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Small Animal Diagnostic Ultrasound - E-Book

Small Animal Diagnostic Ultrasound - E-Book

John S. Mattoon | Thomas G. Nyland

(2014)

Additional Information

Book Details

Abstract

Now in full-color with over 750 vivid images located near their text descriptions, Small Animal Diagnostic Ultrasound, 3rd Edition is the must-have resource for coverage of the basic principles of ultrasonography in small animal medical care. Using a logical body-systems approach, where chapters are organized from "head to tail," this third edition offers completely revised and up-to-date information regarding the latest techniques, applications, and developments in ultrasonography — including expanded coverage of Doppler imaging principles and new gross anatomic and pathological specimen images. Also new to this edition are 100 video clips (housed on a companion website) that demonstrate normal and abnormal conditions as they appear in ultrasound scans.

"This is the book that any clinician that has interest in veterinary diagnostic imaging should have." Reviewed by Denis Novak on behalf of European Journal of Companion Animal Practice, June 2015

"There will be very few clinicians who will fail to learn something new within a few minutes of opening it." Reviewed by Louise McLean on behalf of Veterinary Record, July 2015

Video clips accessible on the accompanying website allows the ultrasonographer to visualise organs in motion. The real stuff!" Reviewed by Fabienne Dethioux on behalf of Royal Canin: Vets Today, July 2015

  • Head-to-tail chapter organization makes finding specific information quick and easy.
  • The most up-to-date ultrasound imaging techniques ensure you stay on top of the industry.
  • Online glossary contains over 400 terms offer a more complete understanding of ultrasonography.
  • NEW! Color Design includes over 750 images appearing near their text mentions.
  • NEW! Approximately 100 video clips located on the companion website demonstrate conditions as they appear to an ultrasonographer.
  • NEW! Updated and expanded coverage of Doppler imaging principles and applications, including non-cardiac organs and abdominal vasculature, keep you up to date in this critical area.
  • NEW! Gross anatomic and pathological specimen images accompany the ultrasound images to help orient you to the tissues under study.

