Contrast‐enhanced Ultrasonographic Characteristics of Adrenal Glands in Dogs With Pituitary‐dependent Hyperadrenocorticism

Bargellini, Paolo; Orlandi, Riccardo; Paloni, Chiara; Rubini, Giuseppe; Fonti, Paolo; Peterson, Mark E.; Boiti, Cristiano

doi:10.1111/vru.12018

Cited by 19 publications

(18 citation statements)

References 27 publications

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“…The ultrasound contrast agent employed was the sulphur‐hexafluoride echo‐signal enhancer (SonoVue ® , Bracco Imaging, Milan, Italy). In each dog, a single bolus dose (0.03 ml/kg of body weight) of freshly prepared contrast agent was rapidly infused within 1 to 2 s into the cephalic vein via a 18G catheter, fitted with a three‐way‐valve, and immediately followed by a 2.5 or 5 ml saline flush (0.9% NaCl), depending on dog size . All contrast‐enhanced ultrasound examinations were performed by the same two experienced operators (R.O.…”

Section: Methodsmentioning

confidence: 99%

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Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Bargellini¹,

Orlandi²,

Paloni³

et al. 2018

Vet Radiology Ultrasound

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Gall-bladder diseases are common in dogs and two-dimensional ultrasonography is a current standard method for diagnosis and treatment planning. However, findings from this modality can be nonspecific. The aim of this retrospective, case series study was to describe conventional and contrast-enhanced ultrasound (using SonoVue ) findings in a group of dogs with histologically confirmed gall bladder disease. A total of 65 dogs were included. Branchlike, heterogeneous, and homogeneous contrast enhancement of echogenic intraluminal mass-forming lesions was a contrast-enhanced ultrasound characteristic of polypoid lesions due to cystic mucosal hyperplasia of the gallbladder and/or tumor, which had different wash-in and washout characteristics. In dogs with mobile or immobile biliary sludge or mucocele, the echogenic intraluminal masses remained unenhanced. A double rim mark or enhancement defect in the gallbladder wall was a characteristic of edema or necrosis/rupture of the wall, respectively. Conventional ultrasonography correctly identified biliary sludge or mucocele in 36/37 dogs, cholecystitis/edema in 44/47 dogs, necrosis/rupture in 19/25 dogs, and gallbladder neoplasia in three of three dogs with these pathologies. It falsely identified biliary sludge or mucocele in eight of 28 dogs, cholecystitis/edema in three of 15 dogs, necrosis/rupture in 13/37 dogs, and gall-bladder neoplasia in 20/59 dogs that did not have these pathologies. Contrast-enhanced ultrasound correctly identified cholecystitis/edema in 42/47 dogs, but falsely identified cholecystitis/edema in three of 18 dogs. It correctly identified necrosis/rupture, benign polypoid lesions, and gallbladder neoplasia in all dogs with no false-positive results. Findings supported contrast-enhanced ultrasound as a complement to conventional ultrasonography for dogs with suspected gallbladder pathologies such as edema, necrosis, and rupture.

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Section: Methodsmentioning

confidence: 99%

“…Contrast enhanced ultrasound utilizes gas‐filled microbubbles administered intravenously to obtain real‐time perfusion images of target organs and/or lesions . Recently, we used contrast‐enhanced ultrasound to diagnose gallbladder wall necrosis/rupture in dogs with a sensitivity and specificity of 100% .…”

Section: Introductionmentioning

confidence: 99%

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Bargellini¹,

Orlandi²,

Paloni³

et al. 2018

Vet Radiology Ultrasound

Self Cite

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“…Technique related factors (use of the three-way stopcock, calibre of catheter, contrast medium injection speed and volume of the saline ush) have to be standardised to reduce their in uence on time to peak values [9,23]. The size of the organ and the characteristics of the parenchyma could also in uence the acoustic "strength" of the beam and determine variations in the peak intensity [24].…”

Section: Discussionmentioning

confidence: 99%

Impact of Region- of-interest Size and Location on Quantitative Contrast-enhanced Ultrasound of Canine Splenic Perfusion

