Kelsey Johnson Papers Flashcards
Copied from Quizlet (379 cards)
1
Q
Which quantitative thyroid scintigraphy index is the most accurate for diagnosis of hyperthyroidism? Which correlates the best to serum T4? How are these indices affected by methimazole?
A
- Thyroid-salivary ratio is most accurate; if you can’t do this one because of poor salivary uptake or salivary inflammation, do thyroid-to-heart, it is the next best
- Percent thyroid uptake (TcTU) is most correlated to serum T4
- ALL indices (thyroid to salivary, thyroid to background, percent thyroid uptake) are increased in cats that have been treated with methimazole vs. cats that have not, however authors believe this is because the cats tx’d with methimazole have been hyperthyroid for longer by the time they get scintigraphy, and so have chronic changes to thyroids that cause increased uptake compared to non-methimazole cats that have had the disease for less time
Peterson VRU 2016
2
Q
In MRI of dogs with osseous-associated cervical spondylomyelopathy, which positioning resulted in the most spinal cord compression sites? Which positioning worsened compression compared to neutral?
A
Extension identified the most sites of spinal cord compression, including some not seen on neutral position - both dorsal and ventral compression.
Extension worsened compression compared to neutral. The effect of flexion on compression was variable - worse in some, better in others.
Provencher, VRU 2017
3
Q
Regarding imaging features of Great Danes with and without clinically evident cervical spondylomyelopathy: which group had spinal cord compression? Which group had spinal cord signal changes? What findings distinguished affected from unaffected dogs?
A
- Both groups had spinal cord compression (clinically affected and clinically normal dogs)
- Only the clinically affected group had spinal cord signal changes
- Distinguishing findings included more severe compression, more stenotic foramina, and the presence of spinal cord signal change
Martin-Vaquero, JAVMA 2014
4
Q
What 3 factors act in combination to explain pathophysiology of disk-associated cervical spondylomyelopathy?
A
Recall that disk-associated CSM has Dobermans as its poster child and has a predilection for the caudal cervical spine.
- Congenitally, relatively stenotic vertebral canals
- Caudal cervical spine more prone to torsional forces, which worsen disk degeneration more than compressive forces do
- Dogs with CSM have larger intervertebral disks than clinically normal dogs –> more disk available to protrude into vertebral canal
da Costa, VCNA 2010
5
Q
What are the major differences in signalment and morphology of disk-associated vs. osseous-associated cervical spondylomyelopathy?
A
Disk-associated: older, mean age 6.8 in Dobermans and 7.8 in other dogs; large breed dogs; spinal cord compression is mainly ventral secondary to disk protrusion or herniation, +/- vertebral canal stenosis or ligamentum flavum hypertrophy
Osseous-associated: younger, mean age 3.8 years; giant breed dogs; spinal cord compression mainly dorsal/dorsolateral secondary to proliferation of the vertebral arch, articular facets, and/or pedicles, +/- vertebral canal stenosis. Can also have synovial cysts from articular facets. Can also have disks.
da Costa, VCNA 2010
6
Q
What are the most common clinical signs and biochemical abnormalities in dogs presenting with paraneoplastic hypertrophic osteopathy? What findings make up the radiographic diagnosis of HO?
A
CS: leg swelling, lameness, lethargy
Biochem: anemia, neutrophilia, elevated ALP
Note that CS of HO frequently become apparent prior to the primary pathology.
Radiographic findings: symmetric periosteal new bone proliferation along the long bones of the appendicular skeleton
Withers, Vet Comp Onco 2015
7
Q
What are the reported neoplastic causes of paraneoplastic hypertrophic osteopathy, and of these, which is the most common? What are the other reported non-neoplastic causes?
A
Neoplastic - primary lung tumor (most common); also bladder and renal sarcoma or carcinoma
Others (acronym SCBIDER):
- Infectious or inflammatory lung disease
- Dirofilaria immitis
- Spirocerca lupi esophageal granuloma
- Bacterial endocarditis
- R to L shunt with a PDA (wat)
- Esophageal foreign body (and now gastric FB - the Doberman that ate plastic cups at Tufts)
- Congenital megaesophagus
Withers, Vet Comp Onco 2015
8
Q
What is the signalment most commonly associated with quadrigeminal cysts (rostral cerebellar diverticula)? Are RCD incidental?
A
Signalment: most commonly small-breed dogs, particularly brachycephalic; and often male
Can be incidental or associated with clinical signs. Clinical signs are more likely present if occipital compression is >14%. Over 50% of the patients in this article had RCD as incidental findings.
Matiasek, JVIM 2007
9
Q
Meningiomas and histiocytic sarcomas are typically of what localization in relation to the brain parenchyma and the meninges?
A
Intradural, extramedullary
Recall that histiocytic sarcomas can have dural tail signs.
Wada, VRU 2017
10
Q
In a study of 17 dogs, 11 with intracranial meningioma and 6 with intracranial histiocytic sarcoma, what were the signal characteristics of histiocytic sarcoma vs. meningioma on T1w, FLAIR, and DWI?
A
Histiocytic sarcoma was T1w-hypointense, FLAIR-hypointense, and DWI-hyperintense compared to meningioma.
HS also had worse peritumoral edema compared to meningiomas.
Wada, VRU 2017
11
Q
What distinguishing characteristic was identified for intracranial menigioma vs. histiocytic sarcoma, in a 2017 study evaluating MRI and diffusion characteristics of these two tumors?
A
ALL histiocytic sarcoma dogs had invasion of the sulci - appeared as contrast-enhancing tissue extending into and spreading apart the sulci; meningioma never had this.
Authors acknowledged 17 dogs was not enough to make that into a rule yet.
Wada, VRU 2017
12
Q
What is the expected difference in ADC values vs. fractional anisotropy values for tumor volume of intracranial meningioma vs. histiocytic sarcoma (which tumor has the higher value for each)? What about for peritumoral margins?
A
Tumor volume:
- ADC: histiocytic sarcoma lower, meningioma higher (reflects aggressive/malignant nature of HS: more aggressive = more cellular = less free water = lower ADC value)
- FA value: no statistically significant difference between FA values of meningioma and histiocytic sarcoma
Peritumoral margins:
- ADC: histiocytic sarcoma higher, meningioma lower
- FA value: histiocytic sarcoma margins lower than meningioma margins (reflects invasive HS vs. non-invasive mening: lower FA means tumor invasion disrupting normal architecture, facilitates free water –> HS is invasive and its margins are expected to have lower FA and higher ADC)
Wada, VRU 2017
13
Q
Generally, vasogenic edema has what signal on ADC? Cytotoxic edema?
A
Vasogenic = high ADC signal; increased extracellular water due to leakage of plasma from damaged capillaries Cytotoxic = low ADC signal
14
Q
What are the sensitivities for MRI diagnosis of neoplastic, inflammatory, or vascular intradural spinal cord lesions? What was the overall MRI sensitivity for detection of intradural spinal cord lesions?
A
Neoplastic - 86%
Inflammatory - 64%
Vascular - 25%
Overall - 97%; specificity only 64% –> higher likelihood of false positives.
Masciarelli, VRU 2017
15
Q
What are the spinal predilection sites for meningioma, nephroblastoma, and nerve sheath tumors?
A
Meningioma: C1-C4
Nephroblastoma: T9-L3
Nerve sheath tumor: brachial or lumbosacral plexuses
Masciarelli, VRU 2017
16
Q
True or false: a short clinical course, but with progressive neurologic signs, has been reported in cases of vascular spinal cord disease.
A
True.
Masciarelli, VRU 2017
17
Q
What is the median ratio of left kidney length to L2 length on a VD radiograph for brachycephalic, mesaticephalic, and dolichocephalic dogs?
A
Squish-faced dogs have higher ratio than long-faced dogs (maybe squished L2 vertebrae are shorter than their kidneys - that’s from me, not from the paper)
Brachycephalic: 3.1
Mesaticephalic: 2.97 (almost exactly between 3.1 and 2.8)
Dolichocephalic: 2.8
Dogs <10 kg have a higher LK:L2 ratio than dogs >30 kg
Lobacz VRU 2012
18
Q
What radiographic characteristics have been reported for feline idiopathic pulmonary fibrosis?
What CT characteristics have been reported?
A
Radiographs: broncho-interstitial pattern, alveolar pattern, pulmonary masses, pulmonary bullae, pleural effusion, and cardiomegaly
“Purple cats breathe against pulmonary pathology”
CT: focally increased soft tissue attenuation, masses, ventral consolidation that doesn’t alter with recumbency
Radiographic characteristics are highly variable and can mimic other diseases such as pneumonia, asthma, pulmonary edema, or neoplasia
Evola VRU 2014
19
Q
T/F: Cervical extension can alter which spinal cord site is most severely compressed in up to 33% of patients.
A
True.
Provencher, VRU 2017
20
Q
Describe the CT characteristics of a ‘tree in bud’ pattern.
A
Nonenhancing nodules and branching V or Y lines; at least 5 mm away from pleura. Represents enlarged bronchial airways coursing perpendicular and parallel to CT plane section.
Tree in bud can be seen in non-clinical cats, and in cats with normal radiographs but with clinical signs. Sign of chronic inflammatory airway disease.
Hahn, VRU 2017
21
Q
Most common CT characteristics of idiopathic pulmonary fibrosis in Westies
A
Ground glass pattern - mild degree of severity
Focal reticular and mosaic ground-glass patterns - moderate severity
Thierry, VRU 2017
22
Q
What respiratory condition is associated with a tree-in-bud appearance on pulmonary CT in cats?
A
Chronic lower airway disease
Tree-in-bud can be seen in cats with clinical signs of airway disease, even if no abnormalities are identified on radiographs.
Hahn, VRU 2017
23
Q
What is the mean attenuation of presumed normal canine abdominal lymph nodes on CT, before and after contrast?
A
Before = 37 (20-50) After = 109 (36-223)
Beukers VRU 2013
24
Q
Describe the location of the following canine abdominal lymph nodes: Hepatic Splenic Gastric Pancreaticoduodenal Renal Lumbar aortic Medial iliac Internal iliac and sacral
A
- Hepatic = either side of the portal vein, anywhere between liver and insertion of splenic vein
- Splenic = along the splenic vein, ~2 cm proximal to its insertion on the portal vein
- Gastric = always single; located in lesser curvature of stomach, closer to body than pylorus
- Pancreaticoduodenal = ventral to body of pancreas and/or duodenum, close to pylorus
- Renal = along the renal artery
- Lumbar aortic = long axis parallel to aorta/cava, usually dorsolateral to aorta or cava
- Medial iliac = at the level of or caudal to the trifurcation of the aorta
- Internal iliac and sacral = along the left and right sides of the median sacral artery; not distinguishable from each other
Beukers VRU 2013
25
Gelified ethanol can be injected (with image guidance) into the intervertebral disk in humans as a minimally invasive treatment for disk protrusion. Why does it work (or what is the theory)?
Ethanol causes molecular splitting of the proteoglycans making up the nucleus pulposus --> reduction in nuclear volume and regression of the disk protrusion
Mackenzie VRU 2016
26
Is injection of gelified ethanol into the lumbosacral nucleus pulposus well-tolerated in healthy dogs? What is the rate of leakage into the vertebral canal, and is this clinically significant?
No clinical signs noted for 1 year after injection, appears well-tolerated in healthy dogs.
Rate of leakage was 3/9 immediate, +1 more over the duration of the study, so 33% or a little higher. No adverse effects were noted, so it appears that leakage is subclinical for at least the first year.
Mackenzie VRU 2016
27
What are some distinguishing clinical characteristics of patients with MRPLN masses secondary to inflammatory lymphadenitis vs. neoplasia? Distinguishing MRI characteristics?
Non-neoplastic lymphadenitis: Fever, leukocytosis, neutrophilia, neck pain/painful neck mass; usually younger (<6.5 years is 80% sensitive, 75% specific); moderate to marked perinodal contrast enhancement, presence of muscle enhancement
Neoplasia: older patient, nonpainful neck mass, larger neck mass
Johnson VRU 2016
28
What is the cutoff value for US cross-sectional area of a parathyroid nodule, above which response to radiofrequency ablation of the nodule is less likely to be successful?
0.35 cm^2
Sensitivity of 78%, specificity of 86%
(Probably because the bigger the nodule, the more likely that it is incompletely ablated.)
Bucy VRU 2017
29
Is thyroid size related to likelihood of treatment success with radiofrequency ablation of a parathyroid nodule? Degree of hypercalcemia or PTH elevation? Presence of hypothyroidism?
No. Parathyroid size, yes; thyroid size, no.
Biochemical values were not related to treatment success.
Presence of concurrent hypothyroidism was associated with treatment failure.
Bucy VRU 2017
30
What is the effect of methimazole treatment on thyroid gland size, attenuation, and heterogeneity, in hyperthyroid cats evaluated with CT?
Size - UNCHANGED
Attenuation - decreased: 96 HU to 86 HU
Heterogeneity - decreased (they used standard deviation of attenuation in multiple ROIs to quantify it, but I'm not going to remember that number)
Bush VRU 2017
31
What is the correlation between thyroid gland size pre-treatment, and the dose of methimazole needed to achieve euthyroidism?
Positive. Bigger gland = higher dose (to the surprise of no one).
Bush VRU 2017
32
In hypercalcemic dogs undergoing cervical US, with no palpable neck mass or clinical signs of thyroid disease, what is the prevalence of incidentally identified thyroid nodules? Is sampling indicated?
15%; and yes, because nodules may be benign or malignant and there are no distinguishing features between them on US.
Pollard VRU 2015
33
What are the differentials for a thyroid nodule identified on cervical ultrasound?
- Thyroid cyst
- Thyroid adenoma
- Thyroid adenocarcinoma
- Nodular hyperplasia
Pollard VRU 2015
34
What is the overall prevalence of thyroid masses/nodules in dogs? What is the prevalence of incidentally discovered thyroid masses/nodules in dogs?
Overall prevalence = 2.1%
Incidentally discovered prevalence = 0.76%
Bertolini VRU 2017
35
What percentage of thyroid nodules/masses are malignant, whether incidentally discovered or suspected based on clinical signs and history? Is sampling of a 'thyroid incidentaloma' indicated?
Incidentally discovered masses are 70% malignant
Non-incidentally + incidentally discovered masses are 82-90% malignant (Bertolini paper was 82%, older paper was 90%)
Sampling is ALWAYS indicated because of at least 70% likelihood of malignancy
Bertolini VRU 2017
36
At doses of 10 mcg/kg IV, what effects does dexmedetomidine have on radiographic heart size and echocardiography parameters in dogs?
