaging findings. Veterinary Radiology and Ultrasound 60, 47–55

Answer 6

* Delayed time to UES opening (0.3) and closing (0.6) * Time to max pharyngeal contraction and epiglottic reopening are normal Pollard, E. & Marks, L. (1999) Quantitative Videofluoroscopic Evaluation of Pharyngeal.

Answer 7

0.15 +/- 0.3 PCR = #pixels in max constriction frame / #pixels in hold frame

Answer 8

1. Precocious form: reported in Angus calves, quickly fatal 2. Intermediate form: milder signs, begins early in life * Anemia, hepatomegaly, fractures short stature 3. Osteopetrosis with renal tubular acidosis and cerebral calcifications * Not reported in animals 4. Delayed type * May be asymptomatic or may leaf to fractures, bone pain, cranial nerve palsies Hanel, R.M., Graham, J.P., Levy, J.K., et al. (2004) Generalized Osteosclerosis in a Cat. Veterinary Radiology & Ultrasound 45, 318–324

Answer 9

Arrival time: 7 sec TTP: 10 sec Diana, A., Specchi, S., Baron Toaldo, M., et al. (2011) CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SMALL BOWEL IN HEALTHY CATS. Veterinary Radiology & Ultrasound 52, 555–559

Answer 10

Diacylglycerol -- very hydrophobic doi: 10.1111/vru.12100

Answer 11

* (T): Dogs with chronic PVT are more likely to survive than dogs with acute PVT * (T): Multiple sites of thrombosis in addition to the PVT is associated with non-survival * (F): Medical management with antithrombotics and anticoagulants has no significant impact on outcome * **Positively associated with survival** * Which of the following are significantly associated with survival or non-survival? * Glucocorticoid therapy * Neoplasia * **Multiple thrombi -- nonsurvival** * Severe ascites * \>1 thrombotic risk factors * SVT * **SIRS -- nonsurvival** Respess, M., O’Toole, T.E., Taeymans, O., et al. (2012) Portal Vein Thrombosis in 33 Dogs: 1998-2011. Journal of Veterinary Internal Medicine 26, 230–237

Answer 12

* Changes to vital parameters increased or decreased in different animals; the predominant changes are listed below: * Iodinated: * Dogs: decreased HR, increased RR * Cats: decreased HR, RR, MAP * Gd-based: * Dogs: increased HR, RR, MAP * Cats: increased HR, RR, MAP Scarabelli, S., Cripps, P., Rioja, E., et al. (2016) Adverse reactions following administration of contrast media for diagnostic imaging in anaesthetized dogs and cats: a retrospective study. Veterinary Anaesthesia and Analgesia 43, 502–510

Answer 13

CORRECT: Resolution of lesions on STIR images likely represents healing with a transition to chronic tissue remodeling; persistence of changes on T1w images are of unclear significance. * There is a significant association between the resolution of tendon and ligament lesions on **_STIR_** images and a return to soundness. * There is a significant association between the resolution of tendon and ligament **(NOT BONE)** lesions on STIR images and a return to soundness. * **No significant correlation was found between** time to return to work and resolution of STIR lesions at the time of recheck MRI HOLOWINSKI, M., JUDY, C., Saveraid, T., et al. (2010) RESOLUTION OF LESIONS ON STIR IMAGES IS ASSOCIATED WITH IMPROVED LAMENESS STATUS IN HORSES. Veterinary Radiology & Ultrasound 51, 479–484

Answer 14

Persistent left cranial vena cava occurs when the left-sided cranial venous cardinal system fails to evolve into the coronary sinus. Lee, Y., Jung, J., Park, J., et al. (2017) CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Veterinary Radiology & Ultrasound 58, 62–75

Answer 15

Which of the following interactions between x-rays and matter is responsible for almost all scatter production? a. Coherent scattering b. Photoelectric effect **c. Compton scattering** d. Rayleigh scattering At low photon energies, which interaction between x-rays and matter is responsible for enhancing natural tissue contrast? a. Compton scattering **b. Photoelectric absorption** c. Coherent scattering d. Rayleigh scattering Which of the following interactions between x-rays and matter requires a minimum of 1.02MeV to occur? a. Thompson scattering b. Photodisintegration c. Photoelectric effect **d. Pair production** What is the predominant interaction of 120 kV x-rays from a computed tomography scanner with soft tissue? a. Coherent scattering **b. Compton scattering** c. Photoelectric effect d. Pair production

Answer 16

* Cricopharyngeal achalasia * Dorsal pharyngeal wall (DP) contracts to meet the tongue base (TB) but bolus passage is obstructed by hypertrophied cricopharyngeus muscle (black arrows). The luminal diameter of the UES is very narrow (white arrow) * After the swallow is complete, a large amount of barium remains in the oral cavity Pollard, R.E. (2012) Imaging Evaluation of Dogs and Cats with Dysphagia. ISRN Veterinary Science 2012, 1–15

Answer 17

* **Truncation artifact** * Describe what it is and why it happens: * **Line of abnormal signal intensity that occurs parallel to an interface between tissues of markedly different signal intensity.** * Which sequences are susceptible to this artifact? * **All sequences are susceptible** * How do you minimize it? Can you fix it entirely? * **Can't completely eliminated, but can be mimized by:** * **Increasing spatial resolution** * **Pre-reconstruction filters (Hamming, Turkey)** * **Post-processing optimization techniques (Total Variation method)** Gregori, T., Lam, R., Priestnall, S.L., et al. (2016) TRUNCATION ARTIFACT IN MAGNETIC RESONANCE IMAGES OF THE CANINE SPINAL CORD. Veterinary Radiology & Ultrasound 57, 582–586

Answer 18

CN 5, 7, 9, 10, 12

Answer 19

* What are the CT features of acute wooden FB vs. chronic? * **Acute:** gas in soft tissues * **Chronic:** draining tract, fat stranding, periosteal reaction, higher proportion of FB are visible * What determines the appearance of the FB? * Over time, will absorb fluid * Increased attenuation on CT and T2w-signal on MRI * Decreased echogenicity on US * Hard wood more attenuating than soft wood * What is the typical appearance of wood FB on US and MRI? * US: linear echogenic structure with shadowing * MRI: * T1 hypointense to muscle, often appears as a signal void * T2 variable (see above) Lamb, C.R., Pope, E.H.W.W. & Lee, K.C.L.L. (2017) RESULTS OF COMPUTED TOMOGRAPHY IN DOGS WITH SUSPECTED WOODEN FOREIGN BODIES. Veterinary Radiology & Ultrasound 58, 144–150 Ober, C.P., Jones, J.C., Larson, M.M., et al. (2008) Comparison of ultrasound, computed tomography, and magnetic resonance imaging in detection of acute wooden foreign bodies in the canine manus. Veterinary Radiology and Ultrasound 49, 411–418

Answer 20

* Sewing needle moved * Titanium TH implant was better than stainless steel * T2\*-GRE \>\> T1w SE = T2w TSE Sutherland-Smith, J. & Tilley, B. (2012) MAGNETIC RESONANCE IMAGING METALLIC ARTIFACT OF COMMONLY ENCOUNTERED SURGICAL IMPLANTS AND FOREIGN MATERIAL. Veterinary Radiology & Ultrasound 53, 312–317

Answer 21

Normal dog.

Answer 22

* What is the primary location? * **Extradural** -- in the canal, paravertebral, or polyostotic * What are the top differentials for MCT in the spine? * Lymphoma -- probably the most similar * Multiple myeloma (more often lytic) * Histiocytic sarcoma (more often intradural or intramedullary) * Imaging features are highly variable, but what features were more consistent? * STIR hyperintense * Mild CE Moore, T.W., Bentley, R.T., Moore, S.A., et al. (2017) Spinal Mast Cell Tumors in Dogs: Imaging Features and Clinical Outcome of Four Cases. Veterinary Radiology and Ultrasound 58, 44–52

Answer 23

* Subdural: crescent-shaped, can cross suture lines but is limited by falx and tentorium * Epidural: bi-convex (lens-shaped), can cross dural folds but NOT sutures

Answer 24

* What is a territorial infarct? Lacunar infarct? * Territorial: occlusion of one of the main arteries * Lacunar: limited to the vascular territory of an intraparenchymal superficial or deep perforating artery * What is the typical signalment of a dog that might get a territorial infarct vs. lacunar infarct? * Big dogs --\> lacunar * Small dogs --\> territorial * What are the MRI features of an inschemic infarct? * Homogeneous, T2-hyper region with sharp demarcation between affected and non-affected parenchyma * Minimal to no mass effect * Typically confined to gray matter * Faint CE can occur * Reperfusion injury can result in hemorrhage Hecht, S. & Adams, W.H. (2010) MRI of Brain Disease in Veterinary Patients Part 2: Acquired Brain Disorders. Veterinary Clinics of NA: Small Animal Practice 40, 39–63

Answer 25

* What types of neoplasia are associated with orthopedic implants and which is most common? * OSA by far the most common * Histiocytic sarcoma, fibrosarcoma, spindle cell sarcoma * What is the predilection site for implant-associated neoplasia? **Diaphysis** * What was the median time to tumor development after implant placement? **5.5 years** * Prognosis appears to be similar to naturally-occurring disease Burton, A.G., Johnson, E.G., Vernau, W., et al. (2015) Implant-associated neoplasia in dogs: 16 cases (1983–2013). Journal of the American Veterinary Medical Association 247, 778–785

Answer 26

* What was the relationship between GB volume and sludge? * Median GB volume was higher in dogs with more sludge, likely indicating abnormal emptying * What patient-specific factors were correlated with increased volume of sludge? * Increasing age * HAC and hypothyroidism * Hepatobiliary disease * NOT: biochemical factors or BCS Cook, A.K. & Jambhekar, A. V (2016) Gallbladder Sludge in Dogs: Ultrasonographic and Clinical Findings in 200 Patients. Journal of the American Animal Hospital Association 52, 125–131

Answer 27

* What structure is referred to as the dorsal tracheal membrane? **Trachealis muscle** * The DTM comprises a larger percentage of the tracheal circumference in dogs (*with*) tracheal collapse than in dogs (*without*) TC. * What was the proposed explanation for this finding? **Flattening of the tracheal rings likely leads to stretching of the DTM** * Radiographs (*overestimate*) the degree and location of tracheal collapse in comparison to fluoroscopy. * What was the prevalence of invagination of the DTM in dogs with tracheal collapse? **0%** Lindl-Bylicki, B.J., Johnson, L.R. & Pollard, R.E. (2015) COMPARISON OF THE RADIOGRAPHIC AND TRACHEOSCOPIC APPEARANCE OF THE DORSAL TRACHEAL MEMBRANE IN LARGE AND SMALL BREED DOGS. Veterinary Radiology & Ultrasound 56, 602–608

