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Radiology Packet 30

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Radiology Packet 30. Liver/Spleen. 13 yr ... 2 yr old FS Shih Tzu 'Jolie' ... 2 yr old FS Shih Tzu 'Jolie' 2 yr old FS Shih Tzu 'Jolie' RF. The liver is small. ... – PowerPoint PPT presentation

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Title: Radiology Packet 30


1
Radiology Packet 30
  • Liver/Spleen

2
13 yr old F Collie/LabLaurie
  • HX presented for collapse, she is weak and pale
    on examination and an abdominal mass may be
    present on palpation

3
13 yr old F Collie/LabLaurie
4
13 yr old F Collie/LabLaurie
  • RF
  • On the lateral view there is a round soft tissue
    mass in the mid-ventral abdomen which is
    obliterating the normal splenic shadow.
  • Serosal detail in this area is decreased and also
    the liver margin is rounded but not enlarged.
  • On the VD view the round mass is located in the
    cranial and central abdomen and it is pushing the
    transverse colon cranially,
  • RD
  • Splenic mass
  • Next
  • Abdominal ultrasound
  • Surgical removal of the spleen

5
16 yr old FS DSHBonnie Louise
  • HX presented with icterus and a history of
    chronic renal disease

6
16 yr old FS DSHBonnie Louise
7
16 yr old FS DSHBonnie Louise
  • RF
  • The liver is large, extending beyond the costal
    arch with a rounded caudal border.
  • Three small, roughly marginated mineralized
    opacities are present overlying the liver, in the
    region of the gall bladder and bile duct.
  • Both kidneys are small, a bit irregular, and have
    lost the characteristic shape.
  • Mild spondylosis and sites of IV disc space
    collapse.
  • Malalignment of S3-C1
  • RD
  • Cholelithiasis
  • Hepatomegaly
  • Small kidneys (consistent with history of chronic
    renal disease)

8
13 yr old F Miniature PoodleVelvet
  • HX presented for evaluation of a palpable
    abdominal mass

9
13 yr old F Miniature PoodleVelvet
10
13 yr old F Miniature PoodleVelvet
  • RF
  • The tail of the spleen is visible in the
    cranioventral abdomen and it appears to connect
    to the large centrally located mass.
  • The liver is of normal size.
  • The urinary bladder is small, it is visible in
    the caudal abdominal cavity.
  • The structures of the GI tract are displaced by
    the mass but are otherwise normal in appearance.
  • RD
  • Large abdominal mass, splenic in origin
  • Next
  • Metastasis check
  • Biopsy
  • Surgical Removal

11
3 yr old M Yorkshire Terrier
  • HX referred with a history of recurrent
    urethral obstruction and reported to have
    frequent episodes of lethargy and episodes of
    staring into space

12
3 yr old M Yorkshire Terrier
13
3 yr old M Yorkshire Terrier
14
3 yr old M Yorkshire Terrier
  • RF
  • In one lateral view the gastric axis is displaced
    very far cranially indicating that the liver is
    tiny.
  • The portion of the spleen that is visible appears
    normal.
  • They kidneys are best seen in the lateral view
    and appear approximately normal size.
  • Two fairly large, round mineral opacity
    structures are present in the bladder as well as
    some less defined mineral material.
  • Abdominal detail is less than normal but this is
    a result of lack of abdominal fat (the animal is
    very thin).
  • RD
  • Microhepatia
  • Cystic calculi
  • The radiographic findings and clinical signs lead
    to a single disease process portosystemic shunt

15
12 yr old MC Manx catMerlin
  • HX presented for lethargy and partial anorexia,
    his abdomen is tense on palpation

16
12 yr old MC Manx catMerlin
17
12 yr old MC Manx catMerlin
  • RF
  • Large soft tissue mass, mid-ventral abdomen on
    the lateral view, right of midline on VD view.
  • The head of the spleen is large.
  • There is decreased abdominal detail and the liver
    is large with rounded margins.
  • The left kidney is irregular in shape.
  • RD
  • Large intra-abdominal mass which may be entirely
    splenic in origin
  • Enlarged liver
  • Mild amount of abdominal fluid
  • Next
  • Abdominocentesis
  • Abdominal ultrasound and fine needle
    aspirate/biopsy of mass
  • Abdominal exploratory

18
11 yr old MC Mixed breed dogPal
  • HX presented for evaluation of increasing
    abdominal size and respiratory difficulty for the
    last 7 days, a grade 3/6 heart murmur is ausculted

