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1.
Thoracic duct computed tomography (CT) lymphangiograms were performed on seven clinically normal dogs. The appearance of the thoracic duct system was compared following administration of contrast medium through a mesenteric lymphatic vessel vs. ultrasound guided percutaneous injection into a popliteal lymph node using helical and sequential CT acquisition modes. The number of visible thoracic duct branches and the largest thoracic duct branch cross‐sectional area and mean Hounsfield units (HU) were determined from thoracic vertebra 9 to lumbar vertebra 1. Procedural time and patient discomfort were also assessed. Popliteal administration produced a successful thoracic duct lymphangiogram in eight of 11 dogs (73%) after two attempts, while mesenteric administration was successful in eight of 10 dogs (80%) after a single attempt. Popliteal lymphography required 46% of the time and was associated with less patient discomfort than mesenteric lymphangiography. The number of thoracic duct branches seen was not significantly different for either administration technique (P=0.256) or CT acquisition mode (P=0.417). However, the cross‐sectional area and mean HU of the largest thoracic duct branch were greater with mesenteric administration (P<0.001), and helical image acquisition (P<0.001). The thoracic duct branch number, size, and location were highly variable between dogs. Percutaneous popliteal lymphography appears to be an acceptable alternative to mesenteric lymphangiography for the detection of thoracic duct branches in the dog when using either helical or sequential CT acquisition modes.  相似文献   

2.
OBJECTIVE: To evaluate the efficacy of percutaneous administration of iohexol into the popliteal lymph node as a non-invasive technique for thoracic duct lymphangiography in dogs. STUDY DESIGN: Experimental study and clinical report. ANIMALS: Normal adult dogs (n=4) and 1 dog with recurrent chylothorax. METHODS: For the experimental study, 4 dogs (weight, 8.4-12.3 kg) had 5-10 mL iohexol injected percutaneously into 1 popliteal lymph node and then thoracic radiographs were taken. Popliteal lymph nodes were examined by histopathology 8 days later. One 25-kg dog with recurrent chylothorax had 25 mL iohexol injected into the right popliteal lymph node followed by thoracic radiography. RESULTS: In experimental dogs, the thoracic duct was best visualized on thoracic radiographs after administration of 10 mL iohexol. Clinically, no abnormalities were identified in the injected limb and except for 1 dog that had large numbers of siderocytes and erythrophagocytic macrophages in the injected lymph node, the histopathologic findings in the other injected popliteal lymph nodes were not different from contralateral nodes. In the clinical case, the thoracic duct was visualized, but there was leakage of iohexol around the node. CONCLUSION: The thoracic duct in dogs can be visualized by lymphography after percutaneous injection of iohexol (1 mL/kg at 2 mL/min) into the popliteal lymph node. CLINICAL RELEVANCE: Percutaneous popliteal lymph node administration of iohexol should be considered as an alternative to mesenteric lymph node injection for radiographic identification of the thoracic duct in dogs.  相似文献   

3.
Standard radiographic lymphangiograms and computed tomography (CT) lymphangiograms were performed on 10 female dogs without intrathoracic disease. Positive contrast lymphagiography was performed by injection into a catheterized mesenteric lymphatic vessel, and lateral thoracic radiographs, ventrodorsal thoracic radiographs, and thoracic CTs were obtained. The number of visible ducts was recorded for each image at the midbody of the ninth thoracic vertebra (T9) through the first lumbar vertebra (L1). Data were combined for all dogs at each data acquisition point. Data were analyzed by comparing data from all three images independently, and then by combining data for the radiographs and comparing the study with the highest number of visible duct branches to the CT. Significant differences in numbers of branches were found at T11 and L1. This study suggests that CT may be able to quantify branches of the thoracic duct more accurately than standard radiographic lymphangiography.  相似文献   