Answer 28

* What are common MRI features? * About half were masses * 8/18 had ascending thickening; most of these extending into the vertebral canal * T2 hyper, T1 iso * Heterogeneous CE * What sequences are recommended? * Dorsal STIR * Trans/sag T2 * Trans T1 pre- and post C+ * Smaller FOV trans of cervical spine to evaluate nerve roots Kraft, S., Ehrhart, E.J., Gall, D., et al. (2007) Magnetic resonance imaging characteristics of peripheral nerve sheath tumors of the canine brachial plexus in 18 dogs. Veterinary Radiology and Ultrasound 48, 1–7

Answer 29

* What level of stiffness was associated with acute, subacute, and chronic lesions? * Acute lesions = softer * Subacute/chronic = stiffer * What is the explanation for the differences in stiffness? * In humans, areas of fiber disruption and hematoma formation are softer * As tensons heal over time, the progressive collagen deposition increases stiffness * Was there a correlation with lesion echogenicity? * Hypoechoic lesions tend to be softer (likely more acute) Lustgarten, M., Redding, W.R., Labens, R., et al. (2015) ELASTOGRAPHIC EVALUATION OF NATURALLY OCCURING TENDON AND LIGAMENT INJURIES OF THE EQUINE DISTAL LIMB. Veterinary Radiology & Ultrasound 56, 670–679

Answer 30

* A radiographically normal prostate gland has been defined as a height less than 70% of the pubic brim–sacral promontory dimension on a lateral view * Neutered = 100% PPV carcinoma * Intact = paraprostatic cyst, BPH, or prostatitis BRADBURY, C.A., WESTROPP, J.L. & Pollard, R.E. (2009) RELATIONSHIP BETWEEN PROSTATOMEGALY, PROSTATIC MINERALIZATION, AND CYTOLOGIC DIAGNOSIS. Veterinary Radiology & Ultrasound 50, 167–171

Answer 31

* Neosporosis: T2 hyperintensity of the vermis and cerebellar hemispheres with mild CE * Toxoplasmosis: Multifocal, indistinct, CE parenchymal lesions, which are iso on T1 and hyper on T2 and have associated edema. Hecht, S. & Adams, W.H. (2010) MRI of Brain Disease in Veterinary Patients Part 2: Acquired Brain Disorders. Veterinary Clinics of NA: Small Animal Practice 40, 39–63

Answer 32

* B -- hyperacute (IB) -- 1 hour post trauma * A -- acute (I/B D) -- 3 days * D -- early subacute (ring B/D) -- 5 days * C -- late subacute/chronic -- 14 days * T1 iso or hypo * T2 center hyper, rim hypo Tamura, S., Tamura, Y., TSUKA, T., et al. (2006) SEQUENTIAL MAGNETIC RESONANCE IMAGING OF AN INTRACRANIAL HEMATOMA IN A DOG. Veterinary Radiology & Ultrasound 47, 142–144

Answer 33

Portocaval shunt

Answer 34

* MPICL and LPICL are most clinically relevant; function: stabilization and prevention of hyperextension * 10-12 ml iohexol diluted 1:1 with saline into the carpal sheath * Contrast within the proximal aspect of the suspensory ligament in all horses Gray, S.N., Puchalski, S.M. & Galuppo, L.D. (2013) COMPUTED TOMOGRAPHIC ARTHROGRAPHY OF THE INTERCARPAL LIGAMENTS OF THE EQUINE CARPUS. Veterinary Radiology & Ultrasound 54, 245–252

Answer 35

1. Rostral cerebral a. 2. Rostral communicating a. 3. Middle cerebral a. 4. Internal carotid a. 5. Caudal communicating a. 6. Caudal cerebral a. 7. Maxillary a. Kang, B.-T., Jang, D.-P., Gu, S.-H., et al. (2009) Three-Dimensional Time-of-Flight Magnetic Resonance Angiography of Intracranial Vessels in a Canine Model of Ischemic Stroke with Permanent Occlusion of the Middle Cerebral Artery. Comparative Medicine 59, 72–77

Answer 36

* Normal dogs: * Pulmonary arteries and veins are similar in size * Cranial lobar vessel diameter smaller than 4th rib (lateral) * Most had caudal lobar veins that were larger than the 9th rib (previous criteria for enlargement) * Proposed new cut-off with better specificity but slightly lower sensitivity than the 1:1 ratio * Right caudal PV \< 1.22x width of 9th rib (VD) * Right caudal pulmonary vein in dogs with MMVD was significantly larger than in normal dogs; the remainder of the pulmonary vessels showed no significant difference Oui, H., Oh, J., Keh, S., et al. (2014) MEASUREMENTS OF THE PULMONARY VASCULATURE ON THORACIC RADIOGRAPHS IN HEALTHY DOGS COMPARED TO DOGS WITH MITRAL REGURGITATION. Veterinary Radiology & Ultrasound 56, 251–256

Answer 37

CN 10 and 12

Answer 38

* Sacral osteochondrosis - lesion in dorsal endplate * ~30% of GSDs with CES have sacral OC * Clinically normal with OC \<18mo * CES with OC \>18mo * Dogs with CES and OC were 2 years younger than CES dogs w/o OC * Males \>\> females Lang, J. & Hani, H. (1992) A SACRAL LESION RESEMBLING OSTEOCHONDROSIS IN THE GERMAN SHEPHERD DOG. Veterinary Radiology & Ultrasound 33, 69–76

Answer 39

* Ratio = A/B (see image) * What value confers a 90% probability of spinal cord compression at that site? **Ratio = 0.4** * At what sites was there a significant difference in measurement between affected and clinically normal dogs? **C5-6 and C6-7** * As the ratio increases, how does the probability of spinal cord compression change? **For every 0.1 incremental increase in ratio, there is a 65% decrease in the odds of spinal cord compression being present at that site** Martin-Vaquero, P. & da Costa, R.C. (2014) EVALUATION OF TRADITIONAL AND NOVEL RADIOGRAPHIC VERTEBRAL RATIOS IN GREAT DANES WITH VERSUS WITHOUT CERVICAL SPONDYLOMYELOPATHY. Veterinary Radiology & Ultrasound 55, 488–495

Answer 40

* Diffuse idiopathic skeletal hyperostosis * Flowing ossifcation along the ventrolateral aspect of at least FOUR vertebral bodies without a bulge at the IVDS * Preservation of IVDS; no signs of IVDD * No fusion of articular processes, joint ankylosis, SI joint erosion, intra-articular osseous fusion * Extra-spinal: calcification of tendons, ligaments, joint capsule * Adjacent segment disease * Vertebral fusion _\>_ 2 consecutive IVDS was correlated with ASD = degeneration of adjacent segment Ortega, M., Gonçalves, R., Haley, A., et al. (2012) SPONDYLOSIS DEFORMANS AND DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS (DISH) RESULTING IN ADJACENT SEGMENT DISEASE. Veterinary Radiology & Ultrasound 53, 128–134

Answer 41

* 50% of horses will have muscle uptake * In 20% of horses it could be mistaken for a tibial lesion * Lasts up to 7 days * Higher dose volume and higher BW--\> increased count density Griffin IV, J.F., Young, B.D., Fosgate, G.T., et al. (2010) FOCAL SKELETAL MUSCLE UPTAKE OF 99mTECHNETIUM-HYDROXYMETHYLENE Diphosphonate FOLLOWING PERONEAL NERVE BLOCKS IN HORSES. Veterinary Radiology & Ultrasound 51, 338–343

Answer 42

* What is the appearance of a patent intracranial aneurysm on MRI or CT? * Flow void on T1/T2 images * Expansile, strongly-enhancing mass along the intracranial cavernous sinus Hecht, S. & Adams, W.H. (2010) MRI of Brain Disease in Veterinary Patients Part 2: Acquired Brain Disorders. Veterinary Clinics of NA: Small Animal Practice 40, 39–63

Answer 43

* What are the common anatomical variants of the spinous process of C7 in horses? * Sharp triangular shape, rounded triangular shape, spur-like shape * What are the common variants of the T1 spinous process? * High and pronounced or short and squat * What variation was seen associated with C6? * Transposition of the ventral aspect onto C7 * Small center of ossification at the caudal limit of the ventral process Santinelli, I., Beccati, F., Arcelli, R., et al. (2015) Anatomical variation of the spinous and transverse processes in the caudal cervical vertebrae and the first thoracic vertebra in horses. Equine Veterinary Journal 48, 45–49

Answer 44

* What is the dose range of ^99mTcO₄^-? * 0.5-2 mCI = 35-75 MBq * How is this procedure performed? * Dose injected into spleen using US-guidance and 22g needle (shielded syringe obvi) * Dynamic frame-mode acquisition initiated after needle placement within the spleen and approximately 2 s prior to injection of 99mTcO4 * Images acquired at a frame rate of 4 fps for 5 min * Stored in 128 x 128 x 16 matrix * How is shunt fraction calculated? * SF = Heart counts / (Heart counts + Liver counts) * Where these counts are summed over 7 sec beginning at first arrival of radionuclide in liver or heart * What is the normal transit time from liver to heart? * 5-10 sec (mean 7 sec) Morandi, F., Cole, R.C., Tobias, K.M., et al. (2005) USE OF 99MTCO TRANS-SPLENIC PORTAL SCINTIGRAPHY FOR DIAGNOSIS OF PORTOSYSTEMIC SHUNTS IN 28 DOGS. Veterinary Radiology & Ultrasound 46, 153–161

Answer 45

Pituitary apoplexy secondary to macroadenoma Beltran, E., Dennis, R., Foote, A., et al. (2012) IMAGING DIAGNOSIS-PITUITARY APOPLEXY IN A CAT. Veterinary Radiology & Ultrasound 53, 417–419

Answer 46

* Which device was associated with more complicatons and what was the proposed cause of this difference? * Automatic biopsy device * No complications with semi-automatic device * Theory: automatic device induced intense vagotonia possibly due to increased force (14 lbf vs. 9 lbf in a different study with no fatalities) * What was the nature of these complications? * Fatal shock reactions: bradycardia, hypotension, hypoventilation * 1/5 of these patients had a necropsy and no hemorrhage was identified Proot, S.J.M. & Rothuizen, J. (2006) High Complication Rate of an Automatic Tru-Cut Biopsy Gun Device for Liver Biopsy in Cats. Journal of Veterinary Internal Medicine 20, 1327–1333

