Abdominal Imaging in Small Animals
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Questions and Answers

Which term describes the condition of large intestinal dilation with opaque faecal material?

  • Ocdysis
  • Megacolon
  • Constipation (correct)
  • Stenosis

What should be avoided if there is a risk of perforation or swallowing disorder?

  • Plain radiography
  • Barium sulphate (correct)
  • Water-soluble contrast
  • IV contrast agents

What is a prerequisite action before performing a barium swallow study?

  • Starvation for 12-24 hours (correct)
  • Immediate feeding
  • CT imaging
  • Starvation for 8 hours

Where is barium sulfate typically administered for gastrointestinal contrast studies?

<p>Orally or rectally (B)</p> Signup and view all the answers

What effect does an enlarged prostate have on the large bowel?

<p>Narrowing of the bowel (A)</p> Signup and view all the answers

Which of the following is not an indication for abdominal radiography?

<p>Dental examination (A)</p> Signup and view all the answers

What is the recommended exposure setting for obtaining abdominal radiographs?

<p>Low kV and high mAs (C)</p> Signup and view all the answers

What should be done prior to conducting a urinary study?

<p>Perform an enema (B)</p> Signup and view all the answers

During which phase should the abdominal radiograph be taken to minimize motion blur?

<p>End expiratory phase (A)</p> Signup and view all the answers

Which of the following patient positions is not typically used for standard abdominal radiographic views?

<p>Supine (B)</p> Signup and view all the answers

How many views should ideally be taken of every vomiting animal?

<p>Three views (C)</p> Signup and view all the answers

Which statement about patient preparation is incorrect for conducting an abdominal study?

<p>Dry coat is not crucial for imaging. (A)</p> Signup and view all the answers

What is one way to reduce scatter in abdominal radiography?

<p>Use a grid (B)</p> Signup and view all the answers

What is the primary method used to assess the anatomy of the bladder?

<p>Ultrasound (D)</p> Signup and view all the answers

Which stones are known to be radio-opaque when examining the bladder?

<p>Struvite, Calcium Oxalate, Calcium Phosphate (C)</p> Signup and view all the answers

What should be evaluated in the kidneys when performing a radiographic analysis?

<p>Opacity and shape (B)</p> Signup and view all the answers

What condition is characterized by generalized hepatomegaly and is often diagnosed via ultrasound-guided FNA?

<p>Neoplasia (A)</p> Signup and view all the answers

What can artificially prolong gastric emptying in animals?

<p>Stress (D)</p> Signup and view all the answers

In the case of a portosystemic shunt, what notable radiographic finding is observed?

<p>Microhepatica (C)</p> Signup and view all the answers

What is a common cause of haemoabdomen regarding the spleen and liver?

<p>Loss of serosal detail (D)</p> Signup and view all the answers

Which imaging technique is required to visualize the ureters and urethra?

<p>Contrast study (C)</p> Signup and view all the answers

What is the primary preparation required before conducting a double contrast cystogram?

<p>Enema essential (C)</p> Signup and view all the answers

Which contrast medium is classified as a positive contrast for urinary tract studies?

<p>Water soluble iodinated contrast material (A)</p> Signup and view all the answers

What is a critical step prior to exposure during a retrograde urethrogram?

<p>Occluding the urethra around the catheter (C)</p> Signup and view all the answers

What indicates a requirement for a retrograde vagino-urethrogram?

<p>Anatomical abnormalities (A)</p> Signup and view all the answers

In a double contrast cystogram, after filling the bladder with gas, what is the next step before exposure?

<p>Palpate the bladder for fullness (B)</p> Signup and view all the answers

What does an enlargement of the spleen indicate when interpreting an abdominal radiograph?

<p>Pathological enlargement potentially due to disease (B)</p> Signup and view all the answers

When considering opacity in abdominal imaging, what is a common cause of abnormal mineralisation?

<p>Presence of foreign bodies (B)</p> Signup and view all the answers

What does loss of serosal detail in an abdominal radiograph typically indicate?

<p>Presence of free abdominal fluid (C)</p> Signup and view all the answers

Which part of the gastrointestinal tract is located cranially in the abdomen and caudally to the liver?

<p>Stomach (D)</p> Signup and view all the answers

What can free abdominal gas in the abdomen indicate in the context of gastrointestinal health?