- Larger heart on rads (bigger VHS on lateral, cardiothoracic ratio on VD)
- Increased LVEDV and LVESV --> increased preload
- Decreased FS, CO
- Moderate to severe mitral and tricuspid regurgitation, +/- lesser aortic and pulmonic regurgitation
(Recall that the normal dose of dex is only 2 mcg/kg, maybe up to 4)
Wang VRU 2016
37
At doses of 40 mcg/kg IM, what effects does dexmedetomidine have on radiographic heart size in cats?
- Mild increase in VHS measured on R lateral
- Mild increase in % thoracic width occupied by the heart on VD and DV
Zwicker VRU 2016
38
What diagnoses can be evaluated using lung ultrasound in an ER setting in a dyspneic patient?
Presence/absence of peripheral pulmonary edema - does NOT distinguish between causes of peripheral pulmonary edema, e.g. NCPE, cardiogenic, ARDS, diffuse interstitial disease.
Ward JAVMA 2017
39
What is the upper limit of normal for MPA:Ao ratio on echocardiography in dogs?
0.98 for echo
Granger VRU 2016
40
What is the effect of respiratory phase on MPA:Ao as measured on CT (insp vs. exp)? Can the echocardiographic limit for MPA:Ao ratio be used on CT of the canine thorax? Does contrast administration alter MPA:Ao?
Expiratory scan = lower MPA:Ao ratio than inspiratory (I can't really get my head around why this would happen pathophysiologically so just go with it)
No, the echo limit cannot be used on CT because it is too low. In this study, between various inspiratory/expiratory scans, the ratio was at least 1.1. A normal for CT MPA:Ao has not been established.
Contrast has no effect on MPA:Ao on CT.
Granger VRU 2016
41
What are the differentials for focal contrast enhancement of the myocardium on CT?
- Neoplasia
- Revascularization of a myocardial infarct secondary to a thromboembolic event
- Inflammation
Stieger-Vanegas VRU 2016
42
What are the 4 reported types of primary pulmonary artery neoplasia?
Hemangiosarcoma, hamartoma, leiomyosarcoma, and chondrosarcoma (what)
Stieger-Vanegas VRU 2016
43
What is the difference between arteriovenous fistula, arteriovenous malformation, and hamartoma?
```
AVF = connection between a single artery and vein; most commonly acquired, secondary to blunt/penetrating trauma, surgical procedure, or catheterization
AVM = multiple aberrant shunting vessels that originate from >/=1 arteries and terminate in >/=1 veins; usually congenital
Hamartoma = nodular growth consisting of disorganized, excessive proliferation of nonneoplastic vascular tissue; many contain AVFs and AVMs
```
Shaikh VRU 2016
44
How is percent thyroid uptake (TcTU) calculated on a scintigraphic image?
- Thyroid uptake is corrected for background, depth, and decay
TcTU = net counts of all visible thyroid tissue / number of counts injected
**TcTU requires that 99mTc was given IV
Peterson VRU 2016
45
What percentage of hyperthyroid cats are likely to have unilateral disease, bilateral disease, or multifocal disease?
Unilateral - 42%
Bilateral - 56%
Multifocal - 2%
Peterson VRU 2016
46
Do the intestinal layers as identified on US correspond to those identified on histology?
Yes. This was a worthless paper.
LeRoux VRU 2016
47
What is the effect of a normal meal and a high-fat meal on echogenicity of the canine duodenal and jejunal mucosa, immediately post-prandial vs. at 1 hour later, in healthy dogs?
Normal meal: mucosal hyperechogenicity increased at 60 min
High-fat meal: mucosal hyperechogenicity of the DUOD increased immediately and at 60 min; jejunal mucosal hyperechogenicity increased at 60 min just like with normal meal
Hypothesis that the increased echogenicity at 60 min represents physiologic, post-prandial lacteal dilation; hyperechogenicity at immediate post in duodenum is likely due to admixture of substances at mucosal surfaces, b/c lacteal dilation doesn't happen that fast
Take home message: intestinal echogenicity can be increased after a meal in healthy dogs, regardless of meal fat content
Gaschen VRU 2016
48
What structures are hyperintense vs. hypointense in the distal limb of the horse using 18F-FDG PET?
Hypointense - medulla of bone (P1-P3)
Mild hyperintensity - tendons
Moderate hyperintensity - the rest of the soft tissues
Greatest hyperintensity - coronary band
Spriet VRU 2016
49
What is the range of risk of iatrogenic hypothyroidism after I131 treatment in cats?
- 7-30% of cats can become biochemically hypothyroid
- Wallack's ACVR abstract in 2010: 18%
Bettencourt VRU 2016
50
Which quantitative scintigraphic measurement is most closely correlated to serum radioactivity in thyroid scintigraphy with 99mTc?
Thyroid to heart background ratio
Bettencourt VRU 2016
51
What is the definition of craniomandibular osteopathy? What is a distinguishing feature between CMO and calvarial hyperostosis syndrome?
- CMO = bilateral, irregular, non-neoplastic osseous proliferative disease of YOUNG DOGS, usually affecting multiple bones of the cranium, +/- the metaphyses of long bones
- CMO differs from calvarial hyperostosis syndrome because CMO involes the mandible, and hyperostosis syndrome does not
Matiasovic VRU 2016
52
What are the predilection sites for CMO? Predisposed breeds? MRI appearance?
- Sites: frontal, parietal and occipital bones; tympanic bullae, mandibular rami, TMJs
- Breeds: Westies, Cairn terriers, Scotties
- Bone lesions are T2w-hyperintense, T1w-hypointense, with intense and homogeneous contrast enhancement of the lesion and surrounding soft tissue
Matiasovic VRU 2016
53
What is calvarial hyperostosis syndrome?
Similar to CMO, characterized by osteoproliferative lesions of the flat bones of the skull; but does NOT affect the mandible
Only described in bullmastiffs and one Springer
Matiasovic VRU 2016
54
What is the rate of recurrence of hypercalcemia after radiofrequency ablation of the parathyroid in dogs with primary hyperparathyroidism?
Between 2 and 28%, depending on the study
Bucy VRU 2017
55
How does methimazole interfere with thyroid hormone synthesis?
Methimazole blocks ORGANIFICATION of iodide, and COUPLING of iodotyrosines --> inhibits production of thyroid hormone (recall organification = incorporation of I into tyrosine)
Does NOT directly block iodide uptake by the thyroid gland
Fischetti VRU 2005
56
Why might 99mTcO4 uptake increase in cats made hypothyroid by methimazole therapy?
When cats become hypothyroid, TSH will increase; TSH supports all thyroid gland functions, including iodide trapping, and increased iodide trapping = increased 99mTcO4 uptake because they are treated the same by the thyroid.
Because 99mTcO4 isn't actually iodine, methimazole doesn't interfere with it (b/c methimazole blocks organification of iodide and coupling of iodotyrosyl groups)
Fischetti VRU 2005
57
What is the normal thyroid:salivary ratio in euthyroid cats? Normal percent thyroid uptake in euthyroid cats?
```
T:S = 1.0; up to 1.5 has been reported in older euthyroid cats.
TcTU = 0.64-0.75%
```
Fischetti VRU 2005
58
Does methimazole increase uptake of pertechnetate (99mTcO4) compared to pre-treatment uptake in hyperthyroid cats?
No. Methimazole treatment does not affect radionuclide uptake with pertechnetate in hyperthyroid cats. This is because (at least in this study) TSH suppression by elevated T4 was NOT relieved over the 30 days of methimazole therapy.
Fischetti VRU 2005
59
T/F: A 'good' radiology report should have clinical history and the clinical question provided, and should include a prioritized differential list.
True.
Weissman VRU 2016
60
In brief, how is indirect computed tomography lymphography performed for dogs with anal sac adenocarcinoma?
Peritumoral injection of contrast followed by serial caudal abdominal CT scans for iliosacral lymph node identification; 2 ml of 1:1 Isovue-300 and saline in a 4-quadrant technique. Put dogs in supported sternal recumbency. Identification of primary sentinel nodes in 1-20 min post-contrast.
Majeski VRU 2017
61
In CT lymphography for canine mammary tumors, what factors are useful in distinguishing LN metastasis presence vs. absence?
Neoplastic invasion: Heterogeneous contrast enhancement of the sentinel LN, no contrast enhancement of the sentinel LN, HU <444 in the center of the LN
No invasion: Homogeneous contrast enhancement
Size, shape are LESS correlated with neoplastic invasion than the enhancement characteristics above.
Soultani VRU 2017
62
What proton magnetic resonance spectroscopy findings have been associated with tick-borne encephalitis?
Reduced compared to normal dogs: N-acetyl aspartate, creatine
Increased: glutamine-glutamate complex (mainly from glutamate)
Unchanged: myoinositol, choline
Not found: lactate, lipids, taurine
Sievert VRU 2017
63
What proton magnetic resonance spectroscopy findings have been associated with non-infectious meningoencephalitis?
LOW N-acetyl aspartate, creatine, glutamine-glutamate complex, myoinositol
HIGH choline
Sievert VRU 2017
64
What are the findings associated with tick-borne encephalomyelitis on 3T MRI imaging?
- Bilaterally symmetric, grey matter lesions
- Hippocampus, thalamus, brainstem, basal nuclei of brain; ventral horn of spinal cord
- T2w-hyperintense, T1w-iso to hypointense
- No contrast enhancement, mass effect, or perilesional edema
* *MRI can be structurally normal.
Beckmann VRU 2016
65
Is general anesthesia (vs. sedation) contraindicated for CT diagnosis of idiopathic pulmonary fibrosis in West Highland white terriers? What is the effect of anesthesia vs. sedation in this scenario?
Not contraindicated - can still provide a diagnostic scan. However, sedation vs. anesthesia provide non-systematically different (aka variable) results for identification and severity of findings consistent with IPF, e.g. ground glass opacity, consolidation, mosaic attenuation pattern.
* Note that ground glass has been reported in clinically normal Westies.
Roels VRU 2017
66
What are the 3 main CT features of canine idiopathic pulmonary fibrosis in Westies?
Ground glass attenuation, mosaic attenuation, and bronchial wall thickening
Roels VRU 2017
67
What are the differentials for a luminal mass within the canine bladder?
- Hematoma
- Foreign body
- Cystolith
- Laminated debris ball/laminated fibrinous ball
- Fungal ball
Yoon VRU 2017
68
What patients are predisposed to develop fungal and/or fibrinous balls within the urinary bladder?
Immunocompromised patients - diabetes, neoplasia. Reported only in dogs so far.
Yoon VRU 2017
69
What is the radiographic tracheal diameter:thoracic inlet ratio of: normal, non-brachycephalic dogs; non-brachycephalic, tracheal hypoplasia dogs; and English bulldogs with tracheal hypoplasia?
Normal, non-brachycephalic dogs: >0.2
Tracheal hypoplasia, non-brachycephalic dogs: <0.16
Tracheal hypoplasia, English bulldogs: <0.12
Kaye VRU 2015
70
What is the extent of variation in % tracheal diameter on CT between inspiration and expiration in healthy dogs?
Up to 24%
Kaye VRU 2015
71
What breeds have smaller cricoid cartilage cross-sectional areas on CT? Is this associated with brachycephalic airway syndrome?
Brachycephalic breeds
Not associated with clinical brachycephalic airway syndrome, can be seen in clinically normal dogs
Pugs and French bulldogs have vertically ovoid cricoids compared to Labs and JRTRs
Rutherford VRU 2017
72
What neoplasms can have dural tail signs?
Meningioma, histiocytic sarcoma, inflammatory fibrosarcoma
Scarpante VRU 2016
73
When imaging equine lumbosacral nerve roots (L6, S1, S2) with transrectal ultrasound, what are three anatomic markers and is size correlated with age or sex?
Anatomical markers include L7-S1 disk, intervertebral foramina, and the caudal gluteal artery
Size is quite variable in normal Warmbloods. Overall L6 is larger than S1 and S2, and S2 is smaller than L6 and S1. Comparison of right and left sides recommended, since they are normally bilaterally symmetric.
Espinosa VRU 2017
74
What is the association between aberrant caudal nasal turbinates and age, sex, and clinical signs in English bulldogs? (Excluding grade 4 turbinates, which protrude into the nasopharynx.)
- There is no association between age, sex, and presence/absence of aberrant caudal turbinates
- 100% of healthy (not affected by BAS) English bulldogs had them --> effect of aberrant caudal nasal turbinates is subclinical, consider them to be incidental and breed-related up to grade 3 (grade 4 was not seen in any dog in this study)
Grosso VRU 2015
75
What are the differences in tympanic bulla morphology between brachycephalic and non-brachycephalic dogs?
Brachycephalic dogs have thicker bulla walls and smaller total bullae volume, and greater prevalence of sub-clinical middle ear effusion, than non-brachycephalic dogs.
Salguero VRU 2016
76
What is the relationship between soft palate thickness and the presence of material in the tympanic bulla?
Brachycephalic dogs with material in their bullae had thicker soft palates (~12 mm) than brachycephalic dogs without fluid in their bullae (~9mm)
Salguero VRU 2016
77
Which are more common in brachycephalic breeds, vertebral segmentation defects or vertebral body formation defects? What is the most common site?
Vertebral body formation defects are more common; sites are T7, T8, T12.
Gutierrez-Quintana VRU 2014
78
Can vertebral body malformations be the cause of neurologic signs, and which types are more likely to be associated with neurologic signs?
Yes - spinal cord compression
Ventral and ventro-lateral aplasia (creating dorsal and dorso-lateral hemivertebrae) are more commonly associated with clinical signs, at least in this study
Gutierrez-Quintana VRU 2014
79
How is 99mTc-MDP 'taken up' into bone? Why does it end up in soft tissue?
- Taken up into bone via 'chemisorption' to exposed inorganic bone, particularly hydroxyapatite crystal
- Will also occur in areas of calcium phosphate, which is present in dystrophic and metastatic mineralization --> will get taken up in soft tissues if calcium phosphate is present
Ruff VRU 2016
80
What is a pilomatricoma? What is its rate of metastasis and its predilection site for metastatic disease in dogs?
- Pilomatricoma = follicular tumor, comes from metrical cells of the hair bulb (whatever those are)
- Metastasis in 1/3
- Predilection site is BONE - very different from other species
Ruff VRU 2016
81
What is the effect on laparoscopic-assisted gastropexy on GI transit time in normal dogs? On GI transit time in dogs with GDV?
Difficult question over at least 2 different studies. Short version, normal dogs have no altered GITT in at least 2 studies, GDV dogs have prolonged GITT in 1 study.
Balsa JVIM 2017
82
What is a noninvasive imaging method of measuring lung area changes during respiration in normal dogs?
Fluoro of the thorax - can measure max inspiratory and expiratory lung volume (by drawing ROI around lung margins, excluding mediastinal structures) and calculate % change. Mean is 20.8%. There are body weight correction factors.
Chan JVIM 2017
83
Which joints of the equine carpus bear the majority of stress during locomotion?