Answer 47

* Why does this occur? * Failure of regression of the right caudal cardinal vein * Describe the course of the ureter; what is the proportion of left vs. right-sided precaval ureters? * Ureter courses medially at the level of L4/5, passing dorsal to the cava, then wraps around the contralateral side of the cava, coursing ventrally back toward its side of origin toward the bladder (reverse J-shape) * Right \>\>\> left-sided * What additional vascular anomaly is sometimes found with the condition? * Double vena cava * What is the clinical significance of this condition? * Increased risk of urinary tract signs * Prevalence = 25% Pey, P., Marcon, O., Drigo, M., et al. (2015) MULTIDETECTOR-ROW COMPUTED TOMOGRAPHIC CHARACTERISTICS OF PRESUMED PREURETERAL VENA CAVA IN CATS. Veterinary Radiology & Ultrasound 56, 359–366

Answer 48

- All parathyroid lesions were round or oval-shaped and hypoechoic to the thyroid parenchyma. Some had distal acoustic enhancement. - Significant difference in size between neoplastic and non-neoplastic nodules. - All neoplastic nodules were _\>_ 4mm in maximum dimension - All but one hyperplastic nodules were \< 4mm -- this larger one was secondary to CKD Wisner, VRU 1997 38(6)

Answer 49

* CT features: * Hypoattenuating to muscle; isoattenuating to soft tissue * Rim enhancement * Pedunculated with a stalk through the auditory tube to the affected bulla * Complete or partial obliteration of bulla lumen with ST attenuating material * Minimal osteolysis; uncommon * Expansion and thickening of the bulla wall * MRLNpathy commonly ipsilateral, can be bilateral * Rim enhancement is positively correlated to inflammation of the superficial stroma and negatively correlated to edema in the superficial stroma Oliveira, C.R., O’Brien, R.T., MATHESON, J.S., et al. (2012) COMPUTED TOMOGRAPHIC FEATURES OF FELINE NASOPHARYNGEAL POLYPS. Veterinary Radiology & Ultrasound 53, 406–411 Lamb, C.R., Sibbing, K. & Priestnall, S.L. (2016) PATHOLOGIC BASIS FOR RIM ENHANCEMENT OBSERVED IN COMPUTED TOMOGRAPHIC IMAGES OF FELINE NASOPHARYNGEAL POLYPS. Veterinary Radiology & Ultrasound 57, 130–136

Answer 50

**Normal:** central vessel --\> radial vessels --\> homogeneous CE with phrenicoabdominal vein visible **Three Abnormal Patterns in PDH:** 1. central vessel --\> disorderly uptake in the entire gland --\> homogeneous CE 2. no central vessel --\> disorderly uptake in the entire gland --\> homogeneous CE 3. abnormal, nodular-appearing vessels --\> progressive nodular appearance --\> homogeneous CE

Answer 51

Small splenic arteries become visible --\> heterogeneous enhancement in the early phase --\> homogeneous at peak CE Rossi, F., Fina, C., Stock, E., et al. (2016) EFFECT OF SEDATION ON CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SPLEEN IN HEALTHY DOGS. Veterinary Radiology & Ultrasound 57, 276–281

Answer 52

- All pancreatic nodules were visible on B-mode ultrasound - CEUS resulted in increased conspicuity of the nodules and better demarcation of their margins. - CE patterns were different in all three nodules (hyperechoic for 5 sec, mildly hyperechoic for 1 sec, hypoechoic for over 30 sec)

Answer 53

# * How did CXR compare to CT for the identification of pulonary nodules (i.e. what % were detected on rads)? * CXR identified 80% of cases with nodules * In which dogs (signalment, disease) were nodules detected only on CT? * Large breed dogs with OSA * (F): Rads have an excellent PPV **AND MODERATE (65-90%)** NPV for pulmonary nodules * Fill in the blank: One third of the pulmonary nodules identified on CT had a SUBPLEURAL distribution. ## Footnote Armbrust, L., Biller, D.S. & Bamford, A. (2012) Comparison of three-view thoracic radiography and computed tomography for detection of pulmonary nodules in dogs with neoplasia. Journal of the American Veterinary Medical Association 240, 1088–1094

Answer 54

* How often is there concurrent/underlying(?) thoracic disease? * D'Anjou et al -- 5/13 dogs had concurrent disease * Immune-mediate pyogranulomatous pleuritis/pericarditis/mediastinitis * Heart base tumor * Malignant histiocytosis of torsed lobe * TVD * Latimer et al * Pneumonia * Bullous emphysema * Maybe bronchial cartilage dysplasia in brachycephalics? * What are the radiographic features of LLT? * Pleural effusion * Mediatinal shift (can go either way) * Increased opacity of lobe, loss of visualization of vasculature (100%) * Vesicular pattern in some dogs vs. uniform alveolar in others * Narrowed +/- displaced bronchus * What are the predilection sites for LLT? * Right middle and left cranial lobes * Predominance of males Latimer, C.R., Lux, C.N., Sutton, J.S., et al. (2017) Lung lobe torsion in seven juvenile dogs. Journal of the American Veterinary Medical Association 251, 1256–1450 D’Anjou, M.-A., Tidwell, A.S. & Hecht, S. (2005) RADIOGRAPHIC DIAGNOSIS OF LUNG LOBE TORSION. Veterinary Radiology & Ultrasound 46, 478–484

Answer 55

C I give up on this paper.

Answer 56

* How does diffusion weighted imaging work? * Diffusion gradient pulse excites --\> second diffusion gradient pulse of equal strenth and duration in opposite direction * For **stationary** water, the second pulse restores original phase of protons --\> coherent signal * For **moving** water, the second pulse cannot restore to the original phase because protons are in a different configuration/location --\> dephased protons lead to loss of signal * What is ADC and how is it calculated? * Quantitative measure of water movement calculated from at least 2 trace-weighted images with different b-values * What is T2 shine through? * Hyperintensities on the trace images due to free water diffusion, which remain hyperintense on the ADC map Sutherland-Smith, J., KING, R., Faissler, D., et al. (2011) MAGNETIC RESONANCE IMAGING APPARENT DIFFUSION COEFFICIENTS FOR HISTOLOGICALLY CONFIRMED INTRACRANIAL LESIONS IN DOGS. Veterinary Radiology & Ultrasound 52, 142–148

Answer 57

No effect of torb Dex causes reduced enhancement, appears diffusely hypoechoic. Measured parameters of time were all delayed (AT, TTP, wash-in) and peak intensity was reduced. Rossi, F., Fina, C., Stock, E., et al. (2016) EFFECT OF SEDATION ON CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SPLEEN IN HEALTHY DOGS. Veterinary Radiology & Ultrasound 57, 276–281

Answer 58

**(Bold = affected by varied stance)** 1. Distal phalanx angle 2. **DIPJ angle** 3. **PIPJ angle** 4. Lateral and medial joint spaces of the DIPJ 5. Lateral and medial joint spaces of the PIPJ 6. **Hoof pastern axis** Pauwels, F.E., Rogers, C.W., Wharton, H., et al. (2017) Radiographic Measurements of Hoof Balance Are Significantly Influenced By a Horse’S Stance. Veterinary Radiology and Ultrasound 58, 10–17

Answer 59

Minimized artifacts with: high frequency image reconstruction algorithm, WIDE window setting, proprietary extended CT scale raw data reconstruction (ECTS) also with extra WIDE window setting Increasing tube voltage and use of beam-hardening reduction (PFO) filter did not significantly reduce metal artifacts

Answer 60

Middle cerebral a. and internal carotid a. (although caption in the paper says internal cerebral a.) with concurrent attenuation of the rostral communicating a. Kang, B.-T., Jang, D.-P., Gu, S.-H., et al. (2009) Three-Dimensional Time-of-Flight Magnetic Resonance Angiography of Intracranial Vessels in a Canine Model of Ischemic Stroke with Permanent Occlusion of the Middle Cerebral Artery. Comparative Medicine 59, 72–77

Answer 61

* Osteochondrosis, most likely in a young GSD. * LS junction most common * CE common GENDRON, K., DOHERR, M.G., Gavin, P., et al. (2012) MAGNETIC RESONANCE IMAGING CHARACTERIZATION OF VERTEBRAL ENDPLATE CHANGES IN THE DOG. Veterinary Radiology & Ultrasound 53, 50–56

Answer 62

Portoazygous shunt

Answer 63

* What are the most common types of oropharyngeal neoplasia? * Malignant melanoma, SCC, FSA * What are the common and uncommon CT features of pharyngeal neoplasia? * Space-occupying masses with irregular shape and ill-defined margins * Moderate to marked CE * Oropharynx \> laryngopharynx \> nasopharynx * Uncommon: osteolysis of adjacent structures, infiltration of vessels, mineralization * What significant findings were reported about lymphadenopathy? (Which LN were affected and at what rate?) * MRLN most commonly abnormal (96%) in size, shape, or abnormal enhancement. * 50% metastatic MRLN Carozzi, G., Zotti, A., Alberti, M., et al. (2015) Computed tomographic features of pharyngeal neoplasia in 25 dogs. Veterinary Radiology and Ultrasound 56, 628–637

Answer 64

* T/S ratio most se/sp * % uptake (TcTU) is most closely associated with serum T4 * Normals: * T/S: up to 1.1 (or 1.5 depending on the study) * TcTU: 0.4% mean (\<1% max) * 7-10 days should be sufficient Peterson, M.E., Guterl, J.N., Rishniw, M., et al. (2016) EVALUATION OF QUANTITATIVE THYROID SCINTIGRAPHY FOR DIAGNOSIS AND STAGING OF DISEASE SEVERITY IN CATS WITH HYPERTHYROIDISM: COMPARISON OF THE PERCENT THYROIDAL UPTAKE OF PERTECHNETATE TO THYROID-TO-SALIVARY RATIO AND THYROID-TO-BACKGROUND RATIOS. Veterinary Radiology & Ultrasound 57, 427–440

Answer 65

* No difference in either the intervertebral or intravertebral ratio between normal vs. affected dogs * In all dogs (normal and CVM), ratios decreased progressively along the cervical spine, being smallest at C6–C7 * Funnel-shaped, caudally tapering cervical vertebral canal da Costa, R.C. & Johnson, J.A. (2012) INTERVERTEBRAL AND INTRAVERTEBRAL RATIOS IN DOBERMAN PINSCHER DOGS WITH CERVICAL SPONDYLOMYELOPATHY. Veterinary Radiology & Ultrasound 53, 518–523

Answer 66

Increases transit time in the cervical esophagus, fewer primary peristaltic waves.