Table of Contents

Section Title Page Action Price
Front Cover cover
Endsheet 2 IFC2
Video Contents IFC3
Small Animal Diagnostic Ultrasound 3E i
Copyright Page ii
Dedication iii
Contributors v
Preface vii
Acknowledgments ix
Table Of Contents xi
1 Fundamentals of Diagnostic Ultrasound 1
Basic Acoustic Principles 1
Wavelength and Frequency 1
Propagation of Sound 1
Reflection and Acoustic Impedance 2
Scattering and Speckle 3
Refraction 4
Attenuation 4
Instrumentation 5
Pulser 5
Transducer 5
Receiver 5
Scanner Controls 5
Power (Intensity, Output) Control 8
Overall Gain (Amplification) Control 8
Time-Gain (Depth-Gain) Compensation Controls 8
Dynamic Range 11
Gray-Scale Maps 11
Colorized Gray-Scale Maps 11
Modes of Image Display 11
A-Mode 11
B-Mode 11
M-Mode 11
Real-Time B-Mode 11
Types of Transducers 11
Mechanical Sector Scanners 14
Arrays 14
Linear Array 14
Curvilinear Array 15
Phased Array 15
Annular Array 17
Transducer Selection 17
Image Quality: Spatial Resolution 17
Special New Imaging Modes 19
Tissue Harmonic Imaging 19
Spatial Compounding 20
Extended Field of View 21
Three-Dimensional Ultrasound 21
Image Orientation and Labeling 21
Image Interpretation and Terminology 24
Imaging Pitfalls and Artifacts 26
Propagation Artifacts 26
Secondary Lobe Artifact 26
Slice Thickness Artifact 27
Reverberation, Ring-Down, and Comet-Tail Artifacts 27
Mirror Image Artifact (Multipath) 29
Refraction 29
Propagation Speed Error 29
Attenuation 30
Shadowing 30
Edge Shadowing 31
Enhancement 32
Doppler Ultrasonography 32
Principles of Doppler 32
Pulsed Wave Doppler Ultrasonography 34
Continuous Wave Doppler Ultrasonography 35
Interpretation of the Doppler Spectral Display 35
Color Doppler 36
Power Doppler 39
Instrumentation 39
Doppler Controls 40
Gain 42
Pulse Repetition Frequency 42
Doppler Transducer Frequency 43
Baseline Control 43
Persistence 43
Color Write Priority 43
Wall Filters 45
Important Doppler Artifacts 45
Aliasing and Range Ambiguity Artifact 45
Twinkling Artifact 47
Safety of Diagnostic Ultrasound 47
References 48
2 Ultrasound-Guided Aspiration and Biopsy Procedures 50
Equipment 50
Preparation of the Patient 50
General Techniques 51
Indirect Guidance 52
Freehand Guidance 52
Needle Guidance Systems 52
Principles of Needle Selection and Biopsy 54
Needle Selection 54
Aspiration and Biopsy Technique 56
Potential Complications 58
Slide Preparation Techniques for Fine Needle Aspirates 59
Fine Needle Aspiration and Biopsy of Specific Organs and Locations 59
Brain and Spinal Cord 59
Periorbital tissues 60
Soft Tissues of the Cervical Region 60
Bone 60
Thorax 62
Abdomen 63
Liver 64
Gallbladder and Biliary Tract 64
Spleen 66
Pancreas 67
Gastrointestinal Tract 68
Kidney 68
Adrenal Masses 71
Urinary Bladder 71
Prostate 71
Abdominal Lymph Nodes and Masses 72
References 74
3 Advanced Ultrasound Techniques 78
Ultrasound Guided Therapeutics 78
Chemical Ablation 78
Cervical Lesions 78
Abdominal Lesions 78
Radiofrequency Heat Ablation 78
Joint Injections 79
Advanced Diagnostics 79
Antegrade Pyelography and Pyelocentesis 80
Splenoportography 80
Ultrasound-Guided Computed Tomography and Radiographic Lymphography 80
Ultrasound-Guided Peritoneography 81
Endosonography 82
Elastography 82
Contrast Specific Imaging Techniques 82
Ultrasound Contrast Agents 82
Nonlinear Imaging Techniques 83
Harmonic Imaging 84
Contrast Agent Bioeffects 87
Drug Delivery 87
References 91
4 Abdominal Ultrasound Scanning Techniques 94
Positioning of Sonographer, Patient, and Equipment 94
Preparation of the Patient 94
Getting Started 94
Transducer Motions 99
Liver 99
Falciform Fat 104
Spleen 104
Stomach and Duodenum 110
Pancreas 112
Kidneys 113
Adrenal Glands 117
Small Intestines and Colon 117
Urinary Bladder 119
Prostate 120
Uterus and Ovaries 120