Antebrachiocarpal and middle carpal, particularly the dorsal and medial aspects.
Carpometacarpal remains mostly stable under both axial and torsional loading.
Suarez Sanchez-Andrade VRU 2018
84
What imaging method is most sensitive for detection of articular cartilage defects in the equine carpus?
```
CT-arthrography - 70%
MR-arthrography - 53%
Plain MR - 33%
Plain CT - 18%
Weirdly, there was no statistically significant difference between these.
```
Suarez Sanchez-Andrade VRU 2018
85
Describe the appearance of feline restrictive orbital myofibroblastic sarcoma (FROMS) on MRI.
- Thickening of retrobulbar tissues w/ effacement to loss of retrobulbar fat
- No abnormal T1 or T2 signal intensity, but heterogeneous on STIR
- Marked contrast enhancement
Fat-suppressed images are suggested.
Thomasy Vet Ophth 2013
86
What is the recommended treatment for feline restrictive orbital myofibroblastic sarcoma?
Aggressive and early therapy with surgical excision
Thomasy Vet Ophth 2013
87
What are the normal protein and cell counts for CSF?
Total protein <25 mg/dl
| Total nucleated cell count <5 cells/ul
88
Name 3 types of canine eosinophilic meningoencephalitis, and some of their underlying causes.
- Infectious: Neospora, Toxoplasma, Angiostrongylus, Cryptococcus/Prototheca, distemper, rabies
- Non-infectious: trauma, infarct, shunt placement, paraneoplastic
- Unknown origin: origin...unknown
Cardy JSAP 2018
89
What signalment is associated with canine eosinophilic meningoencephalitis of unknown origin (eosinophilic MUO)?
Young, male, large breed dogs
Cardy JSAP 2018
90
What are the MRI findings of canine eosinophilic meningoencephalitis of unknown origin (eosinophilic MUO)?
Bilaterally symmetric T2/FLAIR hyper, T1 hypo affecting cerebrocortical grey matter; also diffuse meningeal enhancement.
Contrast to NLE, NME, GME, where lesions are more likely bilateral and asymmetric.
Cardy JSAP 2018
91
Name two types of reactions to the presence of textile foreign bodies in the abdomen (e.g. in the GI tract).
- Aseptic fibrous response - adhesions, encapsulation, usually few/vague clinical signs
- Exudative reaction - abscess, fistulation, sepsis; more severe clinical course up to and including perforation
Anson VRU 2018
92
Define dorsal border lesion vs. dorsal abrasion of the DDFT in equine foot MRI.
- Dorsal border lesion: rectangular/geometric area of increased signal in dorsal half of the tendon, +/- tendon thickening
- Dorsal abrasion: disruption of dorsal contour of DDFT, without signal change or thickening of tendon
Busoni VRU 2005
93
What are the enhancement characteristics of polypoid vs. non-polypoid cystic mucosal hyperplasia in dog gallbladders, using contrast-enhanced US?
Polypoid cystic mucosal hyperplasia - polypoid lesions enhance, wall enhances normally
Non-polypoid cystic mucosal hyperplasia - wall enhances normally
Bargellini VRU 2018
94
On small animal radiographs, bowel diameter of ______x the height of L5 has a 50%-66% probability of mechanical obstruction. Bowel diameter of ______x the height of L5 has a 80% probability of mechanical obstruction.
1. 73x = 50%
1. 95x = 80%
Drost VRU 2016
95
A recent study compared diagnosis of small intestinal mechanical obstruction using radiographs vs. abdominal CT. What were the sensitivity and specificity for each modality?
Radiographs - sens 79%, spec 69% (you picked up 8/10 cases, and 3/10 were incorrectly identified)
CT - sens 95%, spec 80% (you picked up 95/100 cases, and incorrectly identified 20/100)
Drost VRU 2016
96
In comparing radiographs to CT for ability to DIAGNOSE small intestinal obstruction, which modality was more sensitive and specific (though not statistically significantly so)? In comparing rads to CT for ability to recommend SURGERY for small intestinal obstruction, which was more sensitive and specific (though not statistical
Diagnosis - CT was more sensitive and more specific than rads
Send to surgery - rads were more specific than CT
(Neither difference was statistically significant)
Drost VRU 2016
97
On CT, an intestinal diameter:L5 ratio of 2.1 corresponds to what sensitivity and specificity for mechanical obstruction?
79% sensitive, 72% specific
Drost VRU 2016
98
MRI of the canine cruciate ligaments may be useful to determine partial versus complete fiber loss in what population of patients?
Dogs with clinically stable stifles - MRI sensitive and specific for determining partial vs. complete fiber loss
In dogs with clinically unstable stifles, MRI was very sensitive but poorly specific, and called a lot of complete ruptures that were in fact partials.
Fazio VRU 2018
99
Is contrast-enhanced ultrasound of the equine limb with perfluorobutane/decafluorbutane safe?
Yes - no adverse effects
Should use intra-arterial injection, produces much better contrast and image quality
Seiler VRU 2016
100
What are the low and high doses for IV and intra-arterial contrast injection, per horse? (US contrast)
IV - 5 and 10 ml
IA - 0.5 and 1 ml
Seiler VRU 2016
101
How is the intravertebral sagittal ratio calculated in horses?
Vertebral canal height divided by vertebral body height
DeRouen VRU 2016
102
What is the association between anomalous C6 vertebrae and presence of radiographic signs of OA in equine cervical spines?
None
However, anomalous C6 is associated with increased frequency of cervical pain?
Is NOT associated with neurologic signs
(This study was crap, I can't believe I wasted a penguin on it.)
DeRouen VRU 2016
103
What shape and density changes occur in the mandibular condyle and TMJ space on CT of young vs. mature horses on temporomandibular CT? (Young being <1 year, mature being >1 year)
- Shape: condyle becomes more flattened and less globoid, with decreased height:width ratio
- Attenuation: condyle increases in attenuation with age; focal hypodensities consistent with cysts present in >50% of asymptomatic horses >1 YO
- TMJ disk: hyperdense in many horses >10 YO
Carmalt VRU 2016
104
What are the broad differentials for ureteral rupture in the horse?
Congenital defect (wat), ureterolithiasis, infection, neoplasia, or trauma
Beccati VRU 2016
105
What are the CT characteristics of equine melanoma of the head? Most common locations affected?
- Most common locations: parotid salivary gland, guttural pouches, larynx and pharynx, and near the hyoid apparatus
- Hyperattenuating to muscle, mean 115 HU; occasional mineralization; moderately, homogeneously contrast-enhancing
- Multiples per horse! Up to 60 in 1 case
Dixon VRU 2016
106
What are the differentials for a soft tissue mass that is hyperattenuating to muscle on CT of the equine head?
MOOO! Melanoma, osteoma, ossifying fibroma, osteosarcoma
Ethmoidal hematoma less likely because those live in the ethmoids, not in the soft tissues
Dixon VRU 2016
107
Why is CT the optimal modality for selecting stent size in cases of tracheal collapse, compared to fluoroscopy or radiographs? Should tracheal height or width be used?
- Radiographs and fluoro underestimate tracheal size compared to CT --> smaller stent selected --> greater risk of stent migration (statistically significant difference in tracheal diameter with CT vs fluoro)
- CT has lowest inter/intra-observer variability in tracheal measurement
- Use height, is less variable than width
Williams VRU 2016
108
Can malignant and nonmalignant hepatic or splenic masses be distinguished based on CT features pre- and post-contrast, using dual-phase CT?
No, there is a lot of overlap.
Jones VRU 2016
109
What are the two underlying anatomical causes leading to intranasal airway obstruction in brachycephalic dogs?
1) Aberrant configurations of the nasal conchae (rostral aberrant turbinates and caudal aberrant turbinates), especially the ventral and middle conchae, that can almost entirely obstruct the airways;
2) failure of growth termination of the turbinates either in combination with, or possibly because of, an extremely undersized nasal cavity --> leads to relative conchal hypertrophy --> subsequent intranasal mucosal contact.
Oechtering Vet Surg 2016
110
What is the mean T2 relaxation time of normal canine articular cartilage?
56 +/- 8 msec
Ruoff VRU 2016
111
Which is preferred for evaluation of articular cartilage defects, 1.5T or 3T MRI?
3T MRI
98% of articular cartilage defects were correctly identified, with size ranging from 0.5 to 3 mm depth. (Slice thickness was 2 mm in this study.)
Note that this study had a scan time of 240 min...so perhaps not ideal in a clinical setting.
Ruoff VRU 2016
112
Are CT and arthroscopy often, sometimes, or rarely in agreement regarding the presence of subchondral bone defects in the medial humeral condyle, in dogs with elbow disease?
Sometimes. No significant agreement was found between CT and arthroscopy for the presence of a subchondral bone defect on the MHC.
Coppetiers VRU 2016
113
Are CT and arthroscopy often, sometimes, or rarely in agreement regarding the presence of fragmentation of the medial coronoid process?
Often. Significant agreement was found between CT and arthroscopy for presence of fragmentation of the medial coronoid process.
Coppetiers VRU 2016
114
What are some differentials for organisms causing infectious pneumonia in companion rats?
Mycoplasma pulmonis, Pneumocystis carinii, Strep pneumoniae, Corynebacterium kutscheri...
Fouriez-Lablee VRU 2017
115
What are some differentials for primary pulmonary neoplasia in companion rats? Metastatic?
Most common: alveolar adenoma; carcinoma from type II pneumocytes
Less common: spontaneous hemangiosarcoma, rhabdomyosarcoma
Metastatic: mammary carcinoma, lymphoma, histiocytic sarcoma, mesothelioma
Fouriez-Lablee VRU 2017
116
What is the anatomic organization of the rat lung?
Right: cranial, middle, caudal, and accessory lobes
Left: single lobe
Fouriez-Lablee VRU 2017
117
T/F: Radiographic pulmonary patterns differ between rats with infectious pneumonia and rats with pulmonary neoplasia (primary or metastatic).
False - there is overlap. For example, nodular lesions and lobar consolidation can represent pulmonary abscesses and lobar necrosis.
Fouriez-Lablee VRU 2017
118
What distinguishing feature is more likely to be associated with pulmonary neoplasia (primary or metastatic) than with infectious pneumonia on thoracic radiographs of companion rats?
Cranial mediastinal mass/mass effect = more likely neoplasia
Fouriez-Lablee VRU 2017
119
Urethrovaginal fistula is a rare complication of vaginal foreign bodies. What is the imaging modality of choice for diagnosis of urethrovaginal fistula?
CT with retrograde vaginourethrogram
Agut VRU 2016
120
What are the differentials for punctate hyperechoic foci within the liver on US? (Very hyperechoic, not just hyperechoic portal markings)
- Mineralization: should not be mobile
- Portal gas: e.g. secondary to severe, raging ulcerative colitis or GDV
- Pneumobilia: Idk what causes this but probably anaerobic or emphysematous cholecystitis
Cartwright VRU 2016
121
What are the potential origins of portal vein gas?
- Severe, raging enterocolitis
- GDV
- Blunt force trauma
- Iatrogenic from endoscopy and/or hepatic biopsy
- Hypertrophic pyloric stenosis (wat - maybe some weird duodenal reflux)
- Abdominal abscessation
* *Portal gas is no longer itself an indication for surgery unless an appropriate underlying cause is identified.
Cartwright VRU 2016
122
What are the signal characteristics of canine spinal lymphoma on MRI?
T2w iso- to hyperintense
STIR hyperintense
T1w iso to hypointense
Moderately to strongly contrast-enhancing
Allett VRU 2016
123
Which of the following are associated with intervertebral disk protrusion vs. extrusion?
- Midline instead of lateralized disk herniation
- Partial instead of complete disk degeneration
- Presence of single instead of multiple herniations
- Dispersed disk material beyond the borders of the disk space
PROTRUSION: disk material on midline instead of lateralized; partial instead of complete disk degeneration
EXTRUSION: single site instead of multiple; disk material dispersed beyond the borders of the disk space
De Decker VRU 2016
124
Which of the following radiographic findings are, or are not, associated with canine influenza virus infection?
- Lymphadenopathy
- Cranial mediastinal widening
- Pleural effusion
- Unstructured interstitial pattern
- Alveolar pattern
- Bronchial pattern
- Structured interstitial pattern
- Multiple lung lobes affected
NOT associated with influenza virus: cranial mediastinal widening, thoracic lymphadenopathy, bronchial pattern, structured interstitial pattern
ASSOCIATED: unstructured interstitial pattern, alveolar pattern, pleural effusion (rare), multiple lung lobes affected
Secrest VRU 2016
125
What is the radiographic distribution of interstitial to alveolar infiltrates in canine influenza virus infection?
Most commonly, cranioventral; can be diffuse or caudodorsal, however this is thought to represent an earlier timepoint in disease course, and infiltrates would become cranioventral over following few days
Secrest VRU 2016
126
What are the possible effects of medroxyprogesterone acetate administration in dogs?
- Contraception (rarely used for this clinically): similar to endogenous progesterone, inhibits myometrial contractility and causes endometrial proliferation
- Weight gain
- Adrenocortical depression
- Diabetes
- Mammary tumors
- Endometrial hyperplasia
- Pyometra
- Diffuse endometrial mineralization (in this case report)
Jeong VRU 2016
127
What is the gastric emptying half-time of solid food mixed with barium in dogs imaged without sedation or restraint? When does contrast first appear in the duodenum?
Gastric emptying half-time = 60-120 min
Duodenal contrast first appears at 30 min
Wrigglesworth VRU 2016
128
Describe the appearance of feline tooth resorption on CT.
Irregular, hypoattenuating defects associated with the external surfaces of the tooth, most commonly at the root or cementoenamel junction. Mandibular PM3 most commonly affected.
Lang VRU 2016
129
What HU correspond to hyperinflated, normoaerated, poorly aerated, and nonaerated pulmonary parenchyma in cats and dogs under inhalant anesthesia?
Hyperinflated: -1000 to -901
Normoaerated: - 501 to -900
Poorly aerated: -101 to -500
Nonaerated: -100 to +100
Guarracino VRU 2016
130
What is the optimal positive airway pressure level to apply during breath-hold for evaluation of the pulmonary parenchyma with thoracic CT?
airway pressure level to apply during breath-hold for evaluation of the pulmonary parenchyma with thoracic CT?
10-12 cm H2O
Best value to minimize atelectasis without causing hyperinflation
Guarracino VRU 2016
131
What are the theoretical cardiovascular effects of application of positive airway pressure? Have these been proven clinically relevant for healthy patients?
- Increased right atrial pressure
- Decreased venous return
- Decreased stroke volume and cardiac output
- Decreased arterial blood pressure
Not documented to be clinically relevant in stable patients, but could potentially be a problem in unstable patients.