Answer 67

* Most common: mixed pattern, bilateral and symmetrical, multifocal, peripheral and dorsal * Post-obstructive: asymmetric, unilateral, dorsal distribution (did not reach significance) * When unilateral, most often R caudal lung lobe * No features differed between survivors and non-survivors Bouyssou, S., Specchi, S., Desquilbet, L., et al. (2017) RADIOGRAPHIC APPEARANCE OF PRESUMED NONCARDIOGENIC PULMONARY EDEMA AND CORRELATION WITH THE UNDERLYING CAUSE IN DOGS AND CATS. Veterinary Radiology & Ultrasound 58, 259–265

Answer 68

* What radiographic features of feline hip dysplasia are different from dogs? * Remodeling/proliferation of cranial acetabulum * Minimal remodeling of the femoral neck * What are the causes of feline DJD (6)? * Trauma * Hip dysplasia * Primary OA (Scottish Fold OCD, MPS) * Nutritional (Vit. A) * Immune-mediated polyarthropathy (rheumatoid, SLE, periosteal proliferative polyarthritis, idiopathic) * Infectious (mycoplasma, cryptococcosis) LASCELLES, B.D.X. (2010) Feline Degenerative Joint Disease. Veterinary Surgery 39, 2–13

Answer 69

Can be normal, but common abnormalities include gallbladder debris, common bile duct dilation, liver enlargement, hyperechoic liver parenchyma, and an enlarged pancreas. No significant difference, but cats with neutrophilic cholangitis seemed more likely to have changes consistent with pancreatitis. Marolf, A.J., Leach, L., Gibbons, D.S., et al. (2012) Ultrasonographic Findings of Feline Cholangitis. Journal of the American Animal Hospital Association 48, 42–46

Answer 70

* What is the typical appearance of the lateral patellar ligament as it is followed in a transverse plane from the patella to its insertion at \_\_\_\_\_\_? * Inserts on the tibial tuberosity * Bilayered, somewhat indistinct appearance at its origin --\> flat, bilobed appearance over the lateral trochlear ridge --\> flattened oval shape with irregular margins as it crosses the joint --\> flat oval to triangular at insertion * Mixed echogenicity/texture and fiber pattern * Although some symmetry was noted between contralateral ligaments in the same horse, comparison is still recommended since injuries tend to be much more dramatic than normal variation. Gottlieb, R., Whitcomb, M.B., Vaughan, B., et al. (2015) Ultrasonographic appearance of normal and injured lateral patellar ligaments in the equine stifle. Equine Veterinary Journal 48, 299–306

Answer 71

* Sensitivity and specificity of MRA in detection of any type of shunt? * 80% / 100% * How were sensitivity and specificity affected by shunt type (MAPSS vs. single congenital)? * Lower sensitivity for MAPSS than single congenital * Specificity unchanged * How accurate was classification of intra- vs. extra-hepatic PSS? * Misclassified 17% * (TRUE): Origin of shunt was more difficult to identify than insertion * MAPSS weren't actually visible, but were inferred due to microhepatia and diminished PV signal * This is due to too small of a volume of blood flowing through these vessels Seguin, B., Tobias, K.M. & Gavin, P.R. (1999) USE OF MAGNETIC RESONANCE ANGIOGRAPHY FOR DIAGNOSIS OF PORTOSYSTEMIC SHUNTS IN DOGS. Veterinary Radiology & Ultrasound 40, 251–258

Answer 72

Male Di Ianni, F., Volta, A., Pelizzone, I., et al. (2014) DIAGNOSTIC SENSITIVITY OF ULTRASOUND, RADIOGRAPHY AND COMPUTED TOMOGRAPHY FOR GENDER DETERMINATION IN FOUR SPECIES OF LIZARDS. Veterinary Radiology & Ultrasound 56, 40–45

Answer 73

* Q_s/Q_p is a measure of the magnitude of a cardiovascular shunt (systemic flow / pulmonary flow). * Q_s/Q_p = SV_LV / SV _RV * Q_s/Q_p \< 1 is considered insignificant; up to 2 is borderline Lee, Y., Jung, J., Park, J., et al. (2017) CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Veterinary Radiology & Ultrasound 58, 62–75

Answer 74

* What is the best predictor of lesion length? Did it over- or underestimate lesion length? * Intramedullary/endosteal abnormalities were best * Mean overestimation of 1.8% * But did over and underestimate by up to 30% in some patients * What tumor features were poor predictors of length and did they typically over- or underestimate? * Periosteal reaction and CE both overestimated by an average of 9% but went in both directions (under and over) * Tumor necrosis may have contributed as necrotic areas would not enhance, but would add to length of mass -- this may account for some underestimates Karnik, K.S., Samii, V.F., Weisbrode, S.E., et al. (2012) ACCURACY OF COMPUTED TOMOGRAPHY IN DETERMINING LESION SIZE IN CANINE APPENDICULAR OSTEOSARCOMA. Veterinary Radiology & Ultrasound 53, 273–279

Answer 75

* Only 2 of 3 dogs went to surgery, but both had measurements on MRI within 1mm of measured diameter in surgery. Lee, Y., Jung, J., Park, J., et al. (2017) CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Veterinary Radiology & Ultrasound 58, 62–75

Answer 76

* White: Long plantar ligament * Yellow: Lateral digital flexor tendon * Green: Plantar aspect of the tarsal sheath, extending from the calcaneus around the LDFT * Pink: Medial digital flexor tendon Dyson, S., Blunden, A. & Murray, R. (2017) Magnetic Resonance Imaging, Gross Postmortem, and Histological Findings for Soft Tissues of the Plantar Aspect of the Tarsus and Proximal Metatarsal Region in Non-Lame Horses. Veterinary Radiology and Ultrasound 58, 216–227

Answer 77

n the Latimer et al. paper regarding lung lobe torsions in juvenile dogs (\<12 mo), which lung lobes were affected most commonly and in what order? * Left cranial lung lobe * Right middle lung lobe * Right cranial lung lobe This paper consisted of mostly pugs, which are predisposed to L Cr LLT. The two non-pugs in this paper did not have torsions of L Cr. Latimer, C.R., Lux, C.N., Sutton, J.S., et al. (2017) Lung lobe torsion in seven juvenile dogs. Journal of the American Veterinary Medical Association 251, 1256–1450

Answer 78

* Name the numbered structures. * 1. CVC * 2. Aorta * 3. PV * What is indicated by the asterisks? * Portophrenic shunt * What imaging technique was used to obtain these images and what is the advantage of this technique? * CE-MRA -- much faster scan time than TOF-MRA * TOF-MRA allows for selective imaging, however tortuous vessels may lead to signal void Bruehschwein, A., Foltin, I., Flatz, K., et al. (2010) Contrast-enhanced magnetic resonance angiography for diagnosis of portosystemic shunts in 10 dogs. Veterinary Radiology and Ultrasound 51, 116–121

Answer 79

Cats: 7-11 months Dogs: 8-11 months *Source:* Thrall normal variants textbook

Answer 80

* Sequential scan mode for optimal resolution * 300 mAs for reduced noise * 1mm slice thickness for improved longitudinal resolution * 1 sec tube rotation time (just because) * Medium frequency reconstruction algorithm for optimal contrast resolution * Beam hardening correction filter (PFO) Zarelli, M., Schwarz, T., Puggioni, A., et al. (2014) AN OPTIMIZED PROTOCOL FOR MULTISLICE COMPUTED TOMOGRAPHY OF THE CANINE BRAIN. Veterinary Radiology & Ultrasound 55, 387–392

Answer 81

* What was the relative sensitivity and specificity for diagnosis? * SE 85%; SP 96% * How did detection of small colon enteroliths compare to the large colon? * Lower sensitivity * Small colon detection negatively affected by degree of gas distension * In what segment of the colon was the sensitivity highest and for what number of enteroliths? * Transverse colon * 2-5 enteroliths Kelleher, M.E., Puchalski, S.M. & Drake, C. (2014) Use of digital abdominal radiography for the diagnosis of enterolithiasis in equids: 238 cases (2008–2011). Journal of the American Veterinary Medical Association 245, 126–129

Answer 82

Twinkle artifact occurs deep to a strongly reflective surface, appearing as a quickly fluctuating mixture of Doppler signals. This occurs due to a narrow band signal error. Dependent on size and surface texture of a structure, but not mineral composition. Louvet, A. (2006) TWINKLING ARTIFACT IN SMALL ANIMAL COLOR-DOPPLER SONOGRAPHY. Veterinary Radiology & Ultrasound 47, 384–390

Answer 83

* Decreased MST with: * Wall involvement * Heterogeneous echotexture (possible necrosis) * Trigonal location * Very good agreement between US indication of wall involvement and histological findings Hanazono, K., Fukumoto, S., Endo, Y., et al. (2014) ULTRASONOGRAPHIC FINDINGS RELATED TO PROGNOSIS IN CANINE TRANSITIONAL CELL CARCINOMA. Veterinary Radiology & Ultrasound 55, 79–84

Answer 84

- Adenomas, cysts, adenocarcinoma, and nodular hyperplasia were identified. - No sonographic features could be used to differentiate these lesions. Pollard, R.E., Bohannon, L.K. & Feldman, E.C. (2014) PREVALENCE OF INCIDENTAL THYROID NODULES IN ULTRASOUND STUDIES OF DOGS WITH HYPERCALCEMIA (2008-2013). Veterinary Radiology & Ultrasound 56, 63–67

Answer 85

Normal. Pollard, R.E. (2012) Imaging Evaluation of Dogs and Cats with Dysphagia. ISRN Veterinary Science 2012, 1–15

Answer 86

* Dexmedetomidine was associated with a small but significant increase in cardiac silhouette size: * Right lateral (vertebral heart score) * VD/DV (percentage width) * Enlargement may be persistent at a minimum of two hours postdexmedetomidine reversal Zwicker, L.A., Matthews, A.R., Côté, E., et al. (2016) the Effect of Dexmedetomidine on Radiographic Cardiac Silhouette Size in Healthy Cats. Veterinary Radiology & Ultrasound 57, n/a-n/a

Answer 87

Suprahamate process in a cat -- origin of the deltoideus m.