Abdominal Lymph Nodes 121
Abdominal Vessels 125
References 127
5 Eye 128
Normal Anatomy 128
Examination Technique 130
Real-Time B-Mode Examination 130
Corneal Technique 130
Eyelid Technique 130
A-Mode Examination 131
Normal Ultrasound Anatomy 131
Real-Time B-Mode Examination 131
A-Mode Ultrasonography 134
Intraocular Masses 134
General Considerations 134
B-Mode Examination 134
Intraocular Neoplasms 135
Intraocular Hemorrhage and Inflammatory Masses 136
Intraocular Pointlike and Membranous Lesions 137
General Considerations 137
B-Mode Examination 137
Vitreous Chamber 137
Hemorrhage 137
Endophthalmitis 138
Vitreal Degeneration 138
Posterior Vitreal Detachment 139
Persistent Hyperplastic Primary Vitreous 139
Retina 139
Foreign Bodies 140
Cornea and Iris 141
Lens 142
Dislocation 142
Cataracts 142
Glaucoma 144
Retrobulbar Pathology 145
General Considerations 145
B-Mode Examination 145
Retrobulbar Masses 145
Optic Nerve Pathology 149
Orbital and Ocular Vasculature 150
Color Doppler Evaluation of the Ocular and Orbital Vasculature 150
References 151
6 Neck 155
General Considerations 155
Carotid Artery and Jugular Vein 155
Jugular Vein Thrombosis 158
Carotid Arterial Thrombosis and Stenosis 159
Arteriovenous Malformations 159
Neoplasia 159
Nerves 160
Thyroid Gland 161
Thyroid Cysts 164
Hypothyroidism 164
Thyroiditis 164
Hyperthyroidism 164
Neoplasia 165
Parathyroid Glands 169
Parathyroid Hyperplasia and Adenoma 169
Parathyroid Carcinoma 171
Lymph Nodes 171
Reactive Lymph Nodes and Lymph Node Abscess 171
Neoplasia Metastasis 171
Lymphoma 174
Salivary Glands 175
Salivary Cysts 175
Sialoliths 175
Sialitis and Salivary Gland Abscess 175
Salivary Gland Neoplasia 175
Larynx and Trachea 176
Tongue and Esophagus 177
Cervical Musculature 180
Miscellaneous Neck Masses 180
Neoplasia 182
Cysts 182
Hematomas 182
Cellulitis, Abscess, and Granuloma 182
References 184
7 Thorax 188
Scanning Techniques 188
Normal Anatomy 190
Body Wall and Lung Surface 190
Mediastinum 190
Diaphragm 193
Pleural Disease 194
Pleural Effusion 194
Pleural Surfaces 196
Pleural Masses 196
Pneumothorax 198
Mediastinal Disease 198
Inflammation 198
Mass Lesions 198
Cystic Lesions 200
Esophageal Lesions 202
Pulmonary Disease 203
Pulmonary Neoplasia 204
Consolidation 204
Pulmonary Abscesses 204
Pulmonary Cysts 206
Atelectasis 206
Thoracic Wall Lesions 208
Diaphragmatic Hernias 208
Interventional Procedures of the Thorax 210
Thoracentesis 210
Fine-Needle Aspirations and Biopsies of Mass Lesions 212
References 215
8 Echocardiography 217
Overview of Echocardiography 218
Echocardiographic Formats 218
Diagnostic Information 219
Alternative Imaging 219
Limitations of Echocardiography 219
Overview of Instrumentation for Cardiac Studies 220
Transducers 220
Temporal Resolution 221
System Controls 221
Examination Technique 224
Patient Preparation 224
Transducer Management 226
Other Instrument Controls 226
Core Examination 226
Cardiac Imaging: Nomenclature and Display 227
Two-Dimensional Echocardiography 228
2D Instrumentation 228
Long-Axis Images from the Right Side 229
Short-Axis Images from the Right Side 231
Two-Dimensional Images from the Left Side of the Thorax 233
Left Apical Images 233
Modified Apical Images 234
Left Cranial Images 235
Other Imaging Positions 236
M-Mode Echocardiographic Imaging 236
M-Mode Recording and Instrumentation 236
M-Mode: Normal Findings and Interpretation 238
Left Ventricle 240
LV Measurements. 240
LV Motion. 241
Mitral Valve 241
Aortic Valve/Left Atrium 241
Advanced 2D and 3D Echocardiographic Imaging Methods 242
Contrast Echocardiography 242
Transesophageal Echocardiography 243
Three-Dimensional Echocardiography 243
Cardiac Doppler Studies: Overview 244
Doppler Principles 244
Overview of Doppler Modalities 245
