Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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Chapter Three The Abd omen 265 Fig. 3-17 Transverse (A) and longitudinal (B) sonograms of the left kidney of a 5-year-old castrated male cat with a history of vomiting and jaundice of 1-week duration. There is a thin hyperechoic line visible within the renal medulla. This is a normal finding in some cats. It is due to accumulation of mineral within the renal medulla. Diagnosis: Normal kidney. A B may be positioned between the left kidney and the body wall, providing an acoustic window for examination of the kidney. The right kidney may be examined through the liver; however, the ribs may cast acoustic shadows that obscure portions of the right kidney. Ureters. The ureters in both the dog and cat extend caudally from the kidneys to the bladder, traversing the retroperitoneal space slightly ventral to the lumbar muscles and slightly lateral to the vertebral column. Normally, because of their small size the ureters are not visible, but it is helpful to know their course through the abdomen in order to detect conditions such as ureteral calculi. The abdominal portion of the ureter is retroperitoneal in location and lies adjacent to the psoas muscle. Within the pelvic cavity it enters the genital fold in the male and the broad ligament in the female. The ureters tunnel through the bladder wall and empty into the bladder at the ureteral orifice onto converging ridges called urethral columns. These columns continue caudally as ridges called plica urethra and meet to form the urethral crest, which projects into the urethra. In the male, this terminates at the colliculus seminalis. The proximal ureter may be identified during an ultrasonographic examination providing the patient is cooperative and a high-frequency transducer is used. The proximal ureter forms the base of the Y pelvis that extends along both sides of the renal crest. With good resolution, peristalsis may be evident in the proximal ureter just beyond the renal pelvis; however, the normal ureter cannot be traced beyond the pelvis. Mild to moderate renal pelvic dilation (pyelectasis) occurs secondary to intravenous fluid administration, and this dilation can be observed during the ultrasonographic examination in normal dogs. 38 The ureter must be distinguished from the renal artery and vein. This can be done using Doppler imaging to determine which is the artery and which is the vein. In addition, the renal vessels branch and enter the kidney away from the renal crest, more dorsal and ventral than the ureter in the transverse view, while the ureter branches directly on the renal crest. Ovaries. In the female, the ovaries are immediately caudal to the kidneys. They are not identifiable radiographically. The ovaries are difficult but not impossible to identify during an ultrasonographic examination. They can be found adjacent to the caudal pole or just caudal and somewhat lateral to the ipsilateral kidney. The ovaries are hypoechoic and partially obscured by surrounding fat. Their round shape and follicular architecture as well as their relationship to the ipsilateral kidney make their identification possible (Figs. 3-18 and 3-19). Small anechoic cysts and developing follicles have been identified. A lateral scanning plane, rather than a ventral approach, may facilitate localization and examination of the canine ovaries. 39
266 Small Animal Radiolo g y and Ultrasono graphy Fig. 3-18 A, Sagittal ultrasonogram of an ovary (defined by calipers) from a normal adult bitch. Note the numerous, similarly sized (3 to 4 mm) anechoic follicles around the perimeter of the ovary. B, Sagittal ultrasonogram of an ovary (defined by calipers) from a normal adult bitch. Note the large (>8 mm) anechoic follicle seen in the plane of the scan. Compare with A. Diagnosis: A, Normal anestrous ovary. B, Normal estrous ovary. (Figure courtesy Dr. Kathy Spaulding.) A B Adrenal Glands. Usually the adrenal glands are not identified radiographically. In older cats the adrenal glands may become mineralized and therefore evident on the abdominal radiograph. This is apparently an aging change and is not associated with clinical signs. Identification of the normal adrenals using ultrasonography requires a high-resolution transducer and a cooperative patient. 40-45 The left adrenal can be identified in most dogs, but finding the right adrenal is more difficult. The left adrenal lies adjacent to the aorta just cranial to the vascular pedicle of the left kidney. The adrenal may be found by imaging the left
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SAUNDERS An Imprint of Elsevier Sci
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C H A P T E R O N E Introduction GE
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Chapter One Introduction 3 Fig. 1-1
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metal. Soft tissues or organs surro
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Inadequate penetration will result
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Chapter One Introduction 9 signal i
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Chapter One Introduction 13 Mach ba
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Chapter One Introduction 19 Fig. 1-
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Chapter One Introduction 21 Fig. 1-
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Chapter One Introduction 23 24. Lev
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26 Small Animal Radiolo g y and Ult
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A B C Fig. 2-63 A 10-year-old male
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Fig. 2-101 A 7-year-old male mixed
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Page 215 and 216: 214 Small Animal Radiolo g y and Ul
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Fig. 3-234 A 7-year-old female Brit
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Fig. 4-59 A 9-year-old female Russi
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Fig. 4-73 A 2-year-old female Saint
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Fig. 4-97 A 10-year-old male mixed
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Fig. 4-107 A 4-year-old male Chow C
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I N D E X A Abdomen, abnormal prese
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Index 729 Bone, cysts of, 525-527,
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Index 731 Ear, abscess of—cont’
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Index 733 Hydrocephalus—cont’d
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Index 735 Lungs. See also Pulmonary
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Index 737 Pregnancy, determination
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Index 739 S-shaped aortic deformity
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