EVALUATION OF VASCULAR PERFUSION OF ABDOMINAL ORGANS IN THE DOG USING CEUS (CONTRAST-ENHANCED ULTRASONOGRAPHY).

Contrast-enhanced ultrasound (CEUS) is an ultrasonographic technique that reveals the micro-vascularization of organs and is applied in veterinary medicine to study physiological and pathological conditions, focal or diffuse parenchymal lesions. Clinical applications include the possibility to use CEUS in dogs to evaluate the perfusion of spleen, bladder, kidneys, testis, liver, gallbladder, adrenal, soft tissue lesions, pancreas, prostate and emergencies. Aim of this study is to describe the use of CEUS in dogs for some organs, giving some new applications and analysing the literature knowledge. SonoVue®, contrast medium agent, was used. Qualitative evaluation were done and quantitative computerized analysis of the contrast medium blood pool phase were performed using a dedicated commercial software. Particular results were given about Benign Nodular Hyperplasia (BNH): 20 spleens affected by BNH were studied and qualitative analysis showed simultaneous wash-in of lesion, compared to normal parenchyma, and anticipated wash-out, with hypoechoic pattern than surrounding normal spleen. Quantitative results showed the same peak of enhancement of lesions to the surrounding normal parenchyma but the contrast remain into the lesion for shorter time. In few cases, Hemangiosarcoma, Lymphoma and Histiocytic Sarcoma had early wash-in and early wash-out, prominent inner vessels characterize the lesions, associated with malignancy according to literature. Considering previous studies, our results suggest that hypoenhancing is not a specific pattern of malignancy in splenic lesions. Bladder wall was studied in 10 normal dogs using CEUS; wash-in began around 18 seconds and enhancing the bladder wall. Six cases of Transitional Cell Carcinoma (TCC) were evaluated, involvement of muscular layer of bladder wall with hyperenhancement of infiltrating tumor tissue was demonstrated. About kidney perfusion, CEUS showed lower values in case ok kidney failure compared to a control group, this aspect suggested a reduction of renal perfusion during kidney disease. Testes were studied giving referral qualitative and quantitative parameters about Interstitial Cell Tumour in n°=12 non-sedated dogs to study a single type of tumor without any influence by anesthesia: wash-in was around 25 seconds at the same time with surrounding tissue with hyperenhancement of lesion, heterogeneity and inner vessels. CEUS was used also in other organs (Special Section two) including: Liver, Gallbladder, Adrenal, Gastro-enteric tract, Ovary, Soft tissue lesions with few cases. In conclusion, the evidence of hypoenhancement of BNH opens new considerations about CEUS characterization of malignant lesions that was demonstrated by previous studies. Based on our preliminary results about bladder lesions, a larger number of cases of TCC in comparison with inflammatory hyperplastic bladder lesions are needed to conclude if CEUS may be a feasible tool to study bladder wall lesions. Lower CEUS parameters of contrast medium diffusion in kidney of dogs affected by renal failure than normal dogs suggest a reduction of kidney perfusion in case of renal failure. CEUS is a technique that gives important information about perfusion, even if previous data have produced variable results; CEUS may be used expanding the knowledge given by basic ultrasonography.