Doppler Examination Techniques 245
Doppler Transducers 247
Pulsed-Wave Doppler Echocardiography 248
Signal Aliasing 248
High PRF Doppler Echocardiography 249
Instrumentation in PW-Doppler 249
Instrumentation for TDI 249
Physiologic Basis for PW Doppler Velocity Spectra 249
Semilunar Valves 250
Atrioventricular Valves 251
Pulmonary Veins 254
Atrial Function 254
Normal Tissue Doppler Imaging 254
Clinical Applications of Pulse-Wave Doppler Echocardiography 255
Continuous-Wave Doppler Echocardiography 255
Hemodynamic Quantitation Using CW Doppler 255
Continuity Relationship 258
Bernoulli Relationship 258
Color Doppler Imaging 259
Color Mapping 259
Color Doppler Instrumentation 261
Normal Findings 263
Interpretation and Quantitation 263
Limitations and Pitfalls of CDI 264
Advanced Image Analyses 264
Assessment of Cardiac Chamber Size 267
Limitations and Suggested Approach 267
Left Atrial Size and Function 270
Atrial Functional Indices 271
M-Mode Methods 271
Long-Axis Methods 271
Short-Axis Methods 273
Volume Estimates 274
Left Ventricular Chamber Size 274
Models for Estimating Left Ventricular Volume 274
Subjective Methods 276
Ratios in Dogs 276
Measurements Indexed to Body Size in Dogs 277
Canine Breed-Specific Reference Values 277
Left Ventricular Measurements in Cats 277
Left Ventricular Mass in Dogs and Cats 277
Right-Sided Chambers 278
Great Vessels 279
Ventricular Function 279
Systolic Ventricular Function 279
Overview and Practical Considerations 279
Specific Systolic Function Indices 282
M-Mode Measurements and Indices. 282
Two-Dimensional Indices. 283
Intervals of Systole. 284
Doppler Methods for Assessment of LV Function. 285
Myocardial Strain, Twist, and Dyssynchrony. 286
Diastolic Ventricular Function 286
Overview and Practical Considerations 286
Specific Variables in Diastolic Dysfunction 289
Isovolumetric Relaxation Time. 289
Mitral Inflow Velocities. 289
Tissue Doppler Imaging. 291
Other Variables. 291
Valvular Regurgitation 291
Overview and Practical Considerations 291
Mitral Regurgitation 293
Morphologic Lesions and Motion Abnormalities 293
Cardiac Remodeling in Mitral Regurgitation 294
Color Doppler Assessment of Mitral Regurgitation 295
Systolic Function in Mitral Regurgitation 296
Spectral Doppler Findings in Mitral Regurgitation 297
Tricuspid Regurgitation 297
Morphologic Lesions 297
Doppler Assessment of Tricuspid Regurgitation 298
Aortic Regurgitation 298
Pulmonary Insufficiency 299
Valvular Stenosis 299
Overview and Practical Considerations 299
Aortic Stenosis 299
Pulmonic Stenosis 301
Dynamic Right Ventricular Outflow Tract Obstruction 303
Atrioventricular Valve Stenosis 303
Pulmonary Hypertension 303
Cardiomyopathy 304
Overview and Practical Considerations 304
Essential Imaging Characteristics 305
Other Assessments 305
Etiologies of Cardiomyopathy 305
Feline Hypertrophic Cardiomyopathy 307
Diagnostic Criteria 307
2D and M-Mode Examinations 307
Doppler Studies 309
Dilated Cardiomyopathy 310
Restrictive Cardiomyopathy 311
Arrhythmogenic Right Ventricular Cardiomyopathy 311
Pericardial Diseases and Cardiac Masses 312
Pericardial Effusion 312
Cardiac Related Neoplasms in Dogs 312
Congenital Shunts 314
Overview and Practical Considerations 314
Atrial Septal Defects 314
Ventricular Septal Defects 316
Patent Ductus Arteriosus 316
References 317
9 Liver 332
Technique 332
Anatomy 332
Landmarks 332
Lobation and Vascular Anatomy 333
Size 336
Hepatic Parenchyma 337
Gallbladder and Biliary System 338
Doppler Evaluation of the Normal Liver 338
Caudal Vena Cava and Hepatic Veins 338
Portal Vein 339
Hepatic Arteries 340
Focal or Multifocal Disease 340
Nodular Hyperplasia 340
Cysts 342
Hematoma 343
Abscess 343
Necrosis 346
Trauma 348
Liver Lobe Torsion 348
Neoplasia 348