Answer 88

* T/S ratio is the most sensitive * TcTU (% uptake) is most associated with T4 * T/B (axilla, heart, trachea) -- heart has best sensitivity Peterson, M.E., Guterl, J.N., Rishniw, M., et al. (2016) EVALUATION OF QUANTITATIVE THYROID SCINTIGRAPHY FOR DIAGNOSIS AND STAGING OF DISEASE SEVERITY IN CATS WITH HYPERTHYROIDISM: COMPARISON OF THE PERCENT THYROIDAL UPTAKE OF PERTECHNETATE TO THYROID-TO-SALIVARY RATIO AND THYROID-TO-BACKGROUND RATIOS. Veterinary Radiology & Ultrasound 57, 427–440

Answer 89

**EJECTION FRACTION** * DECREASED in all groups compared to normal dogs * Mobile sludge EF \> immobile = mucocele **VOLUME:** INCREASED in all groups compares to normal dogs; largest in mucocele group Tsukagoshi, T., Ohno, K., Tsukamoto, A., et al. (2011) DECREASED GALLBLADDER EMPTYING IN DOGS WITH BILIARY SLUDGE OR GALLBLADDER MUCOCELE. Veterinary Radiology & Ultrasound 53, 84–91

Answer 90

12 hour fast --\> measure GB volume --\> feed a standardized meal +/- administer erythromycin --\> re-measure GB at set time points within 2 hours of meal. Normal EF _\>_ 25% within 2 hours Tsukagoshi, T., Ohno, K., Tsukamoto, A., et al. (2011) DECREASED GALLBLADDER EMPTYING IN DOGS WITH BILIARY SLUDGE OR GALLBLADDER MUCOCELE. Veterinary Radiology & Ultrasound 53, 84–91

Answer 91

* Gestation: 64 d * First detectable mineralization: 26 dpp * Dogs: 20dpp * Skull/ribs: 22 dpp * Scapula/Humerus/Femur/Pelvis/Tibia: 20 dpp * Metacarpals/metatarsals: 8 dpp * Phalanges/teeth: 2 dpp Haney, D.R., Levy, J.K., Newell, S.M., et al. (2003) Use of fetal skeletal mineralization for prediction of parturition date in cats. Journal of the American Veterinary Medical Association 223, 1614–1616

Answer 92

1. Rapid, intense enhancement of the serosa and submucosa 2. Gradual enhancement of the remainder of the wall 3. At peak enhancement, loss of demarcation between wall layers 4. Slow wash-out, with submucosa wash out occurring last Diana, A., Specchi, S., Baron Toaldo, M., et al. (2011) CONTRAST-ENHANCED ULTRASONOGRAPHY OF THE SMALL BOWEL IN HEALTHY CATS. Veterinary Radiology & Ultrasound 52, 555–559

Answer 93

* Causes of pericardial effusion: * Neoplasia (HSA, chemodectoma, mesothelioma) * Idiopathic pericarditis * Congenital pericardial disease * Trauma * Infection * What percentage of masses identified on echo were identified on CT? **100%** * What advantage is conferred by MDCT over echo? * Ability to assess for pulmonary mets or abdominal lesions ## Footnote Scollan, K.F., Bottorff, B., Stieger-Vanegas, S., et al. (2014) Use of Multidetector Computed Tomography in the Assessment of Dogs with Pericardial Effusion. Journal of Veterinary Internal Medicine 29, 79–87

Answer 94

* Good initial opacification, which gradual decreases over time * Normal * Fair/good initial opacification, which persists or increases over time * Contrast reaction -- hypotension, acute tubular obstruction or necrosis, acute renal failure * Poor initial opacification, which persists or decreases over time * Primary renal disease (polyuric RF, glomerular dz) * Insufficient contrast dose * Poor initial opacification, which increases over time * Decreased renal blood flow (pre-existing hypotension, renal ischemia) or decreased urine outlflow (obstruction) * No opacification * Avulsion of the kidney or occlusion of renal artery * Severe chronic hydronephrosis * Neoplasia * End-stage CKD Pugh, C.R., Rhodes, W.H. & Biery, D.N. (1993) Contrast Studies of the Urogenital System. Veterinary Clinics of NA: Small Animal Practice 23, 281–306

Answer 95

* Aortic thromboembolism and ischemic myopathy * MRI features: * Caudal aortic thrombus with visible collateral vessels * Streaky STIR hyperintensity in the muscles of the pelvic limb * Absent CE -- especially pronounced because of surrounding muscle enhancement * Dogs have better collateral circulation, which leads them to present with chronic paresis rather than the acute severe signs cats have BROFMAN, P.J. & Thrall, D.E. (2006) MAGNETIC RESONANCE IMAGING FINDINGS IN A DOG WITH CAUDAL AORTIC THROMBOEMBOLISM AND ISCHEMIC MYOPATHY. Veterinary Radiology & Ultrasound 47, 334–338

Answer 96

* No CT features were significantly associated with malignant masses * What were the common imaging features of most of the hepatic masses in this study? * Heterogeneous compared to normal liver pre-C * Marked, generalized CE in early (portal) phase and delay phase * Describe the typical features of splenic nodular hyperplasia, hematoma, and hemangiosarcoma * Most splenic masses were heterogeneous pre-C * NH + HSA: marked, generalized CE in early phase and delay phase * Hematoma: most had slight CE in early phase, and all had CE in delay phase Jones, I.D., Lamb, C.R., Drees, R., et al. (2016) ASSOCIATIONS BETWEEN DUAL-PHASE COMPUTED TOMOGRAPHY FEATURES AND HISTOPATHOLOGIC DIAGNOSES IN 52 DOGS WITH HEPATIC OR SPLENIC MASSES. Veterinary Radiology & Ultrasound 57, 144–153

Answer 97

* Pyelectasia * Loss of CM distinction * Renomegaly * Renal deformity * Hypoechoic lesions (masses, nodules, indistinct areas) * Hyperechoic lesions less common * Most commonly bilateral Taylor, A.J., Lara-Garcia, A. & Benigni, L. (2014) ULTRASONOGRAPHIC CHARACTERISTICS OF CANINE RENAL LYMPHOMA. Veterinary Radiology & Ultrasound 55, 441–446

Answer 98

* Neuroforaminal area was smallest in an oblique sagittal plane acquired perpendicular to the nerve root when the dog was in a hyperextended position * **Middle zone was smallest in both positions and imaging planes** * ****Exit zone narrower than entry in hyperextension; larger in neutral Zindl, C., Tucker, R.L., Jovanovik, J., et al. (2017) Effects of Image Plane, Patient Positioning, and Foraminal Zone on Magnetic Resonance Imaging Measurements of Canine Lumbosacral Intervertebral Foramina. Veterinary Radiology and Ultrasound 58, 206–215

Answer 99

* How was intra- and inter-operator reproducibility? * Moderate to good * What was the normal appearance of the examined tendons and ligaments of the metacarpus? * All similar, all mostly hard (blue/green), with soft surrounding tissue (yellow/red) * No significant difference between SDFT/DDFT -- can be used as internal reference points for one another. * **However**, both appeared softer in a longitudinal plane. * Suspensory branches softer superficially (abaxially) than deep (abaxially) * What was the effect of weight-bearing vs. non-weight bearing on tendon/ligament stiffness? **No significant effect** Lustgarten, M., Redding, W.R., Labens, R., et al. (2014) ELASTOGRAPHIC CHARACTERISTICS OF THE METACARPAL TENDONS IN HORSES WITHOUT CLINICAL EVIDENCE OF TENDON INJURY. Veterinary Radiology & Ultrasound 55, 92–101

Answer 100

* **Osteopetrosis:** bone disorder that causes increased bone density * Increased medullary opacity and endosteal cortical thickening * CAUSES diffuse osteosclerosis * **Osteosclerosis:** the result of a condition that causes increased bone density WITHOUT change in size * **Hyperostosis:** the result of a condition that causes increased bone density AND increased bone size Fawcett, A., Malik, R., Rolfe Howlett, C., et al. (2014) Polyostotic hyperostosis in a domestic shorthair cat. Journal of Feline Medicine & Surgery 16, 432–440

Answer 101

Prevalence ~4% Typically intra-thoracic (midline mediastinal) -- \>80% Lingual ~10%

Answer 102

* What is the typical signalment of a dog with fatty endplate changes? **Small breed dogs** * What imaging feature(s) helped to differentiate disko and reactive endplate changes? What features were similar? * Paravertebral involvement = disko only * Reduced intervertebral disc space seen in both * What is the predilection site for reactive changes and why are these thought to occur? * LS junction, likely secondary to disc injury/degeneration, which leads to increased loading and shearing forces on the endplates GENDRON, K., DOHERR, M.G., Gavin, P., et al. (2012) MAGNETIC RESONANCE IMAGING CHARACTERIZATION OF VERTEBRAL ENDPLATE CHANGES IN THE DOG. Veterinary Radiology & Ultrasound 53, 50–56

Answer 103

Increasing cortical echogenicity is related to increased concentrations of urinary lipid doi: 10.1111/vru.12100

Answer 104

* How did measurements of tracheal height and width compare between fluoro and CT? * Fluoro underestimated by 0.21 mm compared to CT * (F): Although there was a difference between measurements based on fluoro and CT, there was no significant difference in stent choice. * Larger stents chosen based on CT * (F): Differences in measurements between fluoro and CT led to smaller stent sizes being selected based on CT measurements. * (**T**): Intra- and inter-observer variability was higher with fluoro * Tracheal height was used for selection of stent size Williams, J.M., Krebs, I.A., Riedesel, E.A., et al. (2016) COMPARISON OF FLUOROSCOPY AND COMPUTED TOMOGRAPHY FOR TRACHEAL LUMEN DIAMETER MEASUREMENT AND DETERMINATION OF INTRALUMINAL STENT SIZE IN HEALTHY DOGS. Veterinary Radiology & Ultrasound 57, 269–275

Answer 105

* Rank imaging methods by accuracy * CT + contrast \> RX + contrast \>\> US = CT without contrast * RX without contrast was a no-go * What were the imaging features that allowed sex determination? * RX+C and CT+C: spindle-shaped, contrast-filled structures = hemipenes * CT: smegma was hyperattenuating and allowed recognition of the hemipenes in 2/9 males Di Ianni, F., Volta, A., Pelizzone, I., et al. (2014) DIAGNOSTIC SENSITIVITY OF ULTRASOUND, RADIOGRAPHY AND COMPUTED TOMOGRAPHY FOR GENDER DETERMINATION IN FOUR SPECIES OF LIZARDS. Veterinary Radiology & Ultrasound 56, 40–45

Answer 106

* What is a normal T/S ratio? **0.9 (up to 1.5)** * What is a normal percent dose uptake? **0.2% to 4% depending on the paper**