Guarracino VRU 2016
132
A repeatable pattern of subchondral bone resorption has been observed radiographically and with CT of equine stifles with osteoarthritis. Where is this resorption located?
- Medial tibial plateau, cranial and/or caudal aspects
- Medial aspect of the lateral femoral condyle, in the caudal portion of the intercondylar fossa
De Lasalle VRU 2016
133
What is the most common location for osteophytes affecting the equine stifle?
Medial femorotibial joint - osteophytes can make their own sort of Morgan line associated with the insertion of the medial femorotibial joint capsule cranially on the medial femoral condyle
De Lasalle VRU 2016
134
What is an example of homologous variation in vertebrae?
Variation within vertebral bodies without change in total vertebral number or identity; for example, transposition of the caudal portion of ventral process of C6 onto C7 in horses
Veraa VRU 2016
135
What is an example of homeotic variation in vertebrae?
Change in numbers of one section of vertebrae without a change in the total number; for example, a transitional C7 with hypoplastic ribs, but there is still a proper T1 with normal ribs.
Veraa VRU 2016
136
Which consistently provides better evaluation of articular cartilage thickness in the equine metacarpophalangeal joint, CT-arthrography or MR-arthrography?
Neither, there was no modality that provided consistent assessment of articular cartilage thickness.
Porter VRU 2016
137
Regarding image management:
- What does .jpeg stand for?
- Is .jpeg a 'lossy' method of image compression?
- What is one of the major determinants of the degree to which compression degrades image quality?
- Joint Photographic Experts Group
- .jpeg compression is lossy, which means it is irreversible. The opposite would be 'lossless', or reversible compression.
- one of the major determinants of the degree to which compression degrades image quality is the COMPRESSION RATIO
Noel VRU 2016
138
What is the effect on sensitivity and specificity of recently qualified radiologists, compared to radiologists with many years of post-residency experience?
Recently qualified radiologists tend to have higher sensitivity and lower specificity.
Noel VRU 2016
139
What is/are the recommended diagnostic modalities for evaluating traumatic abomasitis in the cow?
Radiographs AND ultrasound - because US is limited by ingesta, gas, and other organs, so radiographs are needed to identify any radiopaque foreign material and increase the suspicion for foreign bodies, which have been reported (in this paper) to cause traumatic abomasitis and colic.
Constant VRU 2016
140
What is the appearance of gallbladder wall edema on contrast-enhanced ultrasound?
Double-rim sign, just like in conventional US.
Bargellini VRU 2018
141
What is the difference between polypoid cystic mucosal hyperplasia and non-polypoid cystic mucosal hyperplasia, in CEUS of the canine gallbladder?
CEUS will enhance the polyps of the polypoid version, will not enhance the other version because...it doesn't have polyps...
Both will have wall enhancement, no difference there
Bargellini VRU 2018
142
What is the approximate distribution of unilateral, bilateral, and multifocal disease in thyroid lobes for cats undergoing 99mTcO4 thyroid scintigraphy?
1/3 unilateral, 2/3 bilateral, 4% multifocal
Peterson VRU 2014
143
Which is more sensitive for detection of feline hyperthyroidism, thyroid to salivary ratio or thyroid to background ratio? What about total T4 levels?
Both ratios are very sensitive, but thyroid to salivary ratio is more sensitive (98% compared to 96%). TT4 least sensitive at 90%.
Note that this has no relation to specificity.
Peterson VRU 2014
144
What is the effect of methimazole administration on thyroid:salivary ratio in hyperthyroid cats?
No effect, doesn't change it.
Peterson VRU 2014
145
T/F: Quantitatively, thyroid scintigraphy does not change after methimazole therapy in hyperthyroid cats.
True.
Fischetti VRU 2005
146
Name 5 general categories of differentials for young dogs (14 mo or less) with progressive brainstem or cerebral signs.
Inflammatory/infectious, degenerative, malformation, neoplasia, meningioangiomatosis.
Bishop JVIM 2004
147
Describe the MR features of meningioangiomatosis.
T2w hyper, T1w iso- to hypo, strongly contrast enhancing, located peripherally and extending into parenchyma. +/- subarachnoid space narrowing. Does NOT have a mass effect. Is a weird benign hamartoma-y thing.
Bishop JVIM 2004
148
In contrast-enhanced ultrasonography, what is the difference between peak intensity and mean intensity?
Peak intensity = maximum contrast enhancement
Mean intensity = mean pixel intensity over 60 sec
Rademacher VRU 2016
149
What is the effect of pancreatitis on mean and peak pixel intensity on contrast-enhanced US evaluation of the canine pancreas?
Dogs with pancreatitis have increased mean and peak pixel intensity of their pancreas compared to the pancreas of normal dogs.
These values decreased at a 10-15 day recheck.
Rademacher VRU 2016
150
Does ultrasound guidance improve operator total success rate in injection of the canine lumbosacral space, compared to landmark-guided blind injection?
Yes. To the surprise of no one.
Etienne VRU 2016
151
What disease categories are most common causes of neurologic disease in small ruminants? (E.g. neoplastic, vascular)
Toxic-metabolic and infectious.
Ertelt VRU 2016
152
What is the MRI appearance of polioencephalomalacia in small ruminants?
Bilaterally symmetric grey matter lesions of the forebrain: T2w-hyper, T1w-hypo, moderately contrast-enhancing
Ertelt VRU 2016
153
What is the MRI appearance of enterotoxemia in the brain of small ruminants?
Bilaterally symmetric thalamic lesions: T2w/FLAIR-hyperintense, T1w-HYPERintense, non-contrast enhancing (which is weird, it seems like polioencephalomalacia would be not-enhancing and enterotoxemia would be enhancing, but it's the other way around)
Ertelt VRU 2016
154
What is the MRI appearance of listeriosis in the brain of small ruminants?
Brainstem lesions, variable distribution, asymmetric: T2w/FLAIR-hyperintense, T1w-isointense, +/- contrast enhancement.
(Mainly remember it's brainstem and asymmetric.)
Ertelt VRU 2016
155
What are the clinical characteristics common to both ischemic myelopathy and acute noncompressive nucleus pulposus extrusion in dogs?
Both are characterized by hyperacute onset of non-deteriorating, often markedly lateralizing paresis or plegia
Fenn VRU 2016
156
What is the difference in origin of spinal cord injury between fibrocartilaginous embolism (FCE) and acute noncompressive nucleus pulposus extrusion (ANNPE?)
- FCE causes primarily ISCHEMIC injury
- ANNPE causes primarily CONTUSIVE injury, due to explosive extrusion of nucleus pulposus; followed by variable secondary injury and edema
Fenn VRU 2016
157
What are 4 MRI criteria for making a diagnosis of ANNPE?
1) Focal area of intramedullary T2w-hyperintensity overlying a disk space
2) Reduction in volume of T2w-hyperintense nucleus pulposus signal
3) Mild narrowing of the associated disk space
4) Extradural material, or change in signal intensity, with minimal or no evidence of compression at this level
Fenn VRU 2016
158
What are 3 MRI criteria for making a diagnosis of ischemic myelopathy (aka presumed FCE)?
1) Focal, well-demarcated intramedullary T2w-hyperintensity
2) Affects grey matter
3) Does NOT have the criteria of ANNPE (i.e. it's not over a disk space and there is no associated disk space narrowing or loss of nucleus pulposus signal)
Fenn VRU 2016
159
In a study comparing interobserver agreement, lesions that were overlying a vertebral body and were not lateralized were more likely to have what agreed-upon presumptive diagnosis?
Ischemic myelopathy/FCE
Fenn VRU 2016
160
In a study comparing interobserver agreement, lesions that were overlying a disk space, were lateralized, with reduced nucleus pulposus volume of that disk space, +/- extradural material or signal change, were more likely to have what agreed-upon presumptive diagnosis?
ANNPE
Fenn VRU 2016
161
In evaluating transverse MRI images of the spinal cord in dogs with presumed ANNPE, what percent of cross-sectional area of lesion compared to total cord (e.g. lesion represents 30% of total cord) is 92% predictive of unsuccessful outcome?
90%
De Risio JAVMA 2009
162
Why do central tarsal bone fractures in horses tend to be nondisplaced or minimally displaced?
Due to support from the intertarsal ligaments
Knuchell VRU 2016
163
What is the common fracture configuration and orientation of central tarsal bone fractures in racehorses?
Slab fracture in the dorsal plane (best seen on lateromedial radiographs)
Knuchell VRU 2016
164
What is the common configuration and orientation of central tarsal bone fractures in non-racehorses?
Slab fracture, dorsomedial to plantarolateral, non-displaced
Need PLDMO views, often multiple at slightly different angles of obliquity, to see fx
Knuchell VRU 2016
165
What are three common thoracic lesions in horses with lymphoma?
- Pleural effusion
- Cranial mediastinal lymphadenopathy
- Lung parenchymal changes
Janvier VRU 2016
166
What sonographically identifiable abdominal lesions can be seen in equine lymphoma?
- Hepatomegaly, splenomegaly
- Diffuse hyper/hypoechogenicity of liver and/or spleen
- Nodular change
- Masses, less commonly
- Lymphadenopathy
- Peritoneal effusion
(So not unlike small animals.)
Janvier VRU 2016
167
What distinguishing characteristic can be identified on CT in cases of adenosquamous carcinoma, to differentiate it from fungal or other neoplastic causes of rhinosinusitis?
Adenosquamous carcinoma is more aggressive and more severe; characterized (in the 1 existing case report) by extensive osteolysis extending well beyond the sinonasal region to affect the calvaria, occipital condyles, and atlas.
Chow VRU 2016
168
What are the MRI signal characteristics of trigeminal neuritis in horses?
Moderate to marked nerve enlargement, T1w/T2w iso- to hypointense to grey matter, peripherally contrast enhancing; possible widening of the foramina secondary to pressure atrophy
Beltran VRU 2016
169
What are two possible differentials for unilateral trigeminal nerve enlargement identified on CT or MRI of the equine head?
- Peripheral nerve sheath tumor
- Trigeminal neuritis
Beltran VRU 2016
170
What is the most common primary hepatic tumor in dogs?
Hepatocellular carcinoma, makes up 50% of all primary hepatic tumors.
Constant VRU 2016
171
What is gadoxetate disodium, how is it excreted, and what is it used for?
- Paramagnetic contrast agent for MRI
- 50% hepatobiliary and 50% renal excretion in humans
- Used for liver-specific contrast MRI of the liver
Constant VRU 2016
172
What contrast enhancement is expected for lesion vs. normal liver parenchyma in gadoxetate disodium-enhanced MRI of canine hepatocellular carcinoma? Why?
Hepatocellular carcinoma is expected to be LESS enhancing than normal liver parenchyma
This is because HCC hepatocytes have retained, but impaired, functional capacity --> are not able to take up and excrete contrast agent as readily as the surrounding normal parenchyma, so are less enhancing by comparison.
Constant VRU 2016
173
Is the cranioventral recess of the equine coxofemoral joint a normal structure? How is it formed?
Not normal.
Theorized that it forms as a pathologic response to severe effusion and/or joint capsule stretching during excessive femoral head excursion in horses with coxofemoral luxation or subluxation.
Whitcomb VRU 2016
174
What are the two possible approaches for US-guided injection of the coxofemoral joint in horses?
Dorsal or cranioventral; the latter is preferred when a cranioventral recess of the coxofemoral joint is present.
Whibcomb VRU 2016
175
What CT feature of feline nasopharyngeal polyps may help distinguish them from a collection of exudate or a neoplastic mass?
Consistent ring enhancement - masses are more likely to enhance heterogeneously
This paper demonstrated that, to the surprise of no one, the ring enhancement of polyps is correlated with the degree of peripheral inflammation present, and is negatively correlated with the degree of peripheral edema present. Because inflammation is more enhancing than edema.
Lamb VRU 2016
176
What is truncation or Gibbs artifact?
A line of abnormal signal intensity that occurs parallel to an interface between tissues of markedly different signal intensity. Occurs in ALL MR sequences, is a result of Fourier transform. Produces T2w-hyperintense lines and T1w-hypointense lines.
Gregori VRU 2016
177
How can truncation artifact be minimized? Name 3 ways.
- Increasing spatial resolution (decreasing pixel size)
- Applying pre-reconstruction filters (e.g. Hamming or Tukey)
- Post-processing optimization (e.g. Total Variation method)
Gregori VRU 2016
178
What is the appearance of truncation artifact in sagittal vs. transverse T2w images of the canine spinal cord?
- Sagittal: hyperintense line overlying the cord, parallel to the long axis of the cord; wider at lower resolution, becomes multiple smaller bands at higher resolution
- Transverse: multiple concentric zones of alternating signal intensity
Gregori VRU 2016
179
In dynamic sonography of the equine distal limb, what is an indication of palmar/plantar annular ligament desmitis?
Restricted gliding motion between the palmar/plantar annular ligament and the SDFT.
DiGiovanni VRU 2016
180
Is optic nerve sheath diameter as determined by transpalpebral ultrasound correlated with age and weight in horses?
No correlation with age and weight.
Foals were all <5 mm, adults were all <6.5 mm; these could be used as cutoffs if a relationship between ONSD and ICP is ever proven in horses.
Cooley VRU 2016
181
Name four conditions that can present with swelling of the mandible in goats.
- Primary dental disease (abscesses)
- Actinomycosis (lumpy jaw)
- Fibrous osteodystrophy secondary to hyperparathyroidism
- Neoplasia: osteosarcoma, osteoma, ossifying fibroma, non-ossifying fibroma, adenocarcinoma, or multinucleated giant cell tumor
Dixon VRU 2016
182
What are the CT characteristics of multinucleated giant cell tumor in a goat?
Aggressive, monostotic, multiloculated, extensive, with deformation of the affected bone and surrounding structures (mandible, in the 1 reported case). Contrast was not given so don't know how it enhances.
Dixon VRU 2016
183
What are the contrast enhancement characteristics of the spleen on CEUS in dogs?
Progressive enhancement, sometimes heterogeneous, to homogeneous peak enhancement; then progressive and homogeneous washout.
Rossi VRU 2016
184
What is the effect of dexmedetomidine on CEUS of the spleen in dogs? Butorphanol?
Dex - Delayed enhancement with diminished intensity: prolonged arrival time, time to peak; decreased AUC and peak intensity.
Butorphanol - no effect
Rossi VRU 2016
185
What MRI findings are more likely to be associated with intervertebral disk protrusion vs. extrusion?
- Protrusion: longer duration of clinical signs, midline instead of lateralized herniation, and partial instead of complete disk degeneration
- Extrusion: single herniation site, disk material dispersed beyond the borders of the disk space
Gomes VRU 2016
186
What is the difference between pachymeninges and leptomeninges?
