Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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Chapter Five The Skull 617 angling the x-ray beam at 30 degrees caudally (toward the sternum) so that it strikes the patient just caudal to the frontal sinuses (Fig. 5-11). 3 This view is helpful in evaluating the lateral aspects of the calvarium, the foramen magnum, and the odontoid process of C2. DENTAL RADIOGRAPHY Dental radiographs are recommended any time a dental abnormality is observed at the time of physical examination or if there is excessive bleeding during an oral examination. 4 Examples include evaluation of show dogs for missing or unerupted teeth, evaluation of older dogs with periodontal bleeding, evaluation of dogs with facial swelling or nasal discharge, evaluation of gingival masses, postoperative evaluation for the presence of retained tooth fragments or fractures, and evaluating patients for endodontics or periodontics. The use of full-mouth studies has been advocated to try to find clinically unidentified disease. 5-7 Radiographs of the teeth can be obtained either with regular radiographic equipment or dental radiography machines. When standard radiography machines are used an entire maxillary and mandibular arcade may be imaged in a single radiograph. 8 Although detail may be somewhat better using dental films and radiology equipment, the use of high-detail screen or nonscreen film with a standard machine usually provides adequate detail. Due to the curvature of the maxilla of most cats and some breeds of dogs, distortion of the image of the premolars and molars is present and in some cases may prevent accurate assessment of the image. If greater detail is needed, intraoral dental film can be used, with either a dental or standard radiographic unit. However, six or more views are required when nonscreen dental films are used. The greatest detail is achieved with the use of a dental radiographic unit and nonscreen intraoral film. The bisecting angle technique is recommended routinely for dental radiography in the dog, especially when radiographs of the maxillary teeth are desired. This technique requires directing the primary x-ray beam perpendicular to the bisection of an angle formed by the dental x-ray film and the axis of the tooth. 4,9-11 For maxillary molars and premolars in the cat, an extraoral near-parallel technique may be used to avoid the problem of zygomatic arch superimposition on the image. 5 In the parallel technique, the x-ray film is parallel to the long axis of the tooth, and the x-ray beam is perpendicular to the tooth. The technique can be used for some of the mandibular teeth. The dental x-ray film is held in place with stainless steel wire. The wire is secured to the teeth on either side of the tooth of interest. NORMAL ANATOMY OF RADIOGRAPHIC SIGNIFICANCE The anatomy of the normal skull is complex; however, the bilateral symmetry of the skull is helpful when evaluating radiographs because in many instances the opposite side may be used for comparison. Evaluation of the skull using a regional or topographic approach is recommended. In this manner, it is relatively easy to ensure full evaluation of the image. The system this text uses considers the following regions separately: (1) nasal passages and sinuses, (2) calvarium, (3) base of skull, middle ear, temporomandibular joints, (4) mandible, and (5) teeth. N A S A L PA S S AG E S A N D S I N U S E S The nasal passages of the dog and cat consist of several parts. Radiographically the planum nasale at the rostral aspect is apparent as a soft-tissue density with the air passages clearly demarcated. Further caudally, the nasal passages are evident as air-filled structures within the area surrounded by the maxilla and nasal bones. The fine, delicate bone densities of the conchae and turbinates will be seen clearly. Two fine, parallel, radiodense lines, which bisect the nasal passages into left and right sides, will be seen on the open-mouth ventrodorsal and intraoral views. This is the vomer, which supports the cartilaginous nasal septum. 12 The nasal cavity terminates in the nasopharynx ventrally, the frontal bones of the calvarium caudally, and the frontal sinuses dorsally. 12 The maxillary recesses rarely are visible as a specific structure. However, they are located immediately rostral to the frontal sinuses dorsal and medial to the fourth upper premolar. They appear as small, vaguely triangular, air-dense structures. These are not seen in cats and smaller breed dogs. Among dog breeds,
618 Small Animal Radiolo g y and Ultrasono graphy Fig. 5-11 A, Normal modified occipital view of the canine skull. B, Normal modified occipital view of the feline skull. A B the frontal sinuses vary considerably in size and shape. The smaller breeds have small to nearly nonexistent frontal sinuses that appear as small, inverted pyramid–shaped, air-dense structures just rostral to the dorsal part of the frontal bones. In cats and larger breed dogs, the frontal sinuses are relatively large, air-filled structures that are divided by one or more bony pillars.
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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 11 previou
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Chapter One Introduction 13 Mach ba
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Chapter One Introduction 17 indicat
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Chapter One Introduction 19 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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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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