4.
OBJECTIVE: To determine whether injection of a mesenteric lymph node with iodinated aqueous contrast medium results in radiographic delineation of the thoracic duct and its branches, ascertain the ideal interval between injection and radiographic imaging, and evaluate mesenteric lymphadenography performed via laparoscopic and surgical approaches in dogs. ANIMALS: 10 adult dogs. PROCEDURE: In each dog, a right paracostal laparotomy or a right laparoscopic approach was performed to identify a mesenteric lymph node for injection of an iodinated aqueous contrast agent (0.22 mL/kg [81.4 mg of iodine/kg]). Lateral radiographic views were obtained at 60, 120, 180, 240, and 300 seconds after injection. RESULTS: A mesenteric lymph node was identified and injected with contrast medium in each dog. Via paracostal laparotomy, lymph node injection resulted in successful lymphangiographic evaluation in 4 of 5 dogs, whereas via the laparoscopic approach, lymph node injection resulted in successful lymphangio-graphic evaluation in 2 of 5 dogs. In successful radiographic evaluations, injected lymph nodes, mesenteric lymphatics, and the thoracic duct and its branches were delineated. Radiographs obtained at 60 and 120 seconds after injection of contrast medium provided the most detail. CONCLUSIONS AND CLINICAL RELEVANCE: Injection of a mesenteric lymph node directly with contrast medium appears to be a feasible technique for delineation of the thoracic duct and its branches in dogs and might be useful in small animals in which mesenteric lymphatic catheterization can be difficult and lymphangiography is more likely to fail. Refinement of the laparoscopic technique may provide a minimally invasive approach to lymphadenography.  相似文献   

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6.
OBJECTIVE:To describe and compare the time of onset and intensity of thoracic duct coloration after injection of methylene blue into a mesenteric or popliteal lymph node. STUDY DESIGN: Experimental study. ANIMALS: Twenty adult dogs. METHODS: A right tenth intercostal thoracotomy, a right paracostal laparotomy, and an approach to the right popliteal lymph node were performed on each dog. Methylene blue (0.5 mg/kg of a 1% solution, maximum 10 mg) was injected into either a mesenteric (group M, 10 dogs) or popliteal (group P, 10 dogs) lymph node. Thoracic duct color was graded (0 to 3) every 5 minutes for 60 minutes. Statistical analysis was performed on mean thoracic duct color grade data, on number of successful outcomes between groups M and P, and between weight groups. RESULTS: Coloration of the thoracic duct occurred in all group M dogs and 6 group P dogs. Coloration was first recorded 0 to 10 minutes after injection in all dogs and persisted for 60 minutes in 15 dogs. Mean thoracic duct color grade was significantly increased postinjection compared with preinjection at all times in group M. More successful outcomes occurred in group M (P =.03). CONCLUSIONS: Methylene blue injected into mesenteric or popliteal lymph nodes was successful in coloring the thoracic duct, but both mean grade and number of successful outcomes were significantly higher after mesenteric injection. CLINICAL RELEVANCE: Thoracic duct coloration after lymph node injection occurred within 10 minutes and persisted for 60 minutes. This information is useful in planning thoracic duct ligation in cases of chylothorax when observation of the duct is desired. Injection of both lymph node sites was successful, but mesenteric node injection was a more reliable technique.  相似文献   

7.
Tracheal hypoplasia is commonly seen in English Bulldogs affected with brachycephalic airway syndrome. Previously published diagnostic criteria for tracheal hypoplasia in this breed have been a radiographic tracheal diameter:tracheal inlet ratio (TD:TI) < 0.12 or a tracheal diameter:third rib diameter ratio (TD:3R) < 2.0. Computed tomography has become increasingly used for airway evaluation, however published information is lacking regarding CT tracheal dimensions in English Bulldogs. Objectives of this prospective cross‐sectional study were to describe radiographic and CT tracheal dimensions in a sample of clinically normal English Bulldogs and compare these values with tracheoscopy scores. Computed tomography (n = 40), radiography (n = 38), and tracheoscopy (n = 40) studies were performed during a single general anesthesia session for each included dog. Tracheal measurements were recorded at three locations: cervical, thoracic inlet, and thorax. Tracheal diameters were narrowest at the thoracic inlet with all techniques. Computed tomographic measurements averaged 19% greater than radiographic measurements. All included dogs had radiographic tracheal measurements greater than the previously published criteria for tracheal hypoplasia. Mean CT TD:TI was 0.26 (± 0.03, 0.20–0.33), and mean CT TT:3R was 2.27 (± 0.24, 1.71–2.74). Radiographic TD:TI and CT TD:TI were significantly correlated (P = 0.00); however radiographic TT:3R and CT TT:3R were not significantly correlated (P = 0.25). Tracheoscopy identified hypoplastic changes in all dogs and tracheoscopy scores were not correlated with CT or radiography diameter measurements. In conclusion, findings indicated that some CT and radiographic tracheal diameter measurements were comparable in English Bulldogs however diameters for both imaging techniques were not comparable with tracheoscopy scores.  相似文献   