Recall that meninges are dura - arachnoid - pia
Pachymeninges = dura mater
Leptomeninges = arachnoid and pia
187
In a study evaluating dogs with inflammatory brain disease, did dynamic subtraction imaging improve visualization of meningeal enhancement?
No. Dynamic subtraction did improve visualization of contrast-enhancing intra-axial lesions.
Dirrig VRU 2016
188
Why does US contrast enhancement differ between the gallbladder vs. the liver and bile ducts?
Because GB is supplied solely by the cystic artery, has different blood supply than liver and bile ducts.
Bargellini VRU 2016
189
What additional evaluation is preferred to further evaluate gallbladder wall necrosis or rupture suspected on ultrasound, in order to confirm or rule out the need for emergent surgical intervention?
Contrast-enhanced ultrasound provides better sensitivity and specificity than conventional US.
Bargellini VRU 2016
190
Why is it advisable to use specifically medium-size (~8g) solid food boluses when evaluating swallowing with video fluoroscopy?
To minimize variation in swallowing parameters caused by variation in bolus size. Large (12g) boluses are associated with earlier UES opening and later maximum pharyngeal contraction compared to medium boluses.
Cheney VRU 2016
191
Name 3 dog breeds predisposed to supracollicular fluid accumulations (previously called quadrigeminal cysts).
Shih Tzu, Chihuahua, Maltese
Bertolini VRU 2016
192
Name the intensities of the following stages of hemorrhage on T1w and T2w images:
- Hyperacute, < 24 hrs
- Acute, 1-3 days
- Early subacute, 1-7 days
- Late subacute, 7-14 days
- Chronic, >15 days
- Hyperacute = iso/hyper (I Bleed)
- Acute = iso/hypo (I Die)
- Early subacute = hyper/hypo (Bleed Die)
- Late subacute = hyper/hyper (Bleed Bleed)
- Chronic = hypo/hypo (Die Die)
Thomas VRU 2016
193
How long can magnetic susceptibility artifact persist after arthroscopy in horses? What is its suspected origin?
Up to 12 weeks demonstrated so far (their study didn't run longer than that). Theorized to result from either hemorrhage or small surgical metallic debris.
Thomas VRU 2016
194
Which approach is easier to perform and more accurate for CT-guided injection of the lumbosacral epidural space, translaminar or transforaminal?
Translaminar. Incorrect needle position may result in subarachnoid contamination and vertebral venous plexus puncture.
Liotta VRU 2016
195
In ultrasound-guided injection of the collateral ligaments of the equine distal interphalangeal joint, what are the periligamentous structures that are most commonly inadvertently also injected?
Distal interphalangeal joint and common digital extensor tendon.
Lewis VRU 2016
196
Which modality is best for detection of defects in the cruciate ligaments, proximal tibia, and ligament entheses of the equine stifle? Which for detecting articular cartilage damage on the medial femoral condyle?
CT-arthrography is better than rads or US. MRI is not an option because you can't MR the stifle.
No modality is good at detecting articular cartilage; requires arthroscopy.
Nelson VRU 2016
197
Why is axial skeletal lymphoma often not visible on radiographs, and only identified on MRI?
Because axial skeletal lymphoma is often not primarily lytic - does not cause the 30-50% loss of mineral density required for radiographic visualization. Is very visible on STIR sequences because the medullary fat is replaced by malignant cellular infiltrate.
Kornder VRU 2016
198
What condition should be distinguished from diskospondylitis in young dogs?
Physitis of the caudal vertebral physis: lysis is initially restricted to the caudal vertebral physis, leading to collapse of the vertebral body and spondylosis of the caudal aspect of the vertebral body. Disko has symmetric osteolysis of the endplates with spondylosis deformans of the cranial and caudal disk spaces.
Ruoff VCNA 2017
199
What are the two most common sites for dysphagia in dogs?
- Esophagus: esophageal motility disorders (45% of dysphagic dogs)
- Abnormalities of the lower esophageal sphincter/hiatus (45% of dysphagic dogs)
* Note that in this study, 38% of dogs had concurrent abnormalities in multiple anatomic locations, so could also have pharyngeal or cricopharyngeal problem
Pollard VRU 2017
200
If a videofluoroscopic swallowing study is normal in a dysphagic dog, what are two differentials that cannot be ruled out on the basis of a normal study?
Gastroesophageal reflux or sliding hiatal hernia, as these are transient events that may not have been seen during the study period
Pollard VRU 2017
201
What does an elevated pharyngeal constriction ratio indicate, and with which anatomic origins is it associated in dysphagic dogs?
Elevated pharyngeal constriction ratio = decreased ability of pharynx to adequately propel a bolus through the upper esophageal sphincter
Associated w/ dysphagia of pharyngeal (normal UES opening) or cricopharyngeal (abnormal UES opening) origin
Pollard VRU 2017
202
What is the MR appearance of leukoaraiosis?
T2w/FLAIR-hyperintense, T1w-isointense pre- and post-contrast, contiguous with lateral ventricles with variable periventricular extension into white matter
Also hyperintense on ADC, low FA on DTI (humans only)
Often accompanied by brain atrophy and thinning of interthalamic adhesion
Scarpante VRU 2017
203
What is osmotic demyelination syndrome?
Result of hyponatremia + aggressive correction of hyponatremia: leads to myelinolysis and T2w hyperintensities of periventricular white matter, particularly affecting the pons
Scarpante VRU 2017
204
Name three findings associated with the presence of pulmonary hypertension on radiographs.
- Right ventricular enlargement
- Main pulmonary artery enlargement
- Caudal lobar artery enlargement
Adams VRU 2017
205
Are thoracic radiographs able to differentiate severity of pulmonary hypertension?
No, no correlation between radiographic findings and severity of pulmonary hypertension. Echocardiography should remain the gold standard for PHT evaluation, though radiographs can provide useful additional information.
Adams VRU 2017
206
Are lymph nodes with hyperechoic perinodal fat more likely to be reactive, neoplastic, or inflammatory?
Hyperechoic perinodal fat = unlikely to be reactive (which in this study meant hyperplastic); equally likely to still be benign (inflammatory, aka lymphadenitis) or malignant (neoplasia), therefore sampling may be indicated
Dave VRU 2017
207
Should sagittal STIR sequences replace sagittal T2w sequences in evaluation of the canine spine for intervertebral disk herniation?
No, there was no statistically significant difference in sensitivity between T2w and STIR sequences in identifying the exact disk space, or localizing the region of disk spaces, of intervertebral disk herniation
Housley VRU 2017
208
What are the differentials for a broad-based, focal, ventrally convex soft tissue opacity associated with the dorsal tracheal wall on thoracic radiographs of a dog?
- Hematoma
- Abscess
- Migrated or broken extraluminal tracheal ring prosthesis (correlate with history)
- Dorsal tracheal membrane neoplasia
- Esophageal stricture or adhesion or mass
* Unlikely to be redundant tracheal membrane when focal
Paradise 2017 VRU
209
What is the normal range for bronchoarterial ratios in healthy dogs?
0.8 - 2.0
Coia VRU 2017
210
Name 5 differentials for heterogeneously hyperattenuating pulmonary nodules with ground glass opacity on canine thoracic CT.
- Angiostrongylus vasorum infection
- Eosinophilic bronchopneumopathy
- Pulmonary lymphoma
- Granulomatous disease
- Histiocytic sarcoma
Coia VRU 2017
211
What are the thoracic CT findings typically associated with Angiostrongylus vasorum infection in dogs?
- Peripheral distribution of increased lung attenuation with diffuse, poorly organized, and multifocal nodules of ground glass opacity
- Tracheobronchial lymphadenopathy
Coia VRU 2017
212
With which 4 neoplasms is pleural metastasis associated?
- Transitional cell carcinoma
- Mammary carcinoma
- Prostatic carcinoma
- Epithelial neoplasms (e.g. squam)
In theory can be any carcinoma, but these are the top 4
Watton VRU 2017
213
What CT characteristics differ between malignant pleural effusion vs. pleuritis?
More associated with malignancy:
- Presence of pleural thickening (65% malignant, but seen in 35% of pleuritis cases)
- Worse pleural thickening (3 mm vs. 0 mm median)
- Thickening of the parietal pleura only (best discriminator)
More associated with pleuritis:
- Mediastinal LN enlargement
Watton VRU 2017
214
What are the thoracic CT findings associated with the acute phase of leptospirosis in dogs?
- Short-lived peribronchovascular thickening and bronchiolectasis (resolves within 3-7 days)
- Areas of consolidation and consolidated nodules --> rapidly morph into ground glass lesions of similar distribution
- Ground glass nodules
Gendron VRU 2017
215
What are the two most common organs affected at ultrasound in patients with leptospirosis? Name two atypical findings that have occurred in patients with leptospirosis in that one paper, that they said were 'caused by' leptospirosis in a completely unfounded claim.
- Kidneys (100%) and liver (83%)
- Gallbladder mucocele and small intestinal intussusception (wat)
Sonet VRU 2017
216
Screening thoracic radiographs are worthwhile in what populations of canine and feline patients?
- Cats in general
- Geriatric patients in general
- Cats with anemia or low-normal PCV
- Dogs with elevated lactate
Summary: cats, anemic cats, hyperlactatemic dogs, old cats and dogs
Keyserling VRU 2017
217
In a study evaluating use of computational fluid dynamics for assessing airflow resistance in brachycephalic dogs, what region of the nasal passages exhibited the largest airflow resistance?
The rostral third of the nasal passages exhibited larger airflow resistance than the middle or caudal thirds. (This actually makes sense if you picture where the turbinates are densest on CT.)
Hostnik VRU 2017
218
What is the relationship between tympanic bulla morphology and presence of middle ear effusion in brachycephalic dogs?
There isn't one. No significant relationship between tympanic bulla morphology and presence of middle ear effusion could be identified.
Mielke VRU 2017
219
In brief, describe the technique for CT-lymphangiography with aqueous contrast in evaluating tumors of the head in dogs.
- Position in sternal, caution with ET tube ties and padding to ensure no blocking of lymphatic flow
- Inject 1 ml of contrast in 4 quadrants around the tumor
- Serial CT scans 1 min apart until sentinel node identified; usually identified within 3 minutes
Grimes VRU 2017
220
What location was most affected by lumbosacral stenosis in a study evaluating lumbar and lumbosacral CT in Labradors?
Cranial L6
(Study evaluated vertebral canal at endplates of L5-6, L6-7, and L7-S1)
Mukherjee VRU 2017
221
What is the expected effect of age on interthalamic adhesion thickness, ratio of interthalamic adhesion to brain height, and ratio of (interthalamic adhesion to brain height) to (lateral ventricle to brain height)?
All three parameters are expected to decrease with age.
Noh VRU 2017
222
Which MRI sequence is preferred for clearest depiction of normal canine femoral and sciatic nerves in a 3T magnet? Which sequence will reduce nerve visualization the most? Which imaging planes should be used?
- Clearest nerves: T1w, because of good visualization of peri-neural fat
- Reduced nerve visualization: anything fat-saturated, because the fat helps highlight the nerves
- Sciatic and femoral nerves can be seen in dorsal and transverse planes. Sagittal was not useful.
Sievert VRU 2017
223
What is palatal instability in horses?
'Billowing' of rostral and caudal soft palate around the edges of the epiglottis, without displacement of the soft palate over the epiglottis. Can be precursor to DDSP.
Barakzai Eq Vet Educ 2012
224
Which phase of respiration is affected by dorsal displacement of the soft palate in horses?
Expiration - soft palate billows up and blocks a good portion of airflow --> inc airway resistance --> impaired performance
Barakzai Eq Vet Educ 2012
225
In ultrasound evaluation of the equine larynx, what structure can be assessed and its depth (from the skin surface) measured and correlated with likelihood of the horse having DDSP?
Basihyoid bone, where it meets the lingual process; depth from skin surface correlated with likelihood of DDSP. Bigger measurement = less likely DDSP, smaller measurement = more likely.
Chalmers VRU 2009
226
What are the three sites of insertion for congenital extrahepatic portosystemic shunts originating from the left gastric vein in dogs?
1) Left gastrophrenic - to L phrenic vein
2) Left gastrocaval - to post-hepatic caudal vena cava (post-hepatic = after the liver, from a blood flow perspective)
3) Left gastroazygos - to azygos vein
White JSAP 2013
227
What is the definition of ground glass opacity on CT?
Hazy increase in lung opacity without obscuring vessels or bronchi, is secondary to partial replacement of alveolar gas with fluid or cells - or secondary to thickening of the interstitium with fluid or cells.
Schiborra JSAP 2017
228
Describe the signalment associated with open-mouth jaw locking in cats. Name 3 possible predisposing factors.
- 1-10 YO, any breed but brachycephalics overrepresented
- Trauma, TMJ dysplasia, mandibular symphyseal laxity
Nutt JFMS 2017
229
Hyperechoic mucosal striations are associated with what histopathologic finding and clinical syndrome?
Lacteal dilation on histopath; protein-losing enteropathy clinically - hypoalbuminemic, sometimes panhypoproteinemic, hypocalcemic and hypomagnesemic
Sutherland-Smith VRU 2007
230
T/F: Hyperechoic mucosal striations can distinguish between primary inflammatory disease, primary lymphangiectasia, and villus histiocytic sarcoma.
False - all three of these can have hyperechoic mucosal striations, and can look the same.
Sutherland-Smith VRU 2007
231
T/F: Intestinal wall thickness on US can be used to distinguish between food-responsive IBD, idiopathic IBD, and protein-losing enteropathy.
False. There was no significant difference in wall thickness between these two groups. Wall thickness was neither sensitive nor specific for presence, type, or severity of disease.
Gaschen VRU 2008
232
A normal, hypoechoic jejunal mucosa in dogs with signs of chronic enteropathy (>3 wks increased frequency, decreased consistency, and decreased volume of defecation) is suggestive of what subtype of inflammatory disorder?
Food-responsive (aka food allergy) enteropathy; this is in contrast to protein-losing enteropathy, which more often has hyperechoic striations; or idiopathic, which did not have specific US findings. Hyperechoic mucosal speckles are nonspecific inflammatory change.
Gaschen VRU 2008
233
Name some differentials for thoracic CT findings of moderate to marked bronchial wall thickening, alveolar to ground glass multifocally, and mild to moderate bronchiectasis in dogs with a history of chronic cough.
- Crenosoma vulpis
- Angiostrongylosis
- Eosinophilic bronchopneumopathy
- Chronic bronchitis
- Infectious bronchopneumonia of any kind
* * Not the same as for Pneumocystis or HW (remember HW should have vascular changes)
Mortier VRU 2018
234
Briefly describe the thoracic CT features of Pneumocystis carinii, Dirofilaria, Crenosoma vulpis, and Spirocerca lupi infections in dogs.
