"Impact With Imaging"

Today I start my monthly review "Impact With Imaging" for the veterinary imaging Jedi that fight every day for the good, against the evil of rare diseases, artifacts and short turnaround time.

I will choose three articles from the last Veterinary Radiology and Ultrasound issue that I think can have a clinical impact on our daily routine as veterinary imaging Jedi.

Turn on your microphone-lightsaber, wear your headsets to pump your Force and let's get started.

Here they are my 3 favorite articles from July 2024 issue:

1) https://pubmed.ncbi.nlm.nih.gov/38650074/

Computed tomographic features of exocrine pancreatic carcinomas in dogs and cats (Dunn et al.)

Great multicentric study that fills an important gap in the veterinary imaging literature. Authors have done an amazing job reporting the imaging features of pancreatic carcinoma in dogs and cats with comparison between the two species, but...

... what I think is really important in this article, even if limited to a short paragraph in the discussion, is the description of the "infiltrative pancreatic carcinoma" (WARNING for lazy people like me, it is not mentioned in the abstract!).

I had some cases in the past, the diagnosis was really tricky and it takes all the Force a Jedi can have. This type of carcinoma can easily be misinterpreted as acute pancreatitis. However, in my limited experience, I think there could be some findings (ex. focal mass effect on the intra-pancreatic tract of the common bile duct with absence of fat-stranding ot other signs of pancreatic/peri-pancreatic inflammation, mineral foci within an heterogeneous pancreatic parenchyma, nodules in the liver, severe regional lymphadenopathy etc.) that may help finding the way through the laser gun shots and hit our enemy.

Figure 2 in the article is a great example.

2) https://pubmed.ncbi.nlm.nih.gov/38597362/

Anatomical classification of feline congenital extrahepatic portosystemic shunts based on CT angiography: A SVSTS and VIRIES multi-institutional study in 231 cats (Weisse et al.)

You may probably think there is a bias due to my deep interest in vascular imaging... but this is not the case. No bias here. This is the article with the largest number of cases available in the veterinary literature of feline extra-hepatic porto-systemic shunts, great collaboration between surgeons and radiologists. Great completion to the previous works from Parry and White. This is the way.

3) https://pubmed.ncbi.nlm.nih.gov/38572892/

Description and clinical relevance of the variable conformation of canine spinal arachnoid diverticula (De Frias et al.)

Great update for your MRI-based lightsabers when you will fight against arachnoid diverticula. I love when there are efforts in correlating imaging-anatomy-pathophysiology, and Authors have done a great job in the literature review, also bringing up the human theory abut the septum posticum. As expected, Rottweilers and Pugs are the main characters of this episode. You will find some cool additional description features for your MRI interpretation of arachnoid diverticula that could be added to your macros and got also a nice review of the existing literature.