<p>Gastrointestinal perforation (C)</p> Signup and view all the answers

What is the definition of ileus in the gastrointestinal tract?

<p>An abnormal increase in diameter of the small intestine (D)</p> Signup and view all the answers

Which measurement indicates an abnormal dilation of the small intestine?

<p>Greater than 1.6 times the height of lumbar vertebrae L5 (B)</p> Signup and view all the answers

What is one of the potential causes of obstructive ileus?

<p>Neoplasia (C)</p> Signup and view all the answers

What does the 'gravel sign' on a radiograph indicate?

<p>Partial obstruction of the intestine (B)</p> Signup and view all the answers

What characteristic is typically associated with intussusception in younger animals?

<p>Worm infestations (A)</p> Signup and view all the answers

How is intussusception commonly diagnosed?

<p>Ultrasound (A)</p> Signup and view all the answers

What condition can lead to functional ileus?

<p>Hypokalaemia (C)</p> Signup and view all the answers

What specific anatomical site is commonly affected by intussusception?

<p>Ileocolic junction (B)</p> Signup and view all the answers

Flashcards

Size on abdominal radiograph

The size of an organ can indicate pathology. Compare the size to other structures or fixed landmarks.

Shape on abdominal radiograph

Abdominal radiographs can show abnormal shapes due to physiological or pathological reasons.

Number on abdominal radiograph

The presence or absence of an organ can indicate displacement. Look for the organ's normal location.

Opacity on abdominal radiograph

Abnormal mineralisation or metallic opacity can indicate foreign bodies or calculi.

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Margination on abdominal radiograph

Loss of serosal detail suggests free abdominal fluid. Young and emaciated animals naturally have poorer serosal detail.

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Ventrodorsal (VD) view

Radiographic views where the X-ray beam passes through the animal from the ventral side (belly) to the dorsal side (back).

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Right Lateral (RL) view

Radiographic views where the X-ray beam passes through the animal from the right side to the left side.

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Left Lateral (LL) view

Radiographic views where the X-ray beam passes through the animal from the left side to the right side.

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Contrast Radiography

A radiographic procedure that uses a contrast agent to enhance the visibility of internal structures. It's often used for examining the gastrointestinal tract and urinary system.

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Decubitus Lateral

A type of radiographic view where the patient is positioned on their side, allowing visualization of specific areas of the abdomen, often used to diagnose abdominal distention.

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Dorsoventral (DV) view

A radiographic view where the X-ray beam passes from the dorsal side (back) to the ventral side (belly), often used for examining the chest, but not as commonly used for the abdomen.

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Grid Technique

A radiographic technique where the X-ray exposure is adjusted to minimize the amount of scatter radiation, resulting in a clearer image.

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Use of a Grid

A type of radiographic imaging that uses a specialized device called a grid to absorb scattered x-rays, resulting in a higher-quality image with less blurring.

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Large Intestine Appearance on Radiographs

The large intestine's appearance is relatively constant on radiographs, often filled with varying amounts of heterogeneous fecal material.

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Constipation on Radiographs

Constipation results in large intestinal dilation and opaque fecal material, sometimes visible as megacolon. It can be caused by bone ingestion.

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Large Intestine Displacement

Enlargements in the abdomen can displace the large intestine. Ventral displacement can be caused by an enlarged kidney, sub-lumbar lymph node, or retroperitoneal space. Dorsal displacement can be caused by an enlarged prostate, uterus, or bladder.

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Barium Sulphate for GI Studies

Barium sulfate is a positive contrast agent used for gastrointestinal studies. It is given orally or rectally, is palatable, coats the mucosa well, and is contraindicated in cases of perforation or swallowing disorders.

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Barium Swallow Procedure

Performing a barium swallow involves starving the animal for 12-24 hours and giving barium sulfate as a liquid through a stomach tube. Lateral and VD views are taken immediately, including the thorax to visualize the esophagus. Luminal filling defects can be identified.

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Double contrast cystogram

A contrast study that uses both positive and negative contrast media to visualize the bladder. Positive contrast highlights the bladder lumen, while negative contrast outlines the bladder wall.