- Pneumocystis: Diffuse or multifocal ground glass pattern, variable bronchial dilation, parenchymal bands, possible pulmonary hypertension.
- HW: Multifocal interstitial ground glass opacity, tortuous and blunted pulmonary arteries (w/ filling defects from PTE), hypoventilation and bronchial collapse in multiple lung lobes.
- Crenosoma: Multifocal ground glass pattern, marked bronchial thickening, moderate bronchiectasis, sometimes parenchymal bands.
- Spirocerca: Esophageal nodules.
235
Describe the thoracic CT findings of feline heartworm disease.
Multifocal interstitial ground glass opacity, tortuous and blunted pulmonary arteries, multiple arterial filling defects if angiography, bronchial collapse with resulting hypoventilation of lung regions.
Panopoulos VRU 2017
236
At what age does the thymus start to regress? Are the neoplastic cells responsible for a thymoma the thymic epithelial cells or the immune cells?
5 months
Epithelial cells, even though lots of immune cells are there
Patterson JAAHA 2014
237
Describe the thoracic US features of cranial mediastinal thymoma vs. lymphoma.
- Thymoma - often cystic, often heterogeneous echogenicity
- Lymphoma - often homogeneously hypoechoic, but can be heterogeneous, no cysts
=> Lack of cysts + homogeneous = more likely lymphoma; cysts + heterogeneous = more likely thymoma
Patterson JAAHA 2014
238
What is the normal adrenal gland size in both chronically sick (with non-adrenal illness) and healthy cats, as measured on US?
Cranial pole - 3.0-4.8 mm
Caudal pole - 3.0-4.5 mm
No statistically significant difference in size btwn the two groups.
Combes JFMS 2013
239
In cats with unilateral adrenal masses, what may be histologically (but not sonographically) identified in the contralateral adrenal gland?
Contralateral gland is usually sonographically normal, but cat adrenal carcinomas can be bilateral with histologic infiltration of the sonographically normal gland with carcinoma.
Combes JFMS 2013
240
T/F: Benign and malignant adrenal masses can cause hyperaldosteronism in cats.
True.
Combes JFMS 2013
241
Name 5 conditions with which vertebral venous system anomalies have been associated in dogs.
1) Arteriovenous malformation
2) Occlusion (e.g. due to presence of large intra-abdominal masses, or pregnancy)
3) Thrombosis or agenesis of other vessels such as the vena cava or jugular veins
4) Herniated disks
5) Connective tissue disorder (Marfan's syndrome)
Vernon VRU 2017
242
What is subclavian steal syndrome?
Retrograde flow within a vertebral artery as a result of stenosis or occlusion of the subclavian artery. Mostly asymptomatic but can be associated with ipsilateral thoracic limb paresthesia or claudication.
Vernon VRU 2017
243
What is an unusual neoplastic differential for multifocal, intra-axial and/or intramedullary lesions that are hyperintense on T1w images of the canine brain and spine?
Oligodendroglioma
Not typically T1w-hyperintense, but can be
Schkeeper VRU 2017
244
What are the primary sonographic features of insulinoma in ferrets?
Multifocal (contrast to dogs and cats), hypoechoic, can be homogeneous or heterogeneous
Wu VRU 2017
245
Describe the typical signalment and presenting complaint of ferrets with insulinoma. What is the incidence of ferret insulinoma?
- average 5 YO (range 2-7 YO)
- no sex predilection
- signs of hypoglycemia (ptyalism, pawing at face)
- incidence 22%: most common ferret neoplasm; adrenocortical and lymphoma are next most common
Wu VRU 2017
246
Name a recently developed radiographic method of assessing humeroulnar congruity in normal dog elbows.
Measuring radius of curvature of the humeral trochlea and ulnar trochlear notch. This paper was a methods description study that didn't describe the method.
Alves-Pimenta VRU 2017
247
What are the thoracic CT findings more prevalent in aged dogs than in young dogs?
- Heterotopic bone and partial lung collapse (aka atelectasis)
- Fibrosis, emphysema, ground glass or reticular pattern, or pleural/bronchial/septal thickening were NOT age-related and should not be considered incidental in dogs w/ respiratory signs.
Hornby VRU 2017
248
T/F: Fractal analysis of canine pulmonary vasculature based on thoracic CT is able to diagnose pulmonary thromboembolism.
False.
Fractal analysis able to distinguish healthy dogs from sick dogs, but not able to distinguish sick dogs with PTE from sick dogs without.
Muller VRU 2017
249
Name the modality options for injecting the distal DDFT in standing horses. Which is preferred?
- US-guided: difficult, can't be done to distal tendon b/c probe can't reach
- Bursoscopic or CT-guided: both require general anesthesia; bursoscopic requires lesions in dorsal part of tendon, in navicular bursa
- Rad-guided, transcuneal: limited access to only a part of the tendon
- Open MRI-guided, standing: Preferred b/c no general anesthesia, can reach all of needed structures; however no papers yet on injection of lesions, only this proof-of-concept paper using normal cadaver limbs
Groom VRU 2017
250
Describe the MRI findings of idiopathic oculomotor neuropathy in dogs.
- Variable on T2w, FLAIR, and T1w
- Majority are contrast-enhancing, focal or diffuse
- Majority have some enlargement, of variable degree
Clinical signs are always unilateral. CSF is mostly normal. Good prognosis, can improve w/ or w/o meds, and do not deteriorate.
Tetas Pont VRU 2017
251
What cranial nerves can be affected in middle cranial fossa syndrome, also known as cavernous sinus syndrome?
3, 4, 5, and 6
Oculomotor, trochlear, abducens, and the 3 branches of the trigeminal
Tetas Pont VRU 2017
252
Describe the ultrasonographic appearance of intrasynovial hair shafts. What is the clinical relevance of this finding?
Hair shafts appear as small, thin, linear hyperechogenicities WITHOUT distal acoustic shadowing.
In cases with history of trauma and apparent inflammation of the synovial structure, finding of hair shafts indicates need for arthroscopic debridement as opposed to needle lavage.
Partlow VRU 2017
253
What are the differential diagnoses for a geographic, osteolytic lesion with cortical destruction, in the region of the interosseous ligament of the radius and ulna?
- Bone cyst
- Primary bone tumor (weird)
- Metastatic disease
- Fungal disease
- RUIN lesion (necrosis thought to be result of ischemia of interosseous ligament attachment sites)
Schmid VRU 2016
254
What are the cutoffs compatible with dementia based on interthalamic adhesion thickness and ratio of interthalamic adhesion thickness:brain height, on CT or MRI of canine brains? Which parameter is preferred for use?
Interthalamic adhesion thickness: <4.7 mm associated with dementia
Interthalamic adhesion thickness:brain height: <13.6%
Interthalamic adhesion thickness:brain height is preferred because it does not vary as much with age, brain height, body weight, etc.
Noh VRU 2017
255
What 2 anatomic structures are most affected in medial humeral epicondylitis in cats? What 2 structures are not affected by MHE? What is the recommended treatment, surgical or medical?
- Primarily humeral head of the flexor carpi ulnaris
- Ulnar nerve, flattened and impinged by bony proliferation
- Medial coronoid and medial collateral ligament are NOT affected.
- Surgical management: debridement of proliferation, tendon, release of ulnar nerve
Streubel Vet Surg 2015
256
What is the utility of pulmonary trunk:aorta ratio on CT of the canine thorax?
- Can be used to distinguish patients with moderate to severe pulmonary hypertension
- Cannot distinguish between mild PHT, and no PHT
- Ratio of 1.4 is proposed
Sutherland-Smith VRU 2018
257
Name 4 conditions with which sliding hiatal hernia is associated.
- Brachycephalic obstructive airway syndrome
- Chronic diaphragmatic hernia
- Tetanus
- Laryngeal paralysis
Broux Vet Surg 2017
258
What are the predominant clinical features of focal lipogranulomatous lymphangitis in dogs?
- Chronic diarrhea +/- vomiting
- Minimal biochemical abnormalities
- Ultrasonographic evidence of thickened ileal or proximal colonic wall: mainly muscularis and serosa
Sx biopsies recommended, endoscopic were mainly nondiagnostic.
Lecoindre JSAP 2016
259
What are the top three differentials for canine tonsillar neoplasia? Name 3 benign differentials.
1) Squamous cell carcinoma *can be bilateral
2) Melanoma
3) Lymphoma
Benign - tonsillar polyp, hyperplasia, or tonsillitis
Thierry VRU 2018
260
What CT features clearly differentiate benign from malignant tonsillar disease in canines?
Trick question, there aren't any. Both benign and malignant overlap in heterogeneity, size, contrast enhancement. Policy should be that if you have an enlarged MRPLN of uncertain etiology, you should sample the tonsils even if they look normal.
Thierry VRU 2018
261
Which dog breeds are more likely to have sliding hiatal hernias?
French bulldogs - suspected breed predisposition
Any brachycephalic presenting for BOAS with GI signs (regurgitation, vomiting)
Reeve JSAP 2017
262
Name 5 differentials for a well-circumscribed intramedullary lucency with surrounding sclerosis in the long bone of a horse.
- Aneurysmal bone cyst
- Intraosseous ganglion
- Non-ossifying fibroma
- Fibrous dysplasia
- Bone infarction
Stocker EVJ 2017
263
Cats with _______ are 21x more likely to have positive bile culture results compared to cats with _____.
Cats with 1 or more findings of GB disease (sludge, wall thickening, cholelithiasis, mucosal hyperplasia, wall edema) were 21x more likely to have (+) culture results compared to cats with normal GB US.
If normal GB US, 96% probability that bile culture will be negative.
Policelli Smith JVIM 2017
264
What MRI technique has been used to evaluate the vascular anatomy of a PDA in dogs?
Black blood imaging clearly depicted the course of the PDA from the pulmonary artery to the aorta in 3 dogs.
Lee VRU 2017
265
What is the difference between 'torsion' and 'volvulus'?
```
Torsion = twisting of an intestinal segment around its axis - colonic torsion often not associated with acute abdomen
Volvulus = rotation of a segment of bowel around its mesenteric axis - colonic volvulus generally associated with acute abdomen
```
Plavec Vet Surg 2017
266
What is the most sensitive modality for detection of small volume pneumothorax in the horse?
2-D and M-mode ultrasound is most sensitive compared to radiographs (80-84% compared to 48%)
Partlow VRU 2017
267
What are 'rice bodies', where are they found, and with what diagnosis are they associated?
Rice bodies = fusiform, slightly hyperechoic to muscle structures made up of fibrin, collagen, and RBCs; found in bursae of horses (and also humans), associated with chronic bursitis.
Hohu VRU 2018
268
Describe a protocol for positive contrast colonography (radiographs, not fluoro).
- 60% w/v barium suspension, diluted 1:1 with water, administered as enema at dose of 3 ml/kg
- Can also do up to 10 ml/kg, diluted to 20%
Gremillion VRU 2018
269
What are most common presenting complaints in patients with colonic torsion?
Vomiting (most common), mild abdominal pain
* Severe pain or hypovolemic shock are uncommon with colonic torsion
Gremillion VRU 2018
270
What are the most common radiographic signs associated with colonic torsion?
Cecal displacement to the L, descending colonic displacement to the R, colonic narrowing/segmental colon
Gremillion VRU 2018
271
What is a CT MIP?
MIP = maximum intensity projection; this is a CT post-processing technique that uses only the highest attenuating voxels projected along a line through the dataset to generate a two-dimensional image.
Can be used to increase confidence in defining small structures like pulmonary nodules, ectopic urters.
Secrest VRU 2017
272
Describe the CT characteristics of lipomas vs. infiltrative lipomas.
Lipoma = rounded, well-defined, mostly homogeneously fat-attenuating with sometimes hyperattenuating components
Infiltrative lipoma = irregular, margins range from good to poor definition, mostly homogeneous, tendency towards linear hyperattenuating components
**Note that both can be associated with regional lymphadenopathy, if less commonly than liposarcs. LNs do not a diagnosis of aggressive disease make, even with lipomas.
Spoldi VRU 2017
273
Describe the CT characteristics of liposarcomas.
Often rounded to ovoid, margins range from good to poor definition, heterogeneous with hyperattenuating, often nodular or conglomerate components
In contrast to lipomas/infiltrative lipomas, liposarcs can have other features of aggressive dz: mineralization, regional osteolysis
Spoldi VRU 2017
274
Describe the biologic behavior of liposarcoma.
Locally invasive, low metastatic rate, high recurrence rate
Spoldi VRU 2017
275
Describe in brief 3 theories as to how syringohydromyelia develops in COMS patients.
1) Waterhammer effect - change in intracranial pressure during systole drives either CSF or a pressure wave into the central canal, causing progressive expansion
2) Slosh effect - with distention of epidural veins during cough/sneeze, CSF flows more freely in the syrinx than in the subarachnoid space --> pressure waves cause CSF to slosh and fissure surrounding parenchyma
3) Ball valve effect - herniated cerebellar vermis at the foramen magnum contributes to progressive fluid accumulation within the spinal cord
Dewey Compendium 2004
276
Name some causes of prehepatic portal hypertension.
Congenital atresia
PV fibrosis, thrombosis, or neoplasia
Extraluminal obstruction (mass, LN, abscess)
Hepatic arteriovenous fistula (b/c arterial blood overfills the PV)
Flukes - Schistosoma or Heterobilharzia
Complication of congenital PSS attenuation
Buob JVIM 2011
277
Name some causes of posthepatic portal hypertension.
Right heart failure (tamponade, pericardial effusion, pulmonary hypertension)
Budd-Chiari syndrome
Intraluminal or extraluminal fibrosis/thrombosis/neoplasia of the posthepatic CVC
Buob JVIM 2011
278
What is Budd-Chiari syndrome? (Not to be confused with Chiari malformation.)
Budd-Chiari syndrome = obstruction of hepatic venous outflow in the caudal vena cava or larger extrahepatic veins; obstruction is most commonly due to intraluminal obstruction by tumor, thrombosis, or congenital fibrous webs; or to extraluminal compression by tumor.
Buob JVIM 2011
279
What is the effect of ascites on prognosis in dogs with chronic hepatitis?
Worsens it. Ascites is negative prognostic indicator.
Buob JVIM 2011
280
In experimental models of canine portal hypertension, how long does it take for acquired shunts to form?
5-14 weeks
Buob JVIM 2011
281
Which type of portal hypertension CANNOT be the cause of acquired shunts? (i.e. prehepatic, intrahepatic, presinusoidal, etc.)
Post-hepatic - b/c the obstruction is after the PV and CVC have met, so it doesn't matter if there's a shunt between the PV and CVC, and there is no pressure gradient to form one because the PV and CVC are suffering the same hypertension due to whatever is obstructing the posthepatic CVC
Buob JVIM 2011
282
Where do acquired shunts tend to form in dogs - from what vein to what anastomosis to what vein?