Answer 107

* (FALSE): Dogs can develop bilateral OR UNILATERAL pyelectasia when receiving IV saline (0.9%). * A pelvic width of **3** **mm** was seen in clinically normal patients that were not on fluids. * What was the maximum pelvic width identified in a patient with pyelonephritis? **12 mm** * What cut-off for pelvic width is 100% predictive of obstruction? **13 mm** D’Anjou, M.A., Bédard, A. & Dunn, M.E. (2011) Clinical Significance Of Renal Pelvic Dilatation On Ultrasound In Dogs And Cats. Veterinary Radiology and Ultrasound 52, 88–94

Answer 108

Multifocal disease, likely secondary to thyroid carcinoma Peterson, M.E. & Broome, M.R. (2015) Thyroid scintigraphy findings in 2096 cats with hyperthyroidism. Veterinary Radiology and Ultrasound 56, 84–95

Answer 109

* Where do these occur and what type of receptor are they associated with? * Bifurcation of the common carotid * Chemoreceptors * What is the most common presenting complaint? * Cervical mass, dyspnea * Less common: Horner's, head tilt, facial nerve paralysis, dysphagia * What is the typical signalment? * Older, MC, Boston Mai, W., Seiler, G.S., Lindl-Bylicki, B.J., et al. (2015) CT AND MRI FEATURES OF CAROTID BODY PARAGANGLIOMAS IN 16 DOGS. Veterinary Radiology & Ultrasound 56, 374–383

Answer 110

* Osteopetrosis * FeLV-induced diffuse osteosclerosis * Hypertrophic osteopathy (paraneoplastic, infectious) * Hypervitaminosis A * Scottish Fold osteochondrodysplasia * Polyostotic hyperostosis Fawcett, A., Malik, R., Rolfe Howlett, C., et al. (2014) Polyostotic hyperostosis in a domestic shorthair cat. Journal of Feline Medicine & Surgery 16, 432–440

Answer 111

* What significant factors were identified that were correlated with recurrence? * Higher pituitary height/brain area ratio (P/B ratio) * Increased UCCR * What significant factors were identified that were correlated with decreased survival time? * Enlarged pituitary gland * Enlarged: pituitary height to brain height ratio (P/B) \> 0.31 van Rijn, S.J., Galac, S., Tryfonidou, M.A., et al. (2016) The Influence of Pituitary Size on Outcome After Transsphenoidal Hypophysectomy in a Large Cohort of Dogs with Pituitary-Dependent Hypercortisolism. Journal of veterinary internal medicine 30, 989–995

Answer 112

* What is the typical sizing criteria for a tracheal stent? * Diameter 10-20% greater than the maximal tracheal diameter during maximal inflation * What type of force is applied by the stent to maintain lumen patency? * Radial force applied to the tracheal wall * What complications can be seen with inappropriate stent size? * Mucosal ischemia * Granuloma formation * Rupture * Migration Williams, J.M., Krebs, I.A., Riedesel, E.A., et al. (2016) COMPARISON OF FLUOROSCOPY AND COMPUTED TOMOGRAPHY FOR TRACHEAL LUMEN DIAMETER MEASUREMENT AND DETERMINATION OF INTRALUMINAL STENT SIZE IN HEALTHY DOGS. Veterinary Radiology & Ultrasound 57, 269–275

Answer 113

* What are the MRI characteristics of an intracranial abscess? * T1 hypo, T2 hyper, strong peripheral CE * Perilesional edema * Meningeal CE * Ruptured abscess has resulted in failure of CSF suppression on FLAIR * What are the MRI features of parasitic meningoencephalitis? * Focal or multifocal parenchymal lesions of variable SI * Parenchymal and meningeal CE * Intraparenchymal hemorrhage with migration Hecht, S. & Adams, W.H. (2010) MRI of Brain Disease in Veterinary Patients Part 2: Acquired Brain Disorders. Veterinary Clinics of NA: Small Animal Practice 40, 39–63

Answer 114

Muscular hypertrophy, muscular shortening, or infiltrative disease not identified on histopath (i.e. not biopsied at the same site as seen on US)

Answer 115

* Most common: mixed pattern, bilateral and symmetrical, multifocal, peripheral and dorsal * Post-obstructive: asymmetric, unilateral, dorsal distribution (did not reach significance) * When unilateral, most often R caudal lung lobe * No features differed between survivors and non-survivors Bouyssou, S., Specchi, S., Desquilbet, L., et al. (2017) RADIOGRAPHIC APPEARANCE OF PRESUMED NONCARDIOGENIC PULMONARY EDEMA AND CORRELATION WITH THE UNDERLYING CAUSE IN DOGS AND CATS. Veterinary Radiology & Ultrasound 58, 259–265

Answer 116

* Flocculation = sedimentation and clumping * Segmentation (see image) = separation and pooling Gomez, J.A. (1974) The Gastrointestinal Contrast Study; methods and interpretation. Veterinary Clinics of NA: Small Animal Practice 4, 805–841

Answer 117

* What are the sonographic features of FGESF? * Focal mass with loss of layering * Mixed echogenicity with hyperechoic regions (likely fibrosis) * Mild regional lymphadenopathy * What is the prognosis with different treatment regimens? * Cats treated with abx or abx + surgery had a significantly shorter survival time than cats treated with steroid and surgery Weissman, A., Penninck, D.G., Webster, C.R.L., et al. (2013) Ultrasonographic and clinicopathological features of feline gastrointestinal eosinophilic sclerosing fibroplasia in four cats. Journal of Feline Medicine & Surgery 1–7

Answer 118

* (TRUE): There is no association between left atrial enlargement and left mainstem bronchial collapse * (FALSE): The most common airways affected by bronchomalacia are in the left cranial, right middle, and LEFT caudal lobes. Singh, M.K., Johnson, L.R., Kittleson, M.D., et al. (2012) Bronchomalacia in Dogs with Myxomatous Mitral Valve Degeneration. Journal of Veterinary Internal Medicine 26, 312–319

Answer 119

* What is the most likely diagnosis in this cat? **Esophageal stricture** * What are some causes of this condition? **Doxycycline, GE reflux, foreign bodies, ingestion of caustic agents** **** Pollard, R.E. (2012) Imaging Evaluation of Dogs and Cats with Dysphagia. ISRN Veterinary Science 2012, 1–15

Answer 120

* What is the suggested significance of near-complete radiographic opacification of the tracheal lumen by a DTM? **Likely represents clinically significant TC** * Almost every dog in this study had dorsal opacification on rads. What was the breakdown of tracheoscopic findings? What is the significance of this finding? * **About 20% of dogs (both large and small breed) had no invagination and no collapse on scope.** * **Thus dorsal opacification may not represent DTM?** * **About 35% of small dogs had TC (no large dogs)** * **Small proportion of dogs had invagination and no collapse** Lindl-Bylicki, B.J., Johnson, L.R. & Pollard, R.E. (2015) COMPARISON OF THE RADIOGRAPHIC AND TRACHEOSCOPIC APPEARANCE OF THE DORSAL TRACHEAL MEMBRANE IN LARGE AND SMALL BREED DOGS. Veterinary Radiology & Ultrasound 56, 602–608

Answer 121

1. Unilateral 2. Bilateral asymmetric 3. Bilateral symmetric 4. Multifocal Peterson, M.E. & Broome, M.R. (2015) Thyroid scintigraphy findings in 2096 cats with hyperthyroidism. Veterinary Radiology and Ultrasound 56, 84–95

Answer 122

1. Retina, choroid, and retrobulbar structures 2. Iris and ciliary body 3. Optic nerve Color Doppler signal intensity was much weaker, especially around the iris and ciliary body

Answer 123

* The highest attenuating hematoma (sentinel clot; HU 45-70) is expected to be close to the site of bleeding. Lower attenuating unclotted blood (HU 20-45) is located farther from the source. * Sentinel clot shouldn't enhance. If there's enhancement, that's a sign of active bleeding. Specchi, S., Auriemma, E., Morabito, S., et al. (2017) EVALUATION OF THE COMPUTED TOMOGRAPHIC “SENTINEL CLOT SIGN” TO IDENTIFY BLEEDING ABDOMINAL ORGANS IN DOGS WITH HEMOABDOMEN. Veterinary Radiology & Ultrasound 58, 18–22

Answer 124

PCR will be similar (0.6) but the *time to UES opening* will be different. Weakness will have normal time to opening (0.1 sec) and dyssynchrony will be delayed (0.3 sec)

Answer 125

* **CT:** * ****Isodense to muscle often extends toward and sometimes invades through the base of the skull or bullae * Fleck of mineral * **MRI:** * ****T2w AND T1 hyper to muscle, some T2\*w hypo foci (hemorrhage) * Strongly, **_hetero_**geneously CE on both * Variable margination * Often entraps and completely compresses external carotid * Sometimes invades jugular, maxillary, and linguofacial veins * Invasion of the basilar portion of the skull with widening of the petro-occipital fissure, bulla lysis, basisphenoid lysis * Effacement of MRLN Mai, W., Seiler, G.S., Lindl-Bylicki, B.J., et al. (2015) CT AND MRI FEATURES OF CAROTID BODY PARAGANGLIOMAS IN 16 DOGS. Veterinary Radiology & Ultrasound 56, 374–383

Answer 126

Focal muscle uptake (and possible myonecrosis) after a peroneal nerve block. Superimposed with tibial diaphysis on the lateral view, but slightly lateral to the tibia on the caudal view. Griffin IV, J.F., Young, B.D., Fosgate, G.T., et al. (2010) FOCAL SKELETAL MUSCLE UPTAKE OF 99mTECHNETIUM-HYDROXYMETHYLENE Diphosphonate FOLLOWING PERONEAL NERVE BLOCKS IN HORSES. Veterinary Radiology & Ultrasound 51, 338–343

Answer 127

* What are the most common radiographic findings? * RMLL mass in the periphery (commonly ventral) * Lymphadenopathy (sternal, TB \>\> cranial mediastinal) * Less common: pulmonary nodules, pleural effusion, interstitial or alveolar pulmonary pattern * What are the most common CT findings? * Non-cavitated, mildly heterogeneously CE mass * Bronchocentric * Poorly marginated TSAI, S., Sutherland-Smith, J., Burgess, K., et al. (2011) IMAGING CHARACTERISTICS OF INTRATHORACIC HISTIOCYTIC SARCOMA IN DOGS. Veterinary Radiology & Ultrasound 53, 21–27

Answer 128

* **Forelimb: no** significant association between IRU and SL desmitis * **Hindlimb:** significant IRU with SL desmitis * In all limbs, IRU was significantly associaed with lameness * **True:** the majority of horses with proximal suspensory desmitis appear normal on bone scan * False: no correlation with radiographic abnormalities * DDX: stress fracture Dyson, S.J., Weekes, J.S. & Murray, R.C. (2007) Scintigraphic evaluation of the proximal metacarpal and metatarsal regions of horses with proximal suspensory desmitis. Veterinary Radiology and Ultrasound 48, 78–85