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Retrograde Urethrogram

A contrast study that uses positive contrast media injected into the urethra to visualize its anatomy. It's helpful for identifying narrowing, blockage, or other abnormalities.

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Retrograde Vagino-urethrogram

Similar to a retrograde urethrogram, but also includes contrast injected into the vagina. This allows for evaluation of both female reproductive and urinary tracts.

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Contrast Study in Urinary Tract Imaging

Contrast media is used to highlight internal structures, such as the bladder and urethra, during X-ray imaging.

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Positive Contrast Media

A type of contrast media that absorbs X-rays, making the structures they fill appear white on the image.

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What is ileus?

The inability of food to move through the digestive tract. Characterized by an enlarged small intestine with fluid, gas, or a mix of both.

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What is obstructive ileus?

A type of ileus caused by a physical blockage, like a foreign object, tumor, or a section of the intestine folding in on itself.

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What is functional (paralytic) ileus?

A type of ileus caused by the digestive muscles not working properly, like when the body is low on potassium or there's inflammation in the gut.

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How is ileus diagnosed on radiograph?

An enlargement of the small intestine measuring more than 1.6 times the height of the lumbar vertebrae (L5). Suggests ileus.

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How can foreign bodies in the gut be identified on radiograph?

A foreign object in the gut that can be seen on a plain radiograph, especially if it's metallic or mineralized.

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What is the gravel sign?

A sign of partial intestinal obstruction by a foreign body, where small particles of the object are visible.

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What is 'positional radiography?'

Taking multiple radiographs of the abdomen at different angles to move gas and fluid in the intestines, aiding in diagnosis.

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What is intussusception?

A type of ileus where a section of intestine folds into itself, like a telescope. Often seen in younger animals and can be associated with tumors in older animals.

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What is the location of a filling defect along the greater curvature of the stomach?

The greater curvature of the stomach is the outer curve of the stomach. It is a common location for filling defects, which are areas of the stomach that do not fill with barium. This can be due to a variety of reasons, such as tumors, ulcers, or polyps.

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What is the normal kidney size in dogs and cats on a VD view?

The upper limit of normal size is 2.5 -3.5 x L2 for dogs and 2.4 – 3.0 x L2 for cats on a VD view radiograph, where L2 is the vertebral body at the level of the second lumbar vertebrae.

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What happens to the colon if the kidney is enlarged?

The kidney is located in the retroperitoneal space, which is the space behind the peritoneum. The kidney is essentially fixed in this space. However, if the kidney is enlarged, it can displace the colon ventrally, meaning that the colon is pushed towards the belly.

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What types of stones are radio-opaque?

Struvite, Calcium Oxalate and Calcium Phosphate stones are all radio-opaque. Radio-opaque material allows X-rays to pass through them.

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How are the ureters and urethra evaluated on radiographs?

A contrast study is a radiographic examination that uses a contrast agent, such as barium, to highlight specific structures in the body. This is often used to evaluate the urinary system.

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Why is Ultrasound a better diagnostic tool than radiographs for the bladder and prostate?

Ultrasound is a diagnostic imaging technique that uses sound waves to create images of the body's internal structures. This method can give a clearer picture of the luminal surface and bladder wall, as well as the prostate in dogs.

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What can be indicated by loss of serosal detail on an abdominal radiograph?

The presence of free abdominal fluid is suggested when the serosal detail is lost. However, younger and emaciated animals may normally have poor serosal detail, so this should be considered.

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What does microhepatica indicate?

Microhepatica is a condition where the liver is abnormally small. It can be a sign of portosystemic shunt, which is a condition where blood bypasses the liver.