Doppler Evaluation of Focal Neoplasia 355
Contrast Evaluation of Focal Neoplasia 357
Diffuse Disease 359
Decreased Echogenicity 359
Increased Echogenicity 359
Inhomogeneous Echogenicity 366
Pulsed Doppler Evaluation 366
Quantitative Contrast Enhanced Imaging 366
Gallbladder and Biliary Tract 366
Congenital Disorders 366
Gallbladder Wall Thickening 366
Biliary Sludge and Calculi 369
Cholecystitis 373
Gallbladder Mucocele 376
Gallbladder Rupture 378
Cholecystocentesis 379
Extrahepatic Biliary Obstruction 379
Neoplasia 382
Vascular Abnormalities 382
Caudal Vena Cava and Hepatic Veins 382
Doppler Evaluation of the Caudal Vena Cava and Hepatic Veins 383
Portal Vein: Portosystemic Shunts 385
Congenital Portosystemic Shunts 385
Acquired Portosystemic Shunts 388
Other Portal Vein Abnormalities 388
Doppler Evaluation of the Portal Vein 388
Portal Vein Abnormalities with Passive Hepatic Congestion 388
Doppler Abnormalities with Portacaval Shunts 389
Doppler Abnormalities with Portal Vein Obstruction 390
Hepatic Artery Abnormalities 390
Hepatic Arteriovenous Fistulas 390
References 391
10 Spleen 400
Examination Technique 400
Normal Anatomy and Appearance 400
Focal or Multifocal Disease 403
Hematoma 404
Focal Infarcts or Necrosis 406
Abscess 407
Nodular Hyperplasia 409
Neoplasia 409
Hyperechoic Foci 423
Diffuse Disease 425
Congestion 425
Splenic Vein Thrombosis 425
Splenic Torsion 426
Infectious or Inflammatory Disease 428
Diffuse Infiltrative Disease 429
Diffuse Nonneoplastic Disease 429
Diffuse Neoplastic Disease 430
Doppler Evaluation, Harmonics, and Contrast Ultrasound 431
References 436
11 Pancreas 438
Indications for Pancreatic Ultrasonography 438
Examination Technique 438
Normal Anatomy and Ultrasound Appearance 439
Pathology 442
Nodular Hyperplasia 442
Acute Pancreatitis 444
Chronic Pancreatitis 451
Pancreatic Cysts 451
True Cysts 451
Pseudocysts 451
Retention Cysts 453
Pancreatic Bladder 453
Pancreatic Abscess 453
Pancreatic Neoplasia 453
References 465
12 Gastrointestinal Tract 468
Examination Technique 468
Normal Ultrasound Appearance 470
Stomach 470
Small Intestine and Colon 471
Normal Wall Layers 472
Abnormalities of the Stomach 472
Dilation 472
Pyloric Obstruction 472
Gastric Foreign Bodies 474
Gastric Wall Thickening 475
Diffuse Wall Thickening 475
Focal Wall Thickening or Mass Lesions 479
Abnormalities of the Small Intestine 480
Corrugated Bowel Pattern 480
Dilation 480
Obstruction 481
Foreign Bodies 482
Intussusception 482
Intestinal Wall Thickening 484
Diffuse Wall Thickening 484
Focal Wall Thickening or Mass Lesions 486
Doppler Ultrasonography 491
Abnormalities of the Cecum and Colon 493
Intussusception 493
Wall Thickening 493
Diffuse Wall Thickening 493
Focal Wall Thickening 496
References 497
13 Peritoneal Fluid, Lymph Nodes, Masses, Peritoneal Cavity, Great Vessel Thrombosis, and Focused Examinations 501
Scanning Technique 501
Peritoneal Fluid 501
Intraperitoneal Lymphadenopathy 504
Masses 509
Mesentery 510
Free Peritoneal Air 513
Thrombosis of the Abdominal Aorta and Caudal Vena Cava 513
Focused Sonographic Examinations 513
References 516
14 Musculoskeletal System 517
Examination Technique 517
Skin, Subcutaneous Tissues, and Muscle 517
Normal Findings 517
Abnormal Findings 517
Cellulitis and Edema. 517
Cavitary Lesions: Seroma, Abscess, and Hematoma. 517
Draining Sinus. 520
Mass Lesions: Lipoma, Other Neoplasms, and Granulation Tissue. 520
Nerves 522
Abnormal Findings 522
Bone 522
Normal Findings 522
Abnormal Findings 523
Fractures. 523
Osteomyelitis. 524
Neoplasia. 524
Joints 525
Normal Findings 525
Shoulder. 525
Elbow. 525
Coxofemoral Joint. 525
Stifle Joint. 525
Tarsus. 526
Abnormal Findings 526
Osteochondrosis. 526
Elbow Dysplasia. 526
Hip Dysplasia. 526
Avascular Necrosis of the Femoral Head. 526