8.
In this retrospective study the effect of thoracic positioning on the visibility and size of selected cranial thoracic structures in dogs was investigated. Dorsoventral (DV), ventrodorsal (VD) as well as left lateral recumbent (LLR) and right lateral recumbent (RLR) thoracic radiographs of 17 large, 15 medium, and 10 small skeletally mature dogs were evaluated. The craniodorsal and cranioventral mediastinum, the cupula pleura and sternal lymph nodes were examined. The effect of obesity was also evaluated. The craniodorsal mediastinum was better delineated on DV radiographs and was wider on VD radiographs. The craniodorsal mediastinal width: width of T2 cranial end-plate on VD radiographs was 2.41 for all groups combined and obesity significantly influenced this value. The cranioventral mediastinum was more visible in RLR and VD radiographs. A normal sternal lymph node soft tissue opacity was seen most commonly in RLR in large breed dogs and had a mean length of 30 mm. The pulmonary cupula extended beyond the first rib on all views and extended more cranially and was better visualised on VD than DV views.  相似文献   

9.
Sentinel lymph node evaluation is widely used in human medicine to evaluate the first lymph node(s) to which a tumor drains. Sentinel lymph node biopsy allows avoidance of extensive lymphadenectomies in cases where the sentinel lymph node is negative for metastasis, thereby reducing patient morbidity. It has been shown that regional lymph nodes are not always the sentinel lymph node, thus identification and sampling of sentinel lymph nodes allows for more accurate staging, which is critical for treatment and prognostication in dogs with cancer. The objective of this prospective, pilot study was to determine if indirect computed tomography (CT) lymphangiography with aqueous contrast agent would successfully allow identification of sentinel lymph nodes in dogs with masses on the head. Eighteen dogs underwent CT lymphangiography. The sentinel lymph node was successfully identified within 3 min of contrast injection in 16 dogs (89%). Compression of lymphatic vessels from endotracheal tube ties and/or the patient's own body weight delayed or prevented identification of sentinel lymph nodes in two dogs (11%). Computed tomography lymphangiography with aqueous contrast can be used successfully to rapidly identify sentinel lymph nodes in dogs with masses on the head.  相似文献   

10.
Objective— To document a novel technique to image the thoracic duct and its tributaries by contrast enhanced computed tomography (CT) lymphography.
Study Design— Clinical report.
Animals— Dogs (n=6) idiopathic chylothorax.
Methods— Ultrasonography was used to guide percutaneous injection of intestinal lymph nodes with nonionic iodinated contrast medium for preoperative CT lymphography of the thoracic duct in 6 dogs with chylothorax. Thoracic CT images were acquired immediately after contrast medium injection. All dogs had subtotal pericardectomy and thoracic duct ligation. Postoperative thoracic duct lymphography was performed in 3 dogs. Superficial cervical lymph node lymphography was performed in 2 dogs to determine cervical lymphatic contribution to thoracic effusions.
Results— Preoperative thoracic duct lymphography using this technique was successful in delineating the cisterna chyli, thoracic duct, and associated lymphatic vessels in all dogs. Immediate postoperative lymphography performed in 2 dogs revealed successful duct ligation in 1 dog and persistent lymphatic leakage in the other. A 1-month postoperative thoracic duct lymphogram performed in 1 dog revealed unsuccessful ligation or recannulation of 1 of 3 redundant vessels seen preoperatively.
Conclusion— Percutaneous CT lymphography results in excellent detection of the thoracic duct and abnormal thoracic duct drainage patterns both pre- and postoperatively. The contribution of superficial cervical lymph node drainage to reoccurrence of effusions can be evaluated.
Clinical Relevance— Percutaneous CT lymphography using ultrasound-guided contrast medium injection should be considered as an alternative to conventional open abdominal approaches to radiographic or CT lymphography.  相似文献   

11.
Tracheobronchial lymph node evaluation is critical for accurate staging of canine thoracic neoplasia and is more accurately achieved with computed tomography (CT) than radiography. Thoracic CT scans of 18 canine patients with known tracheobronchial lymph node histopathology and 10 clinically normal dogs were compared to establish if enlargement or contrast enhancement pattern correlated with metastatic status. Absolute lymph node size and three anatomically normalized lymph node ratios were significantly correlated with metastasis or severe granulomatous lymphadenitis (P<0.0003). Transverse maximum lymph node diameter of 12 mm or lymph node to thoracic body ratio of 1.05 are proposed cutoffs, above which metastatic involvement is very likely; however, only minimal accuracy was gained with normalized ratios. Lymph node contrast enhancement pattern was also significantly correlated to disease. A heterogenous and/or ring pattern was related to metastatic disease (P=0.03). Recommended protocol for CT examination of the tracheobronchial lymph nodes is 1–1.5 mm slices and intervals, intravenous contrast, and control of respiratory motion.  相似文献   