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Study Notes

Abdominal Imaging

  • Abdominal imaging is used in small animal practice to diagnose various conditions.
  • Learning outcomes include describing positioning, required views, aspects confounding interpretation, and contrast media use.
  • Indications for abdominal radiography include abdominal distension, palpable masses, weight loss, abdominal pain, screening for neoplasia, trauma, gastrointestinal signs, urinary signs, and reproductive tract examination.
  • General considerations for abdominal radiography include low kV and high mAs exposure, end-expiratory views, reducing scatter by using a grid.
  • Patient preparation involves withholding food for 12 hours, allowing defecation and urination before the study, performing an enema if needed for urinary studies, and ensuring the animal's coat is clean.
  • Standard radiographic views include ventrodorsal, right lateral, left lateral, dorsoventral, and decubitus lateral. Three views are recommended for vomiting animals.
  • Röntgen signs for abdominal radiograph review may include size comparison, shape analysis, number checks, opacity assessment (for mineralisation or foreign objects), and margination assessment to note the presence of free abdominal fluid.
  • The gastrointestinal tract is evaluated, focusing on the stomach (cranial abdomen, caudal to liver), its opacity depending on content, gas distribution based on position, and ultrasound being optimal for wall layering, serosa, muscularis, submucosa, and mucosa, along with the lumen.
  • The small intestine is assessed considering ileus (failure of ingesta to pass), abnormal diameter (greater than 1.6 x height lumbar vertebrae L5), fluid/gas/mixture presence in dilated loops, and assessment of the number of dilated loops.
  • Foreign bodies may be metallic or mineralized and could be present.
  • Intussusception, present in younger animals, may be related to worms or in older animals to neoplasia. This shows as an illeocolic junction with a "sausage shape" mass in the abdomen. Ultrasound is beneficial for diagnosis.
  • Large intestine anatomy (ascending, transverse, and descending colon) is essential for its interpretation.
  • The large intestine, with relatively consistent appearance, shows various heterogeneous faecal material. Constipation may be present with large intestinal dilation, opaque faecal material, and possible caused by bone ingestion.
  • Displacement signs in the abdomen, like ventral (kidney, sublumbar lymph nodes, retroperitoneal space) or dorsal (enlarged prostate, uterus, and bladder), should be noted.
  • Contrast studies using barium sulphate are useful, but now often superseded by other modalities, and are either given orally or rectally. This is relatively palatable and can coat the mucosa. But is contraindicated if perforation or swallowing disorders are present (due to aspiration risk).
  • For barium swallows, starvation for 12-24 hours is required. Liquid barium is given (via stomach tube). Immediate lateral and ventrodorsal views are needed, including the thoracic cavity. The image should show luminal filling defects. Barium meals need 24-hour starvation. Mix food with barium and feed to the animal. Serial images are taken to assess gastric emptying and abdominal transit times. Gastric emptying can be slower during stress.
  • Liver and spleen analysis might show generalized hepatomegaly, caudal displacement of the pylorus, and non-specific findings. Ultrasound-guided FNA is necessary for diagnosis. Neoplasia may present as generalized hepatomegaly, or a cranial abdominal mass in the liver, or a variable-sized mid-abdominal mass in the spleen. Common cause of haemoabdomen involves loss of serosal detail and microhepatica.
  • Urinary tract analysis considers size, shape, and opacity of the kidneys, no information on function, length assessments, ureters, urethras, location, size, and shape of the bladder for each.
  • Contrast studies in urinary tract include double-contrast cystograms, retrograde urethrograms, vaginourethrograms, and intravenous urographies using water-soluble contrast materials like "Conray" or "Omnipaque," air, or CO2. Patient prep includes enemas, and plain radiographs are typically taken first.
  • Contrast studies of the urinary tract like double-contrast cystography include general anaesthesia, urinary catheter insertion, bladder filling with gas or contrast, and catheter removal before imaging.
  • Retrograde urethrograms involve catheter placement in the terminal urethra, possible foley catheter use, exposure during or after injection, and positioning. Male, dysuria, and anatomical abnormalities are potential indications.
  • Retrograde vaginourethrograms require general anaesthesia, catheter placement into the vestibule and clamping, gentle contrast injection, exposure prior to injection termination, and female, bladder wall rupture, and urethral disease as potential indications.
  • Intravenous urethrography involves checking renal parameters, administering IV fluids, inducing general anesthesia, and avoiding withholding fluids; Contrast material is injected intravenously.
  • Ultrasound and radiography are used together due to foreign body detection limitations, diarrhoea assessment, abdominal mass characterisation, fluid assessment and sample collection, and evaluation of the whole radiograph, not just the area of interest.

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Description

This quiz focuses on the principles and techniques of abdominal imaging in small animal practice. Participants will learn about positioning, required views, patient preparation, and the role of contrast media in diagnosing conditions. Ideal for veterinary students and professionals seeking to enhance their imaging knowledge.

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