19
11 yr old MC Mixed breed dogPal
20
11 yr old MC Mixed breed dogPal
21
11 yr old MC Mixed breed dogPal
  • RF
  • Evaluation of the cardiac silhouette is hindered
    by the presence of free pleural fluid.
  • There is a generalized increase in pulmonary
    tissue opacity due to superimposition of free
    fluid.
  • An air bronchogram is visible overlying the
    cranial cardiac margin in the lateral view and
    there is a mild increase in opacity of the left
    cranial lung lobe noted in the VD.
  • There is increased opacity in the cranial
    abdominal cavity which is caused by the presence
    of a mass lesion and the presence of free fluid
    leading to a loss of abdominal detail.
  • The tail of the spleen is visible but it appears
    large and has rounded indistinct borders.
  • The head of the spleen is not visible in the VD
    view, instead a rounded structure of soft tissue
    opacity is visible caudal to the stomach.
  • The stomach contains several mineral opacity
    structures(stones).
  • RD
  • Free pleural fluid and possible consolidation of
    the left cranial lung lobe
  • Cranioventral abdominal mass, most likely of
    splenic origin
  • Free abdominal fluid

22
6 yr old F AbyssinianHoney Bun
  • HX history of episodic vomiting and now anorexia

23
6 yr old F AbyssinianHoney Bun
24
6 yr old F AbyssinianHoney Bun
  • RF
  • There is a discrete mineral opacity, irregular,
    noted over the liver within the region of the
    gall bladder.
  • Two discrete, smaller foci of mineralization are
    noted on the lateral view along the rib margin,
    along the cranial edge of the stomach.
  • The stomach is empty.
  • The SI has some gas in it, some of it almost
    looks String of Pearls.
  • A large amount of intra-abdominal fat is present.
  • Note the large amount of sternal fat around the
    heart.
  • RD
  • Gall stones
  • Next
  • Surgical removal

25
11 yr old MC West Highland TerrierSam
  • HX the dog is presented for evaluation of
    splenomegaly and peripheral lymph node enlargement

26
11 yr old MC West Highland TerrierSam
27
11 yr old MC West Highland TerrierSam
  • RF
  • The liver is enlarged and the margins are
    rounded.
  • The head and tail of the spleen are visible and
    enlarged.
  • In the VD view an ovoid structure of soft tissue
    opacity is seen at the cranial margin of the left
    kidney and superimposed with the stomach.
  • The urinary bladder is small but visible in the
    caudal abdominal cavity.
  • RD
  • Generalized hepatomegaly
  • Generalized splenomegaly
  • Mass in left cranial abdominal quadrant (either
    enlarged left adrenal or lymph node)
  • Next
  • Ultrasound and fine need aspirate and/or biopsy

28
2 yr old FS Shih TzuJolie
  • HX Presented for vomiting and signs of
    dementia, blood work is pending. Following
    evaluation of the radiographs a splenoportogram
    is ordered.

29
2 yr old FS Shih TzuJolie
30
2 yr old FS Shih TzuJolie
31
2 yr old FS Shih TzuJolie
32
2 yr old FS Shih TzuJolie
  • RF
  • The liver is small.
  • Faint areas of mineralization are seen associated
    with the renal pelvis.
  • The urinary bladder is distended.
  • The contrast that enters the splenic vein
    proceeds to a venous structure that appears to be
    somewhat tortuous.
  • Also, there is reflux of some contrast material
    into the splenic parenchyma.
  • Contrast extends through a vessel which connects
    the splenic vein directly to the caudal vena cava
    at the level of T13.
  • Contrast is also visible in the cardiovascular
    structures and urinary system and it outlines
    multiple small calculi.
  • RD
  • Portosystemic shunt

33
14 yr old MC DSH
  • HX cranky, depressed, emaciated with pale
    mucous membranes

34
14 yr old MC DSH
35
14 yr old MC DSH
  • RF
  • Enlarged liver with irregular margins extending
    well beyond the costal arch.
  • Right-sided liver mass displacing the right
    kidney caudally.
  • Stomach axis is caudally positioned.
  • Diminished detail in the cranial and mid-abdomen.
  • Misshapen right kidney, left kidney is smaller
    than the right.
  • Stomach and colon contain mineral material.
  • Collapse of the lumbosacral disc space,
    spondylosis.
  • RD
  • Hepatic enlargement
  • Possible liver mass(es)
  • Free abdominal fluid
  • Asymmetric and misshapen kidneys
  • Next
  • Ultrasound and biopsy
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