Transcript Radiology Packet 1 - University of Prince Edward Island

Radiology Packet 13
Thorax – Pleural cavity
7-year old MC DSH
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Hx: Presented for evaluation of progressive respiratory distress. History
obtained from the owner suggests the cat has been lethargic for 2 weeks
and anorexic for 3 days. They noticed the cat has been “breathing faster” for
the last few days and 12 hours ago became obviously dyspneic.
7-year old MC DSH
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RF
– There is an overall increased density within the thoracic cavity.
– Pleural fissure lines are present as well as an increased density surrounding the
costophrenic angle.
– There is marked retraction of the caudal dorsal lungs from the thoracic walls and
the lung margins appear rounded.
– Soft tissue opacity is present especially along the left thoracic wall and
costrophrenic angle.
– A large amount of free air is present in the right hemi-thorax.
– The right caudal lung lobe appears markedly decreased in size and rounded.
– A mediastinal shift to the left is present.
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RD
– Pleural effusion
– Unilateral tension pneumothorax
7-year old MC DSH
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R/O
– Pleural effusion
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Chylothorax
Hemothorax
Pyothorax
Hydrothorax
– CHF
– Neoplasia
– Pneumothorax
• Traumatic
• Spontaneous
– Secondary to underlying pulmonary disease
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Next
– Thoracocentesis - immediately
– Cytology and culture of the fluid
9-year old M German Shepherd
• Hx: Presented with a history of abdominal distension and
weakness. The diagnostic work-up revealed the presence of a
splenic mass and free abdominal fluid.
9-year old M German Shepherd
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RF
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RD
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The heart and pulmonary vessels appear normal.
In the lateral view there is retraction of the ventral lung tissue away from the sternum.
The apex of the heart silhouettes with an area of soft tissue opacity ventrally.
In the VD view there is increased opacity of the lung fields but this change is much more
obvious in the left lung field.
There is minor retraction of pulmonary tissue from the thoracic wall at the caudal lung tips. A
pleural fissure line is present at the 5th intercostal space on the right.
There is an impression of increased opacity of the cranial abdomen which is consistent with
the presence of free abdominal fluid.
Pleural effusion
R/O
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Chylothorax
Hemothorax
Pyothorax
Hydrothorax
4-year old FS DSH
• Hx: Presented in acute respiratory distress after being outside all
night. The owners indicate that she was fine the previous evening.
4-year old FS DSH
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RF
– The heart is partially obscured by surrounding lung changes but appears normal.
– In the lateral view two triangular structures of soft tissue opacity are seen in the
caudal thorax – these are retracted caudal lung lobes.
– There is free air between the caudal lung lobes and the diaphragm. The free air
is difficult to see in the VD - likely due to positioning.
– In the VD there is an area of increased opacity that silhouettes with the heart
along the left side. This is seen on the lateral film cranial to the heart.
– Increased size of the thoracic cavity has pushed the liver and other abdominal
organs caudally giving the false appearance of hepatomegaly.
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RD
– Bilateral pneumothorax
– Pulmonary contusion
8-year old miniature poodle
“Trixie”
• Hx: presented with dyspnea
8-year old miniature poodle
“Trixie”
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RF
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RD
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Pleural effusion
R/O
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Soft tissue silhouetting of the ventral portion of the heart with the sternum and diaphragm.
Pleural fissure lines.
The caudal mediastinal area is opacified by soft tissue; diaphragm is not seen here.
Retraction of the right middle and caudal lung lobes from the thoracic wall, with soft tissue
opacity between the lobes and the wall.
Trachea is diverging from the spine.
Chylothorax
Pyothorax
Hydrothorax
Hemothorax
Next
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Thoracocentesis
8-month old Pug
“Pugwash”
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Hx: Two days ago the owner noticed an open bag of rat poison and
suspects the puppy ate some of it. Yesterday the puppy became depressed
and lethargic. When presented today he was dyspneic.
8-month old Pug
“Pugwash”
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RF
– Diffuse increase in opacity in the thoracic cavity.
– The cardiac silhouette is obscured and the lung lobes are retracted and rounded.
– In the lateral view the trachea is elevated and in the VD view the cranial
mediastinal appears widened.
– Due to the large volume of fluid in the thorax it is difficult to evaluate the lungs for
changes.
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RD
– Pleural effusion
– Possible widened cranial mediastinum
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R/O
– Rodenticide toxicity
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Next
– Evaluation of coagulation and treat with Vitamin K
11-year old Golden Retriever
“Katie”
• Hx: Presented with dyspnea.
11-year old Golden Retriever
“Katie”
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RF
– Increased overall opacity of the thorax.
– Pleural fissure lines are present and the lung lobe margins are rounded on the
lateral view.
– The cranial mediastinum is mildly widened.
– Multiple medium size soft nodules are present in various lung lobes.
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RD
– Massive pleural effusion
– Pulmonary nodules
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R/O
– Pleural fluid secondary to neoplasia
– Cranial mediastinal mass
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Next
– Thoracocentesis