From splenic vein --> anastomose with embryonic connections to the gonadal veins --> empty into left renal vein
Buob JVIM 2011
283
Where do acquired shunts tend to form in cats?
Left gastric --> phrenicoabdominal vein
Left colic --> left gonadal vein
Buob JVIM 2011
284
Name 2 factors that distinguish between single extrahepatic shunts and multiple acquired shunts based on ultrasound findings.
Acquired shunts are greater in number (>2) and smaller in size (<0.4 cm).
Buob JVIM 2011
285
The presence of both multifocal renal cysts and bile duct abnormalities (e.g. dilation, ectasia, calcification) may be seen with what condition?
Caroli's disease
Heather Spain, 2017
286
T/F: Portal hypertension can be associated with gastric ulcers.
True.
Buob JVIM 2011
287
Is the insertion of the lateral patellar ligament in a horse stifle expected to be homogeneous with regular fiber pattern?
No; expected to be inhomogeneous with irregular fiber pattern, or with gaps in the fiber pattern. This is important to remember in order to avoid false positive diagnosis of LPL damage.
Gottlieb EVJ 2016
288
Of injuries to the three patellar ligaments in the equine stifle, one is associated with trauma, and one is not. Which is which?
Middle patellar ligament injuries are mostly atraumatic (no inciting traumatic event known). Lateral patellar ligament injuries are most commonly traumatic (e.g. kicked, ran into something, etc).
Gottlieb EVJ 2016
289
Between radiographs and ultrasound of the equine stifle, which is more sensitive vs more specific for detection of OCD lesions?
Rads: lower sensitivity, higher specificity (80 vs 100)
US: higher sensitivity, lower specificity (100 vs 60-80)
Beccati VRU 2013
290
Name two distinguishing CT characteristics of lipomas/infiltrative lipomas vs. liposarcomas.
- Liposarcomas contrast-enhance, while lipomas/infiltrative lipomas do not.
- Liposarcomas tend to be soft tissue-attenuating (HU>0) with some fat foci, while lipomas/infiltrative lipomas are fat-attenuating (HU<0).
Fuerst VRU 2017
291
In measuring the area of the L7-S1 intervertebral foramen on MRI of dogs with degenerative lumbosacral stenosis, what patient position, location of measurement, and slice orientation provides measurement of the minimum foraminal diameter?
- Hyperextended spine position (as opposed to neutral)
- 'Middle zone' of nerve, defined as the area of nerve passing under the pars interarticularis and pedicle
- Parasagittal oblique, defined as perpendicular to the nerve root exiting the spinal cord, as opposed to parallel to the long axis of the spine
Zindl VRU 2017
292
True or false: Intervertebral foramen diameter, and therefore potential nerve claudication at the foramen, is dynamic and influenced by position in dogs with degenerative lumbosacral stenosis.
True.
Zindl VRU 2017
293
What is the lower limit of normal for interspinous space measurement on a lateral radiograph in horses? (I.e. how small is it before it is abnormal)
4 mm
Djernaes VRU 2017
294
Name one patient factor, one CT scanning factor, and one contrast medium factor that affect contrast enhancement in CT angiography.
- Patient factors: body weight (patient size), cardiac output
- CT scanning factors: scan delay, table direction, scan duration
- Contrast factors: iodine volume, duration/rate of injection, saline flush
Lee VRU 2017
295
T/F: Arterial enhancement on CT angiography is directly proportional to the flux of iodine that enters the circulatory system in mg I/sec.
True. The mg I/sec is calculated from the injection rate, in ml/sec; and the concentration, in mg I/ml.
Lee VRU 2017
296
A 3-kg dog requires a three-phase liver angiogram. Due to small patient size, a 24g IV catheter is placed. Will a contrast injection rate of 1.5 ml/sec provide adequate enhancement of and distinction between arterial, portal and delayed phases?
Yes. Injection rate is decreased because the volume injected in a 3 kg dog is so small, that if you used the standard 3 ml/sec your phases would pass by before the CT could scan it. 3 ml/sec is the standard because this faster injection rate has been shown to provide wider enhancement between arterial and venous phases.
Lee VRU 2017
297
What is traction bronchiectasis?
Irreversible dilation of the bronchioles that occurs secondary to pulmonary fibrosis. Is a result of traction from the surrounding fibrous tissue that dilates the bronchial lumen without other signs of bronchial disease.
Fitzgerald VRU 2017
298
What is the Macklin effect?
(Burt Macklin, FBI.)
Macklin effect = air leaking through sites of alveolar rupture, tracking along the interstitium of the bronchovascular bundle and accumulating in the mediastinum. Means pneumomediastinum as a result of primary lung disease.
Fitzgerald VRU 2017
299
What is the modality of choice for highest sensitivity and specificity in identifying canine tarsal fractures?
CT is most sensitive.
However, the second part is a trick, because radiographs and CT are approximately equally specific.
Greatest difference in sensitivity between rads and CT was for evaluation of 4th tarsal bone - rads could potentially underestimate 4th tarsal fx occurrence.
Butler VRU 2018
300
Which is more sensitive in identifying canine tarsal fractures on radiographs, two orthogonal views or a 10 view study including oblique and stressed views?
Neither, they were equally sensitive.
Butler VRU 2018
301
Name three diagnostic utilities for 18F-FDG PET or PET/CT.
- Cancer staging
- FUO hunt
- Extent of disseminated fungal disease
- Assessment of perfusion
- Localization of inflammation
Grobman VRU 2018
302
Caudal articular process dysplasia in dogs is associated with what signalment and clinical signs?
- Pugs, French bulldogs, and English bulldogs; no age or sex predilection
- Pugs 97% affected! And almost all APLASIA, as opposed to hypoplasia
- Clinical signs part is a trick question: dysplasia is present in clinically normal and neurologic dogs
Bertram VRU 2018
303
Describe the prevalence of caudal articular process dysplasia, and aplasia vs. hypoplasia, in French bulldogs, English bulldogs, and Pugs.
- Frenchies: 70% dysplastic; 1/3 aplasia, 2/3 hypoplasia
- EBLs: 84% dysplastic, 1/4 aplasia, 3/4 hypoplasia
- Pugs: 97% dysplastic, 99% aplasia, 1% hypoplasia
Bertram VRU 2018
304
What is elastography?
Sonographic method that evaluates tissue elasticity by comparing local tissue displacement before and after application of a compressive force. Compares the radiofrequency signal before and after mild tissue compression to reflect the hardness of a lesion.
Seiler VRU 2018
305
Can benign and malignant lymph nodes be differentiated using elastography?
Sort of. LN hardness was statistically significantly different between benign (softer) and malignant (harder), however there was overlap between the two groups, so elasticity cannot be used as a sole criterion. Recommended to use in conjunction with standard greyscale US findings (size, echogenicity, hilus, etc).
Seiler VRU 2018
306
Name the HU ranges for pure fluids (water, bile, urine, intestinal fluid), unclotted extravascular blood, and clotted blood.
Pure fluids: 0-15 HU
Extravascular unclotted blood: 30-45 HU
Clotted blood: 45-75 HU
Specchi VRU 2017
307
Define 'sentinel clot sign'.
The highest-attenuating hematoma adjacent to a bleeding organ in patients with a hemoabdomen. Median attenuation in this study was 56, compared to median attenuation of the hemoabdomen of 34.
Specchi VRU 2017
308
Is a sentinel clot expected to enhance with contrast administration?
In general, no, because it is a clot and therefore avascular. Exception is when there is serpiginous or amorphous, strong enhancement within the sentinel clot, representing active bleeding into the clot from the organ of origin.
Specchi VRU 2017
309
What is the approximate prevalence of canine ovarian tumors, their signalment or other predilections, and general prognosis?
- Low prevalence, 1.2%
- Sex predilection for...female
- Usually unilateral, and more often left-sided (weird)
- Good prognosis if complete excision, poor if metastasis
Rowan VRU 2017
310
Which is more sensitive for evaluation of metastatic lymphadenopathy in dogs with anal sac carcinoma: US, or contrast-enhanced CT?
- Trick question, US and CT+c are about equally sensitive. CT is able to detect many more normal iliosacral LNs, detection rate of abnormal iliosacral LNs was about equal between the two modalities.
- CT is indicated to evaluate specifically sacral LNs (better at these than US, b/c they are intrapelvic) and for surgical planning
Pollard VCO 2017
311
What is the difference between primary and secondary peristalsis, according to Watrous and Suter?
```
Primary = triggered by oropharyngeal reflex/swallowing phase
Secondary = triggered mechanically by esophageal luminal distention or tactile stimulation
```
Watrous VRU 1979
312
For dual-phase CT of the gastrointestinal tract, what timing is likely to present good mucosal enhancement of the small intestines vs. of the stomach and pyloric region?
Small intestines: 30 sec delay is best; PV enhancement >/= 43 HU
Stomach and pyloric region: 'late' enhancement, aka 60 sec or more
Fitzgerald VRU 2017
313
An 11-year-old Warmblood gelding, 2/5 lame on the LF, undergoes standing MRI of the fetlock. There is focal STIR-hyperintensity with PD/T1w/T2*GRE hypointensity adjacent to the sagittal groove of P1, and MCP degenerative joint disease. What common injuries affect this area (sagittal groove of P1), and what is the prognosis for return to function?
- Common injuries: osseous cyst-like lesions, subchondral bone loss, incomplete mid-sagittal fractures
- Prognosis: poor, 30% return to performance level when concurrent sagittal groove injury and OA. Theory that presence of OA indicates a worse prognosis than same injury without OA.
Gold VRU 2017
314
What are the MRI characteristics of a periradicular lipoma? By comparison, what are the MRI characteristics of a myelolipoma?
- Periradicular lipoma = around/along nerve roots, T2w/T1w-hyperintense, STIR-hypointense, non/minimally contrast-enhancing
- Myelolipoma = also T2w/T1w-hyperintense and STIR-hypointense, but more heterogeneous, due to the hematopoietic components of a myelolipoma instead of pure fat
Both can be intraspinal, but rare.
Wahle VRU 2017
315
What is the incidence and signalment associated with atresia ani in dogs? What are the 4 types of atresia ani?
- Incidence: rare; 0.007% (<0.01%)
- Signalment: females > males, more common in Finnish spitz, toy poodles, min Schnauzers, Boston terrier, GShP, Chow; age usually <24 weeks but can be >1 YO
- 4 types: type I - congenital anal stenosis; II - imperforate anus; III - imperforate anus + rectum ends as blind pouch; and IV - distal rectum and anus develop normally but are discontinuous with the proximal rectum, which is atretic
Vianna JAAHA 2005
316
With what other comorbidities is atresia ani associated? What specific imaging test (special procedure) is indicated to identify one of these comorbidities?
Other congenital defects: rectovaginal fistula in particular, also more standard things like cleft palate, hypospadias
Special procedure is retrograde positive contrast vaginography, to see whether there is communication with the rectum
Ellison JAVMA 2012
317
Which sub-phase(s) of oropharyngeal swallowing deficits is/are commonly associated with aspiration?
Pharyngeal and cricopharyngeal.
- Oral dysphagia = almost no aspiration
- Pharyngeal dysphagia = more aspiration
- Cricopharyngeal dysphagia = more aspiration
Suter VRU 1980
318
Cricopharyngeal dysphagia is often associated with dysfunction of what other component of the swallowing reflex system?
Esophageal dysfunction: poor proximal esophageal motility, proximal esophageal dilation, lack of primary peristalsis --> secondary peristalsis is predominant mode of bolus transport to stomach
Can also have mixed dysphagias of cricopharyngeal + pharyngeal or whatever, but that is less common than having cricopharyngeal + esophageal deficits
Watrous VRU 1983
319
What is the most common cause of pneumonia in foals?
Rhodococcus equi
Heidmann Clin Tech Eq Pract 2006
320
What are lesions associated with R equi infection in susceptible foals?
- Pneumonia is most common
- Other lesions include: vertebral osteomyelitis, other osteomyelitis, physitis, uveitis, enteritis/colitis...
Hematogeneous spread presumed
Giguere EVJ 1994
321
What lung patterns are expected on radiographs acquired within 12-24 hours of birth in normal foals, septicemic foals, immature foals, and foals with respiratory distress syndrome?
Normal foals - normal lungs, no pattern
Immature or septicemic - diffuse interstitial
RDS foals - alveolar **differentiate from bronchopneumonia
Lamb VRU 1990
322
Name two differentials for the causative organism in lung abscesses in foals <6 months of age.
Rhodococcus equi
Strep zooepidemicus
*Equal prevalence in this study - one was not more likely than the other. Other studies say R equi is most common cause of foal pneumonia.
Lavoie EVJ 1994
323
What radiographic findings are significantly associated with outcome in foals with rhodococcal pneumonia?
- Severity of alveolar pattern
- # cavitary lesions
Giguere VRU 2012
324
What alternative diagnostic imaging test is recommended for field evaluation of suspected pneumonia in foals, if radiographs are not available?
Thoracic ultrasound. Can see consolidation, abscesses, pleural thickening, pleural fluid. Limited by lack of depth, but R equi pneumonia is usually diffuse enough that there are plenty of lesions in the periphery of the lung.
Ramirez VRU 2004
325
Name 2 underlying etiologies for spontaneous, secondary pneumothorax in cats.
- Small airway disease (chronic lower airway disease, asthma)
- Heartworm or lungworm infection
Recall that secondary spontaneous pneumo = due to parenchymal lung disease. Primary spontaneous = no underlying lung disease, and has not been reported in cats.
White JAVMA 2003
326
What is the overall recommended management strategy for canine vs. feline spontaneous pneumothorax?
Canine - surgical, directed at underlying cause (bulla, migrating FB, neoplasia, etc) often with lobectomy of the affected lung lobe
Cats - conservative, underlying cause seems to be most commonly diffuse lung parenchymal disease (inflammatory airway disease) with fewer cases d/t ruptured neoplasia [do still go to sx if conservative tx not working]
Mooney JFMS 2012
327
List some differentials for an older dog with acquired esophageal dilation.
- Motility disorder causing megaesophagus (thymoma, hypothyroidism, Addison's, myasthenia, lead, neuropathy/myositis, botulism, tetanus)
- Distal esophageal obstruction (stricture, FB, neoplasia, granuloma [spirocerca])
Types of neoplasia: SCC, leiomyoma (good survival time), leiomyosarcoma, lymphoma, carcinoma, OSA or fibrosarc from spirocerca
Robin JAVMA 2018, Okanishi JSAP 2015
328
Describe a minimally invasive interventional radiology treatment option for distal esophageal leiomyoma in a dog.
Palliative stenting - turned out radial compression of stent for a few months was enough to alleviate clinical signs even after the stent migrated, was removed, and never replaced
Robin JAVMA 2018
329
What is Barrett's esophagus? What is its clinical relevance?