12.
OBJECTIVES: To assess the effect of different radiographic projections on thoracic width, as well as position and visibility of the trachea, principal bronchi, cardiac silhouette, aorta, caudal vena cava (CVC) and oesophagus. METHODS: Right lateral recumbency (RLR), left lateral recumbency (LLR), dorsoventral (DV) and ventrodorsal (VD) thoracic radiographs of 42 dogs were reviewed retrospectively. RESULTS: In 78 per cent of cases the thoracic width was significantly larger on the VD projection than on the DV projection. The angle of divergence formed by the principal bronchi was significantly larger on the VD projection than on the DV projection in 80 per cent of dogs. A cardiac silhouette bulge at 1 to 2 o'clock was apparent on the VD projection in 22 per cent of dogs but was never seen on DV projections. The descending aorta was more visible at the 4 to 5 o'clock cardiac silhouette level on the DV projection and laterally at the T8 level on LLR projections. The CVC was better seen on VD and LLR projections. The oesophagus was visible as a soft tissue opacity in LLR in large dogs with normal thoracic conformation in 35 per cent of cases. CLINICAL SIGNIFICANCE: The DV projection appears to be more reliable for assessing the cardiac silhouette, the descending aorta and the angle of divergence of the principal bronchi. The VD projection should be considered for evaluating the CVC. LLR should be used for assessing the descending aorta and CVC.  相似文献   

13.
OBJECTIVE: To evaluate the effect of cisterna chyli ablation (CCA) and thoracic duct ligation (TDL) on abdominal lymphatic drainage in normal dogs. STUDY DESIGN: Experimental study. ANIMALS: Nine female beagle dogs. METHODS: TDL was performed in 3 dogs and was combined with CCA (CCA-TDL) and local omentalization in 6 dogs. Contrast lymphangiography was attempted in all dogs immediately before and after TDL. Dogs were reanesthetized at 31-37 days for lymphatic studies by new methylene blue (NMB) injection into a mesenteric lymph node and by contrast lymphangiography. RESULTS: In 6 CCA-TDL dogs, 2 had direct shunting of contrast from the lymphatic system into major abdominal veins, 3 had contrast material that dissipated into abdominal vessels within the mesenteric root, and 1 had shunting into the azygous vein. NMB was not observed within the omental pedicle after CCA-TDL. Chylous drainage was by the azygous vein in all 3 TDL dogs. CONCLUSIONS: CCA-TDL disrupted chylous drainage to the thoracic duct and resulted in direct intraabdominal lymphaticovenous anastomoses identified by shunting of lymphatic flow directly into the abdominal vasculature in 5 of 6 CCA-TDL dogs. Omentalization of the cisternal ablation site was not beneficial in augmenting extrathoracic lymphatic drainage and is not recommended with CCA-TDL. CLINICAL RELEVANCE: CCA-TDL represents a novel approach to surgical redirection of chylous drainage to the venous circulation outside of the thorax and may be useful in the treatment of spontaneous chylothorax in the dog.  相似文献   

14.
Thoracic duct lymphangiography and ligation were done on 15 dogs with idiopathic chylothorax. Lymphangiography revealed thoracic lymphangiectasia in all dogs; none had a thoracic duct rupture. Lymphangiography immediately after ligation demonstrated missed branches of the thoracic duct in 4 of the 15 dogs. Eleven of the 15 dogs are alive and doing well. Eight of the 11 had no radiographic or clinical signs of pleural effusion (mean follow-up, 31.5 months; range, 4 to 75 months). The other 3 living dogs had persistent effusion; 2 were successfully managed with a pleuroperitoneal shunt (follow-up, 15 months) or pleurodesis (follow-up, 5 months), respectively, and 1 was not treated because the effusion was mild and the dog did not have clinical signs of disease (follow-up, 14 months). Four of the 15 dogs died or were euthanatized because of persistent effusion (mean follow-up, 11.5 months; range, 3 to 24 months). Considering the lack of treatment alternatives for dogs with idiopathic chylothorax, these results support thoracic duct ligation as a treatment method for dogs.  相似文献   