Osteoarthrosis. 526
Joint Effusions. 526
Neoplasia. 526
Tendons and Ligaments 526
Normal Findings 526
Abnormal Findings 527
Tendon Sheath Effusion. 527
Muscle, Tendon, and Ligament Trauma 527
Muscle 527
Tendon and Ligament 528
Individual Tendon Examinations 530
Biceps Brachii 530
Supraspinatus Tendon 531
Infraspinatus and Teres Minor Tendons 532
Carpal Canal. 532
Calcaneal Tendon 532
Cruciate Ligaments and Menisci. 533
Patellar Ligament and Quadriceps Tendon 533
Tarsal Soft Tissues. 533
Iliopsoas Muscle and Tendon 533
Abdominal Wall Trauma 533
Ultrasound-Guided Procedures Based on Needle Insertion Into Musculoskeletal Structures 535
Technical Considerations 535
Percutaneous Tissue Sampling 536
Biopsy of Bone Lesions 536
Fluid Collection 536
Ultrasound-Guided Arthrocentesis 536
Tendon Sheath and Bursae 537
Foreign Body Retrieval 537
References 538
15 Adrenal Glands 541
Examination Technique 541
Normal Anatomy and Ultrasound Appearance 541
Left Adrenal Gland 542
Right Adrenal Gland 542
Normal Adrenal Gland Size 542
Adrenal Gland Enlargement and Masses 545
Reduced Adrenal Gland Size 552
Adrenal Gland Pathology in the Cat 553
Other Adrenal Lesions 553
References 553
16 Urinary Tract 557
Kidneys and Proximal Ureters 557
Examination Technique 557
Normal Anatomy 557
Kidney Echogenicity 559
Kidney and Ureteral Size 559
Absent or Ectopic Kidneys 561
Focal Abnormalities of the Renal Parenchyma 561
Renal Cysts 561
Solid Masses 563
Complex Masses 563
Focal Hyperechoic Areas in the Renal Cortex 566
Diffuse Abnormalities of the Renal Parenchyma 566
Abnormalities of the Renal Pelvis and Proximal Ureter 569
Pelvic and Ureteral Dilatation 569
Pyelonephritis 571
Hydronephrosis 571
Congenital or Idiopathic Disorders 574
Calculi and Blood Clots 576
Ruptured Ureter and Retroperitoneal Disease 577
Subcapsular Fluid or Thickening and Perirenal Fluid 578
Perinephric Pseudocysts 580
Doppler Evaluation of the Kidneys 581
Renal Vein Occlusion or Thrombosis 581
Renal Artery Occlusion and Infarcts 582
Acute Renal Failure 582
Obstructive versus Nonobstructive Pelvic Dilation 582
Renal Masses 582
Other Potential Uses of Renal Resistive Index 583
Renal Transplants 583
Distal Ureters, Urinary Bladder, and Urethra 584
Examination Technique 584
Normal Anatomy 586
Distal Ureters 587
Antegrade Pyelography for Evaluating the Distal Ureters 587
Vesicoureteral Reflux 587
Acquired Ureterovaginal Fistula 587
Ectopic Ureter 587
Ruptured Ureter 589
Ureteral Obstruction 589
Ureteroceles 589
Bladder Pathology 589
Bladder Neck Position 589
Bladder Volume 590
Urachal Abnormalities and Acquired Diverticuli 590
Ruptured Bladder 590
Cystitis 590
Blood Clots and Hematomas 593
Cystic Calculi 593
Foreign Bodies 594
Bladder Neoplasia 594
Urethral Pathology 597
References 601
17 Prostate and Testes 608
Examination Technique 608
Normal Prostate Gland 609
Pathology of the Prostate 614
Benign Prostatic Hyperplasia 614
Infection and Inflammation 614
Neoplasia 616
Cysts 620
Paraprostatic Cysts 622
Normal Testes 622
Testicular Pathology 623
Neoplasia 625
Orchitis 626
Atrophy 628
Torsion 628
Scrotum 631
References 631
18 Ovaries and Uterus 634
Examination Technique 634
Normal Ovary 634
Ovarian Disease 636
Cystic Ovarian Disease 636
Neoplasia 636
Ovarian Stump Granuloma 637
Normal Uterus 637
Uterine Disease 638
Pyometra 638
Uterine Stump Pyometra 641
Neoplasia 641
Pregnancy Diagnosis and Fetal Development 642
Fetal Measurements and Estimation of Fetal Age 647
Postpartum Uterus 649
Abnormal Pregnancy 650
Mammary Gland 651
References 653
Glossary e1
Index 655
A 655
B 656
C 656
D 658
E 658
F 659
G 659
H 660
I 660
J 661
K 661
L 661
M 662
N 662
O 662
P 663
Q 664
R 664
S 665
T 666
U 666
V 667
W 667
X 667
Y 667
Z 667
Endsheets_5-7 IBC5