Answer 129

* Intra-axial: * Focal, T2w hyperintense gray matter lesions primarily in the rostral fossa (*cortical contusions*) * About half voided on T2\* GRE * No CE * About 1/3 of dogs had midline shift +/- herniations * Extra-axial: * Hemorrhage -- subdural \>\> subarachnoid = epidural * Best seen on FLAIR * 50% had fractures of the cranial vault Yanai, H., Tapia-Nieto, R. & Cherubini, G.B. (2015) Results of magnetic resonance imaging performed within 48 hours after head trauma in dogs and association with outcome: 18 cases (2007–2012). Journal of the American Veterinary Medical Association 246, 1222–1229

Answer 130

* Ventriculomegaly (severity correlated to severity of clinical signs) * Compression of brainstem by dilated 4th ventricle * Periventricular FLAIR hyperintensity * Meningeal and ependymal CE * Transtentorial or foramen magnum herniation * Incomplete CSF suppression on FLAIR (less common) * Syringomyelia Crawford, A.H., Stoll, A.L., Sanchez-Masian, D., et al. (2017) Clinicopathologic Features and Magnetic Resonance Imaging Findings in 24 Cats With Histopathologically Confirmed Neurologic Feline Infectious Peritonitis. Journal of Veterinary Internal Medicine 31, 1477–1486

Answer 131

* Hypointense on T1w GRE pre- and post-contrast images (much more hypointense post) * Heterogeneity correlated with increasing grade (hemorrhage or necrosis) * Signal intensity values \<1 -- implies impaired but persistent hepatocyte function * Max hepatic CE (and therefore delineation of the mass) ~ 10 min Constant, C., Hecht, S., Craig, L.E., et al. (2016) GADOXETATE DISODIUM (GD-EOB-DTPA) CONTRAST ENHANCED MAGNETIC RESONANCE IMAGING CHARACTERISTICS OF HEPATOCELLULAR CARCINOMA IN DOGS. Veterinary Radiology & Ultrasound 57, 594–600

Answer 132

The disorderly CE pattern was more pronounced in dogs with higher cortisol levels (\> 24 ug/dl) Bargellini, P., Orlandi, R., Paloni, C., et al. (2013) CONTRAST-ENHANCED ULTRASONOGRAPHIC CHARACTERISTICS OF ADRENAL GLANDS IN DOGS WITH PITUITARY-DEPENDENT HYPERADRENOCORTICISM. Veterinary Radiology & Ultrasound 54, 283–292

Answer 133

* No CT features were significantly associated with malignant masses * What were the common imaging features of most of the hepatic masses in this study? * Heterogeneous compared to normal liver pre-C * Marked, generalized CE in early (portal) phase and delay phase * Describe the typical features of splenic nodular hyperplasia, hematoma, and hemangiosarcoma * Most splenic masses were heterogeneous pre-C * NH + HSA: marked, generalized CE in early phase and delay phase * Hematoma: most had slight CE in early phase, and all had CE in delay phase Jones, I.D., Lamb, C.R., Drees, R., et al. (2016) ASSOCIATIONS BETWEEN DUAL-PHASE COMPUTED TOMOGRAPHY FEATURES AND HISTOPATHOLOGIC DIAGNOSES IN 52 DOGS WITH HEPATIC OR SPLENIC MASSES. Veterinary Radiology & Ultrasound 57, 144–153

Answer 134

Intravenous administration of acepromazine increases peripheral blood ﬂow causing an earlier onset of the vascular phase during the three-phase bone scan; increased count density of vascular phase Acepromazine did not increase the count density of the bone phase scintigrams Solano, M., Welcome, J. & Johnson, K. (2005) EFFECTS OF ACEPROMAZINE ON THREE-PHASE 99mTc-MDP BONE IMAGING IN 11 HORSES. Veterinary Radiology & Ultrasound 46, 437–442

Answer 135

* Which views were best for detecting and grading the severity of pneumothorax? * HB both laterals and VB left lateral * Of these, the right lateral HB was best * Which view(s) had the lowest sensitivity for detection of pneumothorax? * VB VD and DV views * Which view(s) had the lowest sensitivity for grading pneumothorax and pleural effusion? * VB VD and DV views * Which view(s) were best for detecting and grading pleural effusion? * No significant difference between views, however the HB left lateral view had the highest rate detection and severity grade LYNCH, K.C., Oliveira, C.R., MATHESON, J.S., et al. (2011) DETECTION OF PNEUMOTHORAX AND PLEURAL EFFUSION WITH HORIZONTAL BEAM RADIOGRAPHY. Veterinary Radiology & Ultrasound 53, 38–43

Answer 136

* Most common findings: * Hiatal hernia * Esophageal stricture * Esophageal dysmotility (higher percentage of swallows from which no primary peristaltic waves are generated) * No cases of oropharyngeal or cricopharyngeal dysphagia * Cats = dogs (for once) Levine, J.S., Pollard, R.E. & Marks, S.L. (2014) Contrast videofluoroscopic assessment of dysphagic cats. Veterinary Radiology and Ultrasound 55, 465–471

Answer 137

Bilaterally symmetrical T2w-hyperintensities of the lateral geniculate nuclei, caudal colliculi, facial nuclei, medial vestibular nuclei, red nuclei, and cerebellar nodulus LG CC F MV R CN LarGe Crunchy Cats Forcibly Meowing Very Rudely. CAT NO!

Answer 138

Prevalence: 15% of dogs had at least one thyroid nodule Of these nodules, 22% were malignant (adenocarcinoma) Pollard, R.E., Bohannon, L.K. & Feldman, E.C. (2014) PREVALENCE OF INCIDENTAL THYROID NODULES IN ULTRASOUND STUDIES OF DOGS WITH HYPERCALCEMIA (2008-2013). Veterinary Radiology & Ultrasound 56, 63–67

Answer 139

* Dorsal 65 proximal-palmarodistal and a lateral 30 dorsal-mediodistal oblique * Allow the pedal bone and distal sesamoid bone, as well as the distal interphalangeal joint, to be displayed and evaluated in 2 different planes DOI: https://doi.org/10.1016/j.cvfa.2013.11.003

Answer 140

* What dose of contrast/gas/whatever will eliminate bladder wall irregularity that is due to lack of distension? **4 ml/kg** * What are the differentials for attached filling defects in the urinary bladder? Detached? * Attached: clots, neoplasia, polyp, hematoma, ureterocele * Detached: calculi, clots, gas bubbles Pugh, C.R., Rhodes, W.H. & Biery, D.N. (1993) Contrast Studies of the Urogenital System. Veterinary Clinics of NA: Small Animal Practice 23, 281–306

Answer 141

* NLE vs. other: * Cerebral white matter * Brainstem involvement +/- cerebellum * Yorkies * NME: * Pugs, Maltese, Shih Tzus, Lhasa apsos, Chihuahuas * Gray-white matter junction resulting in loss of distinction between the two * Almost always limited to cerebral hemispheres * GME: ocular, focal, or disseminated forms * White matter over gray matter but no specific topography * Non-necrotizing Higginbotham, M.J., Kent, M. & Glass, E.N. (2007) Noninfectious Inflammatory Central Nervous System Diseases in Dogs. Continuing Education Compendium 1–11

Answer 142

* Which types of metal resulted in the largest susceptibiltiy artifact? * Steel \> surgical stainless steel, titanium, and lead * What are the three typical feautures of metallic artifacts? * Geometric distortion * Central area of signal loss * Peripheral, linear, sharply demarcated hyperintense signal Sutherland-Smith, J. & Tilley, B. (2012) MAGNETIC RESONANCE IMAGING METALLIC ARTIFACT OF COMMONLY ENCOUNTERED SURGICAL IMPLANTS AND FOREIGN MATERIAL. Veterinary Radiology & Ultrasound 53, 312–317

Answer 143

* Peristaltic movements of the ureters can be used for ID of this structure. * Ductus deferens is seen dorsomedial to the ureters. * Ampullae are very round and hyperechoic, dorsolateral to ureters. * Seminal vesicles are fluid-filled and dorsal to the urethra. The UVJs are seen as somewhat flattened, oval-shaped structures on the dorsal surface of the bladder. doi: 10.1111/j.1740-8261.2007.00297.x

Answer 144

* Signiﬁcant inﬂuence of head and neck position on pharyngeal diameter, with head position having the major effect; neck position was less important, but still signiﬁcant * Smallest pharyngeal diameter was found at the dorsal, ﬂexed position * Largest diameter at mid-level, extended * At every level, flexion narrowed and extension embiggened CEHAK, A., ROHN, K., BARTON, A.-K., et al. (2010) EFFECT OF HEAD AND NECK POSITION ON PHARYNGEAL DIAMETER IN HORSES. Veterinary Radiology & Ultrasound 51, 491–497

Answer 145

* Vertebral endplate changes at apposed vertebrae * T2w/T1w ***hypo***intense, STIR hyperintense * Erosion * Intervertebral disc changes: * T2w/STIR hyperintense * Distorted shape/narrowed, some protruding/extruding * Contrast enhancement of the vertebral endplates, intervertebral discs and paravertebral soft tissues * Epidural extension of proliferative/inflammatory tissue * Focal \> multifocal * L7-S1 most common * No cervical lesions in this study * Subluxation uncommon Carrera, I., Sullivan, M., MCCONNELL, F., et al. (2011) MAGNETIC RESONANCE IMAGING FEATURES OF DISCOSPONDYLITIS IN DOGS. Veterinary Radiology & Ultrasound 52, 125–131

Answer 146

Portocaval shunt

Answer 147

* Why does this artifact occur? * Magic angle is the condition in which the dipolar interaction between two nuclei becomes zero; this occurs at an angle of 55\* to the main magnetic field * In which sequences is this artifact typically seen? * T1, PD, GRE * Low TE (\<30ms) and high flip angle increase this effect * Which sequence is less susceptible? **T2 (longer TE)** Busoni, V. & Snaps, F. (2002) EFFECT OF DEEP DIGITAL FLEXOR TENDON ORIENTATION ON MAGNETIC RESONANCE IMAGING SIGNAL INTENSITY IN ISOLATED EQUINE LIMBS—THE MAGIC ANGLE EFFECT. Veterinary Radiology & Ultrasound 43, 428–430

Answer 148

Bright blood angiography. Low signal intensity is due to turbulence of the blood flowing through the PDA into the PA Lee, Y., Jung, J., Park, J., et al. (2017) CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Veterinary Radiology & Ultrasound 58, 62–75