- Barrett's esophagus = human term, but happens in dogs: replacement of the squamous epithelium of the esophagus with glandular epithelium that more resembles intestine
- Occurs secondary to chronic reflux/regurg
- Clinically relevant because is considered 'premalignant', due to stepwise progression from metaplasia, to dysplasia, to neoplasia --> leads to adenocarcinoma or adenosquamous carcinoma
Okanishi JSAP 2015
330
How is Spirocerca lupi infection diagnosed?
Finding eggs in feces, or gastroesophageal endoscopy
Kirberger VRU 2015
331
What is the classic triad of CT/rad findings for spirocercosis in endemic (tropical) areas?
- Aortic aneurysm
- Caudal thoracic spondylitis
- Caudal mediastinal mass (the esophageal sarcoma)
Kirberger VRU 2015
332
Name the differentiating factors between neoplastic and non-neoplastic Spirocerca nodules in esophageal CT in dogs.
between neoplastic and non-neoplastic Spirocerca nodules in esophageal CT in dogs.
Neoplastic: irregular, have mineralization, poor perfusion, and reduced contrast enhancement
Non-neoplastic: smoother, never have mineralization, more hypoattenuating with necrotic pockets pre-contrast, enhance well (around the necrotic pockets)
Both are hypoattenuating precontrast (30 vs 40 HU, malignant vs non)
Kirberger VRU 2015
333
What contrast medium would you choose for an upper GI in a red-eared slider turtle and why?
Gastrografin, aka diatrizoate, chosen over barium sulfate because it can be administered faster and has faster transit time --> faster results available. Both have minimal hemodynamic effects. Gastrografin does dilute out a little in distal SI and colon.
Long VRU 2010
334
What is the difference in total intestinal transit time of barium sulfate vs. ionic iodinated contrast in tortoises/turtles? (Ballpark only.)
BaSO4: 144-166 hours
Diatrizoate: 17-24 hours
This question is just to illustrate why diatrizoate would be a much better choice than barium for upper GI in a reptile.
Numbers from Seth's book.
335
What are the 3 most common diagnoses for dysphagic cats undergoing fluoro studies?
Hiatal hernia, esophageal stricture, and esophageal dysmotility. Most cats have multiple.
Oropharyngeal or cricopharyngeal causes of dysmotility were not identified in any cat.
Levine VRU 2014
336
Does sternal vs lateral recumbency affect swallowing parameters in dogs?
Yes. Sternal has faster transit times and more swallows associated with primary and secondary peristalsis.
Bonadio JVIM 2009
337
What is recommended first-line procedure after barium aspiration in humans and dogs, to reduce severity of inflammation afterwards?
Bronchoscopy with suction to remove as much barium as possible.
BAL contraindicated, b/c it just washes barium further into lungs without removing it.
Lobectomy can be considered based on severity and volume of barium
Meola JVECC 2008
338
What is the normal diameter of ferret small intestine?
5-7 mm
Schwarz VRU 2003
339
What is the normal gastric emptying time for barium sulfate in cats? Normal small intestinal transit time?
They are the same: 30-60 min.
Morgan VRU 1981
340
Name 6 differentials for causes of arterial thromboembolism in cats.
1) Secondary to HCM
2) Tumor emboli from primary pulmonary carcinoma
3) General anesthesia
4) Progestagens (wat)
5) Hyperthyroidism
6) Hypercortisolism
van Stee Can Vet J 2014
341
What is a recently reported potential cause for dorsal displacement of the soft palate in the horse?
Unilateral malformation of the hyoid apparatus - could have been congenital vs. traumatic
Dixon VRU 2017
342
Name three factors that suggest additional imaging (e.g. CT-myelography or MRI) will be required after CT with contrast of the spine in a T3-L3 myelopathy patient.
- Increasing patient age
- It's not a Dachshund (if it is, it almost never needs more imaging because it's almost always a disk)
- A surgical lesion was not identified on the CT
Emery VRU 2018
343
What common condition of prairie dog dentistry often presents as respiratory distress?
Incisor pseudo-odontomas: benign proliferative growth of the incisor tooth roots, which are elodont (constantly growing) teeth --> if affecting maxillary incisors, proliferation eventually impinges on the nasal cavity --> respiratory distress (turns out they are obligate nasal breathers). If mandibular, facial deformity but otherwise no effect.
Pelizzone VRU 2017
344
What is the basis of left lateral recumbency in a patient undergoing double contrast cystography?
Left lateral recumbency = right atrium UP and pulmonary trunk DOWN, keeps air bubbles from entering into the pulmonary arterial circulation which causes an air trap --> cyanosis, syncope, death
Zontine VRU 1970
345
What is neuronal heterotopia?
CNS malformation with arrest of normal migration of neuronal progenitor cells from the germinal matrix into the outer layers of developing cerebrum; results in accumulations of histologically normal, but aberrantly located, grey matter throughout the brain.
ADJ VRU 2018
346
What are the imaging features of neuronal heterotopia on MRI?
Isointense to normal grey matter on most/all sequences.
ADJ VRU 2018
347
What is the typical signalment associated with pneumocystosis?
Miniature Dachshunds and Cavalier King Charles spaniels; presumed breed-related immunodeficiency. Other breeds can be affected d/t immunosuppression from co-infection. Classically ~1 YO, but range 6 months - 6 years of age
Weissenbacher-Lang JVDI 2018
348
What is the typical clinical presentation of pneumocystosis?
Chronic respiratory signs, exercise intolerance, weight loss, partial or no response to usual treatments, usually not febrile unless pneumonia of other cause. Can have low or low-normal gamma globulins.
Weissenbacher-Lang JVDI 2018
349
In a study using CT-lymphangiography to define sentinel nodes for a variety of neoplasms all over the body, what were the doses of contrast vs body weight that provided good opacification of the nodes? (canine)
Dogs <10 kg: 0.8 ml
Dogs 10-20 kg: 1.2 ml
Dogs >20 kg: 2 ml
These were the total volumes, 1/4 of each amount was injected in 4 quadrants around the tumor bed.
Rossi VRU 2018
350
What is gliomatosis cerebri?
An extensive, aggressive growth pattern of various glioma types. Is not its own tumor type, because its histology is not unique.
Schweizer-Gorgas VRU 2018
351
What is the MRI appearance of gliomatosis cerebri?
White and grey matter + 3 or more contiguous lobes affected + thalamic and caudal fossa involvement = gliomatosis cerebri. 'Affected' = looks like a glioma, being T2w/FLAIR-hyper, T1w-iso to hypo, variable but generally little contrast enhancement.
Schweizer-Gorgas VRU 2018
352
In evaluating canine/feline abdominal radiographs of cases with signs of acute abdomen, is there increased accuracy or increased reader confidence associated with 3 views as opposed to 2 views in the study?
No. No statistically significant difference in diagnostic accuracy or reader confidence between 2-view and 3-view studies.
Mavromatis VRU 2018
353
What sonographic ratios were recently validated for assessing degree of dehydration in dogs?
Diameter of CVC to aorta in transverse and longitudinal planes. This paper was stupid. If you do this ratio, do it intercostal to avoid compressing the vessels, and trans diameters are more repeatable than long.
Kwak VRU 2018
354
Describe the normal characteristics of the feline pancreas on three-phase CT-angiography.
Hypo- to isoattenuating to liver and spleen in all phases, and homogeneously enhancing in all phases.
Secrest VRU 2018
355
What are the normal times to peak arterial enhancement and to peak portal enhancement in cats undergoing dynamic CT-angiography, in a study evaluating the angiographic appearance of the normal feline pancreas?
Peak arterial: mean 9 sec, range 4-12 sec
Peak portal: mean 21 sec, range 16-32 sec
Secrest VRU 2018
356
Describe a technique recently reported for diagnostic evaluation of bilateral congenital ureterovesicular junction stenosis in a ferret.
Negative contrast cystography (5 ml room air) + intravenous pyelography (850 mgI/kg), provided good opacification of kidneys and ureters and clear visualization of ureteral entrance into bladder.
Vilalta VRU 2017
357
What is the difference between ectopic spleen, accessory spleen, and splenosis?
Ectopic spleen = normal splenic tissue in an abnormal location; includes both accessory spleen or splenosis
Accessory = congenital extra splenic tissue, usually located in the gastrosplenic ligament
Splenosis = secondary to splenic rupture, splenectomy, trauma (splenic tissue grafts itself onto other tissue and stays there)
**Histopath diagnosis, no distinguishing features
Kutara VRU 2017
358
What is the difference in blood supply for accessory spleen vs. splenosis?
Accessory spleen - supply from branches of splenic artery and hilus
Splenosis - vasculature parasitized from surrounding tissue
Suggested that this is why ectopic spleen that is heterogeneously CT-contrast-enhancing is more likely splenosis, because of heterogeneous blood delivery via surrounding tissue
Kutarau VRU 2017
359
What rare embryonic remnant neoplasm might be associated with a mass that is located on midline, well-demarcated, T2w-hyper/T1w-iso to hypo, mildly heterogeneous and mildly contrast-enhancing, with a "honeycomb" appearance +/- GRE voids (of hemorrhage)?
Chordoma, uncommon neoplastic lesion derived from embryonic remnants of the notochord (and the one with 'physaliferous' cells)
Treat w/ sx + RT, no data on outcomes in animals
Brocal VRU 2017
360
What is a rare differential for a cat with multifocal neuro signs, signs of systemic disease (CBC/chem abnx), and bilaterally symmetric T2w/FLAIR hyperintensities that are non-contrast enhancing on brain MRI?
Feline systemic reactive angioendotheliomatosis: intravascular proliferative disorder that causes multisystemic vasculopathy, and is idiopathic and fatal. Other ddxs could be infx/infl encephalitis, intravascular lymphoma, post-ictal change.
Schkeeper VRU 2017
361
In a 2017 JVIM study of risk factors for acute ascending/descending myelomalacia in dogs with IVDD, what 4 factors were associated with development of myelomalacia?
- T2 length ratio >4.5 (ratio of length of T2w hyperintensity to length of L2 body): 15x more likely to develop MM
- <24 hours to become non-ambulatory: 3x
- <5 YO: 3x
- Paraplegia w/ no deep pain: 4x
Balducci JVIM 2017
362
What is the preferred location and technique for image-guided collection of CSF in the rabbit?
- Cerebellomedullary cistern (cisterna magna)
- US-guided
Anselmi VRU 2018
363
Why is CEUS preferred over standard color or power Doppler for evaluation of renal blood flow (e.g. in post-renal transplant patients)?
CWD and PWD can underestimate flow from small vessels, low-volume flow, or flow from unfavorable angles. CEUS is better at this and allows 'capillary level perfusion' quantification.
Greenbarg JFMS 2018
364
What changes to CEUS parameters were reported in a case of feline renal transplant allograft rejection?
Increased mean time to peak cortical echogenicity, slower wash-in and slower wash-out rates
Greenbarg JFMS 2018
365
What is a hamartoma?
Excessive, unorganized growth of normal cells and associated tissues intrinsic to the organ in which they occur (so sounds like cancer) but, because they have minimal growth in the mature animal, are NOT considered neoplastic. Are considered a congenital malformation.
Taylor-Brown VRU 2018
366
When are hamartomas more commonly diagnosed?
Juvenile patients, before the onset of skeletal maturity.
Taylor-Brown VRU 2018
367
What clinical effects can be associated with vascular hamartomas?
Clinical signs are based on location and may include mass effect, spontaneous hemorrhage, or adherence to adjacent tissues
Taylor-Brown VRU 2018
368
What is an osteochondroma?
Abnormal cartilaginous growth that is replaced with bone via endochondral ossification. Can affect soft tissues (esophagus, trachea) or skeletal structures (axial or appendicular).
Caporn JSAP 1996
369
What is the name of the condition in which an animal is affected by multiple osteochondromas?
Osteochondromatosis, OR multiple cartilaginous exostoses
Caporn JSAP 1996
370
What are the imaging findings associated with pulmonary pythiosis in dogs?
- Tracheobronchial lymphadenopathy
- Bronchopneumopathy: bronchial thickening, peribronchial interstitial infiltrates; the one case had a pulmonary mass with displacement and involvement of trachea and a principal bronchus
Kepler VRU 2017
371
What is the pressure-volume index with respect to the brain and spinal cord?
PVI = the volume of fluid that, when injected intrathecally (aka into the subarachnoid space) would increase ICP by a factor of 10. Higher PVI = more compliance, can inject larger volume without much increase in ICP.
Arany-Toth VRU 2012
372
What are the general doses of iodinated, non-ionic contrast for myelography in dogs 5 kg, 15 kg, or 30 kg?
5 kg or less: 0.35 ml/kg
15 kg: 0.22 ml/kg
30 kg or more: 0.19 ml/kg or slightly less
Arany-Toth VRU 2012
373
What signalment is associated with congenital corpus callosal abnormalities in dogs?
- Staffordshire bull terriers and miniature Schnauzers
- Young: 3-19 months reported
Interestingly, they can live years with supportive care (externally managed water supplementation)
Goncalves JVIM 2014
374
What clinical signs are associated with corpus callosal abnormalities in dogs?
- Can be neurologically normal (weird) but can also have ataxia, proprioceptive deficits, circling, tremors, seizures
- Main sign is adipsia/hypodipsia
- +/- ichthyosis, hyperkeratosis of footpads
- Hypernatremic on bloodwork
Goncalves JVIM 2014
375
Miniature horses, Shetland ponies, and falabella ponies are predisposed to what orthopedic condition, which rarely occurs in full-size horses?
Primary shoulder osteoarthritis; suspected due to dysplasia of the scapulohumeral joint. In full-size horses shoulder OA occurs secondary to trauma, OCD, septic arthritis, or bone cyst.
Clegg Vet Rec 2001 (also in Parth Aust Vet J 2008)
376
What condition causes stertorous respiration, pharyngeal swelling, and sometimes nasal return of milk, coughing during suckling, or aspiration pneumonia in foals?
Guttural pouch tympany. Etiology unknown, fix with chronic Foley catheterization of the nasopharyngeal ostium, or laser ablation of the nasopharyngeal ostium.
Greet EVJ 2015
377
What MR features suggest high grade for astrocytoma?
Intratumoral hemorrhage
Degree of contrast enhancement (signals disruption of BBB)
Wisner VRU 2011
378
Most common sites for astrocytoma and oligodendroglioma
Both have predilection for frontal, piriform, and temporal lobes
Astrocytomas can also be in the diencephalon
Wisner VRU 2011
379
Choroid plexus tumors
6 yo, Golden retrievers
50% arise from 4th ventricle and apertures
Papillomas and carcinomas
Variable T1w appearance, T2w hyperintense, strongly and uniformly contrast enhancing