Morabito

Pietro

Cicero

et al. 2020

Preprint

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BackgroundDuring the contrast enhanced ultrasound (CEUS) the features of regions of interest (ROI) can affects the value of the perfusion parameters obtained from a time intensity curves (TIC). In veterinary medicine, the influence of ROI size and location during the CEUS exam has been described using the kidney as target organ, with contrasting results. No guidelines have been reported for the ideal placement or size of the ROI during the quantitative analysis of CEUS in canine spleen.The aim of this study was to evaluate the effect of the size and location of ROIs in the spleen of conscious dogs on perfusion variables determined using contrast-enhanced ultrasonography with sulphur hexafluoride. ResultsA prospective, observational study on 15 adult client-owned mixed-breed dogs was performed using a system equipped with contrast-tuned imaging technology. Qualitative and quantitative assessment of the enhancement pattern of the spleen were performed. Three square ROIs (0.05 cm2) were manually drawn in a row and spaced 1mm apart, placing adjacent ROIs at three different depths. Three medium rectangular ROIs (0.3 cm2 ) encompass the 3 smaller ROIs of each row and a single large square ROI (1 cm2) containing all the previous ROIs were drawn. Software analysis of generated time-intensity curves within each ROI allowed to calculate the perfusion parameters: peak enhancement, time to peak, regional blood flow and volume and mean transit time. The coefficient of variation for all parameters was always lowest in the largest ROI in comparison with the other smaller ROIs. The ROI A and B, positioned in proximal and middle levels respectively, showed coefficients of variation similar to the largest ROI. The analysis of variance model showed a significant effect of location and size of ROIs in the quantitative perfusion analysis of the canine spleen, with a reduction of perfusion parameters in the distal ROI.Conclusions The analysis of splenic perfusion through quantitative evaluation of enhancement with a contrast agent into a large enough and proximal to the ultrasound beam area of splenic parenchyma may be of clinical importance in the diagnosis of splenic disorders.

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“…In normal dogs, contrast enhancement distribution in the adrenals is homogeneous and in the washout phase there is a gradual and homogeneous decrease in enhancement [26]. In dogs with PDH, there is a rapid, chaotic, and simultaneous contrast enhancement in both the cortex and medulla [28]. In addition, the peak contrast intensity in both the cortex and the medulla was twice as high in dogs with PDH compared with that of healthy controls.…”

Section: Diagnostic Imaging Of the Pituitary And Adrenal Glandsmentioning

confidence: 94%

“…In hyperplastic adrenal glands the normal shape is preserved and the sonographic appearance is homogeneous [25]. Contrast-enhanced ultrasonography is a relatively new approach in evaluating adrenal glands [26][27][28]. During this procedure, the contrast agent is administered IV and time-intensity curves are generated for the adrenal cortex, adrenal medulla, and ipsilateral renal artery of both adrenal glands.…”

Section: Diagnostic Imaging Of the Pituitary And Adrenal Glandsmentioning

confidence: 99%

Selecting The Best Treatment Option For A Dog With Cushing’S Syndrome

Galac

2015

Acta Veterinaria

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Spontaneous hypercortisolism or Cushing's syndrome is a common endocrinopathy in dogs. Pituitary-dependent and adrenal-dependent hypercortisolism each require specifi c treatment and diagnostic imaging is very helpful in choosing the treatment that is appropriate. The aims and expectations of the treatment need to be established beforehand and discussed with the owner to avoid unexpected disappointments. The clinical signs of pituitary-dependent hypercortisolism caused by a pituitary microadenoma can be managed with the adrenocorticostatic drug trilostane, but the drug will not affect the pituitary tumor. Hypophysectomy is therefore preferred in those dogs that have an enlarged pituitary but are in good clinical condition and have a long life-expectancy. Inoperable pituitary tumors can be treated by radiotherapy. The best treatment in dogs with cortisol-secreting adrenocortical tumors is adrenalectomy. If surgery is not possible, because of vascular invasion or metastatic spread, mitotane is recommended. Treatment with trilostane can be considered but is only palliative: it does not affect the adrenocortical tumor.

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Contrast‐enhanced Ultrasonographic Characteristics of Adrenal Glands in Dogs With Pituitary‐dependent Hyperadrenocorticism

Cited by 19 publications

References 27 publications

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Impact of Region- of-interest Size and Location on Quantitative Contrast-enhanced Ultrasound of Canine Splenic Perfusion

Selecting The Best Treatment Option For A Dog With Cushing’S Syndrome

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