Answer 149

* Origin: transverse processes of L2 and L3 * Insertion: lesser trochanter of the femur * Triangular/linear, hyperechoic tendinous insertion * The origin at L2 and the origin of the iliacus portion of the muscle were consistently difficult to image. * What are the clinical signs of injury to the iliopsoas? * Pain upon extension and internal rotation of the hip Cannon, M.S. & Puchalski, S.M. (2008) ULTRASONOGRAPHIC EVALUATION OF NORMAL CANINE ILIOPSOAS MUSCLE. Veterinary Radiology & Ultrasound 49, 378–382

Answer 150

Self-expanding endovascular stents in the cranial vena cava and pulmonary artery. Chylothorax resolved after surgery with post-op survival times of \>6 months. Complications: periprocedural arrhythmia and eventual obstruction of the stent with tumor extension in 1 dog (the other died of GDV) Taylor, S., Rozanski, E.A., Sato, A.F., et al. (2017) Vascular stent placement for palliation of mass-associated chylothorax in two dogs. Journal of the American Veterinary Medical Association 251, 696–701

Answer 151

Muscularis thickening is associated with disease in the mucosa and submucosa Lymphadenopathy is associated with disease in the mucosa and submucosa +/- muscularis Zwingenberger, A.L., Marks, S.L., Baker, T.W., et al. (2010) Ultrasonographic Evaluation of the Muscularis Propria in Cats with Diffuse Small Intestinal Lymphoma or Inflammatory Bowel Disease. Journal of Veterinary Internal Medicine 24, 289–292

Answer 152

* What are the three clinical neurological syndromes that were identified? * Multifocal CNS \> central vestibular \> T3-L3 myelopathy * Describe the pathophysiology of these neurological syndromes. * Pyogranulomatous vasculitis, primarily affecting leptomeninges, ependyma and choroid plexus * What was the prognosis? * Terrible. All cats euthanized within 2 weeks.

Answer 153

* Normal values for swallow studies are measured from what time point? **Closure of the epiglottis** * What is considered normal for each of the following: * UES opening: 0.1 sec * UES closing: 0.25 sec * Epiglottic reopening: 0.3 sec * Maximal pharyngeal contraction: 0.15 sec * There is a significant difference between liquid and kibble, but the numbers are so close to these numbers that there's no way I'm memorizing both! Pollard, R.E. (2012) Imaging Evaluation of Dogs and Cats with Dysphagia. ISRN Veterinary Science 2012, 1–15

Answer 154

* In order of prevalence: * Stifle * Coxofemoral joint * Elbow * Tarsus * Common signs of DJD: * Joint associated mineralizations in the elbow * Dorsal bone proliferation at the tarometatarsal joint * Intra-articular mineral in the stifle (medial compartment) * Osteophytes of the coxofemoral joint * NO effusion or subchondral bone erosions Freire, M., ROBERTSON, I.A.N., BONDELL, H.D., et al. (2011) RADIOGRAPHIC EVALUATION OF FELINE APPENDICULAR DEGENERATIVE JOINT DISEASE VS. MACROSCOPIC APPEARANCE OF ARTICULAR CARTILAGE. Veterinary Radiology & Ultrasound 52, 239–247

Answer 155

* Increased age and TNCC were significantly associated with poorer prognosis * Midline shift, CSF total protein, and weight were _not_ significant * Humans with TBI: midline shift \>0.5 is clinically significant * None of the patients in this study had shift \>0.3 mm Oliphant, B.J., Barnes Heller, H.L. & White, J.M. (2017) Retrospective Study Evaluating Associations Between Midline Brain Shift on Magnetic Resonance Imaging and Survival in Dogs Diagnosed With Meningoencephalitis of Unknown Etiology. Veterinary Radiology and Ultrasound 58, 38–43

Answer 156

1. Medial palmar intercarpal 2. Lateral palmar intercarpal 3. Radiocarpal ligament 4. Lateral collateral branch 5. Transverse intercarpal ligaments 6. Palmar carpometacarpal ligaments Gray, S.N., Puchalski, S.M. & Galuppo, L.D. (2013) COMPUTED TOMOGRAPHIC ARTHROGRAPHY OF THE INTERCARPAL LIGAMENTS OF THE EQUINE CARPUS. Veterinary Radiology & Ultrasound 54, 245–252

Answer 157

1. SDFT 2. Lateral DFT 3. Medial DFT 4. Metatarsocalcaneal ligament 5. Accessory ligament of the suspensory ligament 6. Long plantar ligament 7. Vessel 8. Interosseous ligament between the third tarsal bone and MtIV Arrows point toward the accessory ligament of the DDFT (ALDDFT) Dyson, S., Blunden, A. & Murray, R. (2017) Magnetic Resonance Imaging, Gross Postmortem, and Histological Findings for Soft Tissues of the Plantar Aspect of the Tarsus and Proximal Metatarsal Region in Non-Lame Horses. Veterinary Radiology and Ultrasound 58, 216–227

Answer 158

* What was the typical presenting complaint? * Ventral laryngeal mass, most often asymptomatic * In the patient that underwent thyroid scintigraphy, what findings were described? * Normal thyroids and vague IRU in the region of the larynx * Not helpful for diagnosis * What were the common CT features? * ALL lesions were ventral to the larynx, osteolytic, centered on the basihyoid bone, and had infiltration of the laryngeal wall * Fewer protruded into the lumen * Ovoid, symmetrical, well-defined margins (ventrally) * Highly vascularized capsule with hypoattenuating central areas (colloid) * Vascular invasion (lingual vein) * MRLNpathy - 3/5 metastatic * Foci of mineralization * Two normal thyroid glands are identifiable * What are the main ddx for a mass in the region of the hyoid apparatus? * Soft tissue sarcoma * Primary bone tumor * Primary laryngeal carcinoma Rossi, F., Caleri, E., Bacci, B., et al. (2013) COMPUTED TOMOGRAPHIC FEATURES OF BASIHYOID ECTOPIC THYROID CARCINOMA IN DOGS. Veterinary Radiology & Ultrasound 54, 575–581

Answer 159

* Which was most common? What radiographic features are noteworthy? * SCC most common * Often lytic, may affect multiple digits (either at the time of presentation or later) * What factors had a positive impact on survival time? * Surgical intervention * What factors were related to a decreased survival time? **None!** * What factors were related to a shorter local disease-free or metastasis-free interval? **Stage of tumor** Henry, C.J. & Brewer, W.G. (2005) Canine Digital Tumors: A Veterinary Cooperative Oncology Group Retrospective Study of 64 Dogs. Journal of Veterinary Internal Medicine 19, 720–724

Answer 160

* Extradural ddx: * Bone tumors (OSA, FSA, CSA) * Metastatic carcinoma * Hemangiosarcoma * LSA * Multiple myeloma * Intradural-extramedullary ddx * Meningioma * PNST (can also be intramedullary and extradural) * LSA * Neuroepithelioma (neuroblastoma) * Intramedullary ddx * Glial cell tumors * Ependymoma * Metastatic (HSA, TCC, other) Bagley, R.S. (2010) Spinal Neoplasms in Small Animals. Veterinary Clinics of NA: Small Animal Practice 40, 915–927

Answer 161

* True * Smaller dog, bigger ratio Lobacz, M.A., Sullivan, M., Mellor, D., et al. (2012) EFFECT OF BREED, AGE, WEIGHT AND GENDER ON RADIOGRAPHIC RENAL SIZE IN THE DOG. Veterinary Radiology & Ultrasound 53, 437–441

Answer 162

* Mixed pulmonary patterns (mostly unstructured interstitial and alveolar) * Cranioventral distribution \> diffuse = caudodorsal * Mild pleural effusion in 1/6 dogs * No lymphadenopathy or mediastinal changes Secrest, S.A. & Sharma, A. (2016) THORACIC RADIOGRAPHIC CHARACTERISTICS OF CANINE INFLUENZA VIRUS IN SIX DOGS. Veterinary Radiology & Ultrasound 57, 462–466

Answer 163

* What are the histological layers of the hoof wall from superficial to deep? * Stratum externum, stratum medium, stratum internum, dermis parietis * Which layer(s) make up the bulk of the dorsal hoof wall and how much of the total hoof wall thickness does this represent? * Stratum externum + medium = 65% of total dorsal hoof wall Goulet, C., Olive, J., Rossier, Y., et al. (2015) Radiographic and anatomic characteristics of dorsal hoof wall layers in nonlaminitic horses. Veterinary Radiology and Ultrasound 56, 589–594

Answer 164

* Where did these shunts typically insert? * Insert into the azygous vein in the thorax (T8-T13) * A small number had a left-sided shunt until its insertion in the azygous * From which portal tributaries did these shunts originate? * 90% originate from left gastric vein * Others from right gastric vein, some with caudal splenic loop * Where was maximal shunt diameter? * Abdomen * What additional anomalous vasculature was identified in these dogs? * Azygous continuation of the CVC Or, M., Ishigaki, K., de Rooster, H., et al. (2016) Determination of Porto-Azygos Shunt Anatomy in Dogs by Computed Tomography Angiography. Veterinary Surgery 45, 1005–1012

Answer 165

* Esophageal wall: 5 mm * Cardia wall: 5 mm * Pyloric wall: 4.4 mm * Muscularis layer of the pylorus: 2.5 mm * Length of the proximal duodenal submucosal thickening: 4.7 mm Couturier, L., Rault, D., Gatel, L., et al. (2012) ULTRASONOGRAPHIC CHARACTERIZATION OF THE FELINE CARDIA AND PYLORUS IN 34 HEALTHY CATS AND THREE ABNORMAL CATS. Veterinary Radiology & Ultrasound 53, 342–347

Answer 166

* Inflammatory disease * Normal to rapid GET and SITT * Flocculation, ulceration, ill-defined & smudged appearance * Malabsorption * Usually normal, but anywhere from delayed to rapid GET and SITT * Functional ileus, flocculation, segmentation, fragmentation * Mechanical ileus * Delayed gastric and/or SITT +/- complete stasis * Distension of GIT, dilution of contrast if marked fluid distension * Intussussception: thin rim of contrast around a tubular filling defect * Functional ileus * Delayed transport with patent lumen * Mild distension * Masses * Intra-luminal = filling defects * Mural = luminal narrowing, wall thickening, wall rigidity * Serosal = displacement of bowel without luminal change Gomez, J.A. (1974) The Gastrointestinal Contrast Study; methods and interpretation. Veterinary Clinics of NA: Small Animal Practice 4, 805–841

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