"Impact With Imaging"

Fall is here, the leaves are starting to fall, and our mood is certainly not what it was a few months ago.... let's cheer ourselves up with a good dose of imaging and science! Here are the 3 articles from the latest Veterinary Radiology and Ultrasound that I found most interesting and with potential clinical impact:

1) https://pubmed.ncbi.nlm.nih.gov/39102361/

Anatomical classification of canine congenital extrahepatic portosystemic shunts based on CT angiography: A SVSTS and VIRIES multi-institutional study in 1082 dogs (Weisse et al.)

As I previously recommended the one on cats (https://www.dhirubhai.net/pulse/impact-imaging-swan-specchi-e3iif/?trackingId=zFzb2l35TlO%2F4k8wxM1LKA%3D%3D), similarly I recommend that you check out this article that complements and helps further clarify the anatomy of extra-hepatic shunts in dogs. As with cats, it is good to see that the colleagues confirm what has been already published previously by White and Parry.

It would seem that we have finally found agreement on how to anatomically describe extrahepatic shunts. It took years, but I'd say we're there... I'd be surprised if anyone came up with different proposals! But anything is possible...

2) https://pubmed.ncbi.nlm.nih.gov/39297764/

Clinical presentation, imaging characteristics, and short-term outcome of eight cats presented with suspected traumatic atlantoaxial hyperflexion (Llanos et al.)

Article describing a larger number of cases of what has been reported only in case reports so far. A medical condition that we hear little about, and which presents itself as a differential diagnosis of what is believed to be one of the most classic conditions at this level in the cat: ischemia myelopathy due to hyaline arteriopathy (https://pubmed.ncbi.nlm.nih.gov/24518252/, https://pubmed.ncbi.nlm.nih.gov/24509256/). A question arises: perhaps in the past we have confused cases of atlantoaxial hyperflexion with ischemic myelopathy?

Since both conditions have a similar clinical presentation, it is certainly the clinical history of trauma/no trauma that can help us and neurologists understanding which of the two is more likely (along with other MRI findings sometimes also present in the surrounding bony and ligamentous structures in case of trauma), but it is also true that cats, compared to dogs, are more often alone and it is not certain that the owner witnessed the trauma...

3) https://pubmed.ncbi.nlm.nih.gov/39331530/

A “gullwing sign” on magnetic resonance imaging of extradural spinal tumors in dogs and cats allows prioritization of round cell neoplasia (Monto et al.)

We have talked about this article before and discussed together with Ryan Appleby and other colleagues the positives and negatives aspects of including radiographic signs in the reporting terminology (https://www.dhirubhai.net/posts/swan-specchi-166778172_reportbabel-activity-7252196650939498498-y2RF?utm_source=share&utm_medium=member_desktop). Regardless of this digression, if you are trying to figure out where to spend your limited time for continuing education this month, this article is a short, concise read that encapsulates a brief summary of the imaging of extradural neoplasms. The article has only one purpose: to put in black and white that the presence of an extradural vertebral mass with these features ("gullwing sign") is almost certainly a round cell tumor. Another fine article from the University of Tennessee.