15.
Though identification of lymph nodes is essential in staging cancer patients, little has been reported about the CT features of canine abdominal lymph nodes. The purpose of this retrospective study was to describe the visibility, location, and characteristics of abdominal lymph nodes in abdominal CT studies of dogs considered unlikely to have lymphadenopathy. The relationship between the number of identified lymph nodes and intraabdominal fat ranking, body weight, and slice thickness was also investigated. A total of 19 dogs were included. At least two jejunal lymph nodes and both left and right medial iliac lymph nodes were identified in all dogs. Colic lymph nodes were not identified in any of the dogs. Visualization of all other lymph nodes varied. There were significantly more lymph nodes visible in dogs with more intraabdominal fat (P < 0.0001). No correlation between the number of identified lymph nodes and body weight (P = 0.64) or slice thickness (P = 0.76) was found. Though most of all identified lymph nodes had an elongated shape, a rounded shape was most common in splenic, pancreaticoduodenal, renal, ileocolic and caudal mesenteric lymph nodes. Most lymph nodes had a homogeneous structure before and following the intravenous administration of contrast medium. Some lymph nodes had a slightly irregular structure or were relatively more hyper attenuating in the periphery than centrally before and/or after contrast administration. Mean attenuation before contrast was 37 Hounsfield Units (HU) (range 20–52 HU), and 109 HU after contrast (range 36–223 HU). Findings indicated that the CT visibility, characteristics of different abdominal lymph nodes may be variable in dogs.  相似文献   

16.
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17.
Staging and therapeutic planning for dogs with malignant disease in the popliteal lymph node are based on the expected patterns of lymphatic drainage from the lymph node. The medial iliac lymph nodes are known to receive efferent lymph from the popliteal lymph node; however, an accessory popliteal efferent pathway with direct connection to the sacral lymph nodes has also been less frequently reported. The primary objective of this prospective, anatomic study was to describe the frequency of various patterns of lymphatic drainage of the popliteal lymph node. With informed client consent, 50 adult dogs with no known disease of the lymphatic system underwent computed tomographic lymphography after ultrasound‐guided, percutaneous injection of 350 mg/ml iohexol into a popliteal lymph node. In all 50 dogs, the popliteal lymph node drained directly to the ipsilateral medial iliac lymph node through multiple lymphatic vessels that coursed along the medial thigh. In 26% (13/50) of dogs, efferent vessels also drained from the popliteal lymph node directly to the internal iliac and/or sacral lymph nodes, coursing laterally through the gluteal region and passing over the dorsal aspect of the pelvis. Lymphatic connections between the right and left medial iliac and right and left internal iliac lymph nodes were found. Based on our findings, the internal iliac and sacral lymph nodes should be considered when staging or planning therapy for dogs with malignant disease in the popliteal lymph node.  相似文献   

18.
The medial iliac and superficial inguinal lymph nodes are not routinely palpable in the dog, and ultrasound imaging provides an alternate noninvasive technique to assess these lymph nodes, as well as to guide needle aspiration. Herein we describe the ultrasound characteristics of the medial iliac and superficial inguinal lymph nodes in 50 healthy dogs, as well as frequency and ease of node detection. The relationship between the size of the lymph nodes and the following variables was assessed: age, gender, body weight, body condition score, body length, and thoracic height and width. Right and left medial iliac lymph nodes were detected in 50 (100%) dogs, right superficial inguinal lymph node(s) in 49 (98%) dogs, and left superficial inguinal lymph node(s) in 47 (96%) dogs. In >90% of both sets of lymph nodes, the echogenicity was hypoechoic or isoechoic to surrounding tissues, with a corticomedullary or homogenous echotexture, smooth, clearly defined margins, and a fusiform shape. Increasing weight, distance from the sternal manubrium to the ischium, and thoracic height and width were associated with increased lymph node size (P‐values<0.05). Average lymph node sizes and range of sizes provide preliminary reference values for the medial iliac and superficial inguinal lymph nodes in normal dogs.  相似文献   

19.
Three different doses (1.0, 1.5, and 2.0 ml) of iohexol (300 mgl/ml) were injected percutaneously into the popliteal lymph node of eight adult cats under ultrasound guidance. Serial transverse CT images of five regions of interest (L3, T13, T8, T4, and T1 level) were performed at 2-min intervals, and the attenuation in Hounsfield Units (HU) of the lymphatic vessels was measured for determination of the optimal dose of iohexol and CT scan parameters. The optimal dose was 1.5 ml and helical CT acquisition is recommended to be performed as soon as possible after iohexol injection. In helical scans, the thoracic duct was characterized by variable branch numbers that formed a single trunk and entered the venous system at variable levels. CT lymphography using this protocol was performed in a cat with chylothorax. The thoracic duct was tortuous and focally dilated, and leakage of contrast medium was observed. Percutaneous CT lymphography using ultrasound-guided administration of iohexol into the popliteal lymph node appears reliable for delineation of the thoracic duct in cats.  相似文献   

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