Small Animal Radiology and Ultrasound: A Diagnostic Atlas and Text

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Chapter Five The Skull 645 Fig. 5-41 A 4-year-old male West Highland White Terrier with occasional seizures for 2 months. The ventrodorsal radiograph revealed a tissue density in the caudal portion of the right nasal passages and frontal sinus (f). Scrutiny, or comparison of the presence of the left frontal bone (arrow) with the opposite side, revealed lysis of the right frontal bone suggesting tumor penetration into the cranial vault. Differential diagnoses include nasal neoplasia and cranial neoplasia. Diagnosis: Nasal adenocarcinoma with extension into the cranial vault. Fig. 5-42 An 11-year-old male German Shepherd dog with a softtissue mass rostral to and involving the right eye. The lateral radiograph revealed a large tissue-density mass in the area cranial to the eyes (open white arrow). Scrutiny revealed some loss of bone density in the maxillae (open black arrow) and a fine linear periosteal response dorsal to the maxillae (small black arrow). Differential diagnoses include nasal tumor with extension, primary bone tumor of the maxilla, and metastatic neoplasia. Diagnosis: Nasal adenocarcinoma with extension through the maxillae.
646 Small Animal Radiolo g y and Ultrasono graphy Nasal Hemorrhage. Nasal hemorrhage may occur as a result of bleeding diatheses, trauma, or vascular erosion caused by infection or neoplasia. The resulting tissue density in the nasal passages (one or both) is indistinguishable from the radiographic pattern that results from exudate accumulation or from neoplastic involvement without turbinate destruction. In most patients with nasal hemorrhage there is little accumulation of blood within the nasal cavity and the turbinates will appear normal. Trauma. Fractures of the maxilla are the most common sequelae to nasal cavity trauma. Fracture fragments may be minimally displaced and may be evident as lucent lines within the bone. Displaced fractures may overlap and produce a radiodense rather than a radiolucent line. If the fracture completely encircles the nasal passages there may be complete detachment of the nose from the remainder of the skull. With fractures of the frontal sinuses, the fragments may be depressed into the sinuses. These may form sequestra, and removal of the fragment may become necessary. All fractures into the nasal passages and sinuses should be considered open because they communicate with the outside. Tooth root involvement should be identified at the time of the initial injury because periapical abscesses could develop. Hemorrhage may accompany the fracture, producing a soft-tissue density within the nasal cavity or frontal sinus. Complete evaluation of nasal cavity fractures often requires multiple oblique views. Foreign Bodies. Radiopaque foreign bodies, such as wires, bullets, or metal fragments, are detected easily. Bone-dense foreign objects, such as chicken bones, may be more difficult to detect because of the overlying shadows of the skull bones. Radiolucent foreign objects, such as grass, straw, or plant awns, cannot be detected on noncontrast radiographs. They may produce no radiographic changes if the exudate drains completely, may produce a soft-tissue density if the exudate accumulates or if there is a focal granulomatous reaction or, rarely, may cause turbinate destruction. The radiographic changes are unilateral unless the foreign body has migrated or been displaced iatrogenically from one side to the other. Endoscopy may be helpful in identifying the foreign object. Flushing the nasal cavity with saline may dislodge a foreign body. Computed Tomography and Magnetic Resonance Imaging. CT is extremely valuable for the assessment of lesions of the nasal cavity. 139-141 The dorsal imaging plane has been recommended as being more accurate for assessing lesions within the cribriform plate when compared with the transverse plane. 142 CT has been shown to be more sensitive and more accurate than either radiography or linear tomography for detecting lesions of the cribriform plate. 138 CT has been compared with radiography for the evaluation of nasal tumors. 143 Although CT was more accurate in delineating tumor extent and in documenting tumor extension into adjacent structures, such as the palate and the cranial cavity, the tumor could be identified correctly on the radiographs. CT is useful for tumor staging and planning of radiation therapy or surgery. Destruction of ethmoid bones, extension of soft tissue into the retrobulbar area, destruction of the maxilla or nasal bone, or hyperostosis of the maxilla were identified in CT scans of dogs with nasal tumors. 140 In CT scans obtained following intravenous contrast injection, patchy areas of increased density, possibly due to contrast enhancement, were observed. Infection resulted in cavitating lesions, which thickened and distorted the turbinates. 141 No single finding or combination of findings was specific for tumor. MRI produces similar information. The soft-tissue changes are better defined with MRI, and the bony lesions are better defined with CT. The extent of the tumor mass within the nasal cavity, the presence of exudate within the frontal sinus, and spread of the tumor to the brain are all easily identified with MRI. T E E T H Developmental. A large number of developmental problems can occur. These include missing teeth, both deciduous and permanent; retained deciduous teeth; supernumerary teeth, erupted or not; malaligned teeth; and malformed teeth (Fig. 5-43). 15,144,145 Odontoma, a tumor that arises from odontogenic tissue, may be seen in very young
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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 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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100 Small Animal Radiolo g y and Ul
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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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Page 595 and 596: 594 Small Animal Radiolo g y and Ul
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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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