Nardini Giordano, Di Girolamo Nicola, Leopardi Stefania, Paganelli Irene, Zaghini Anna, Origgi Francesco C, Vignoli Massimo
Veterinary Clinic Modena Sud, Spilamberto, MO 41057, Italy.
BMC Vet Res. 2014 May 13;10:112. doi: 10.1186/1746-6148-10-112.
Contrast-enhanced diagnostic imaging techniques are considered useful in veterinary and human medicine to evaluate liver perfusion and focal hepatic lesions. Although hepatic diseases are a common occurrence in reptile medicine, there is no reference to the use of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) to evaluate the liver in lizards. Therefore, the aim of this study was to evaluate the pattern of change in echogenicity and attenuation of the liver in green iguanas (Iguana iguana) after administration of specific contrast media.
An increase in liver echogenicity and density was evident during CEUS and CECT, respectively. In CEUS, the mean ± SD (median; range) peak enhancement was 19.9% ± 7.5 (18.3; 11.7-34.6). Time to peak enhancement was 134.0 ± 125.1 (68.4; 59.6-364.5) seconds. During CECT, first visualization of the contrast medium was at 3.6 ± 0.5 (4; 3-4) seconds in the aorta, 10.7 ± 2.2 (10.5; 7-14) seconds in the hepatic arteries, and 15 ± 4.5 (14.5; 10-24) seconds in the liver parenchyma. Time to peak was 14.1 ± 3.4 (13; 11-21) and 31 ± 9.6 (29; 23-45) seconds in the aorta and the liver parenchyma, respectively.
CEUS and dynamic CECT are practical means to determine liver hemodynamics in green iguanas. Distribution of contrast medium in iguana differed from mammals. Specific reference ranges of hepatic perfusion for diagnostic evaluation of the liver in iguanas are necessary since the use of mammalian references may lead the clinician to formulate incorrect diagnostic suspicions.
对比增强诊断成像技术在兽医和人类医学中被认为有助于评估肝脏灌注和肝脏局灶性病变。尽管肝脏疾病在爬行动物医学中很常见,但目前尚无关于使用对比增强超声(CEUS)和对比增强计算机断层扫描(CECT)评估蜥蜴肝脏的相关报道。因此,本研究的目的是评估绿鬣蜥(Iguana iguana)在给予特定造影剂后肝脏回声性和衰减的变化模式。
在CEUS和CECT过程中,肝脏回声性和密度分别明显增加。在CEUS中,平均±标准差(中位数;范围)峰值增强为19.9%±7.5(18.3;11.7 - 34.6)。达到峰值增强的时间为134.0±125.1(68.4;59.6 - 364.5)秒。在CECT过程中,造影剂在主动脉中的首次显影时间为3.6±0.5(4;3 - 4)秒,在肝动脉中的显影时间为10.7±2.2(10.5;7 - 14)秒,在肝实质中的显影时间为15±4.5(14.5;10 - 24)秒。主动脉和肝实质达到峰值的时间分别为14.1±3.4(13;11 - 21)秒和31±9.6(29;23 - 45)秒。
CEUS和动态CECT是确定绿鬣蜥肝脏血流动力学的实用方法。鬣蜥体内造影剂的分布与哺乳动物不同。由于使用哺乳动物的参考范围可能会导致临床医生产生错误的诊断怀疑,因此需要有用于鬣蜥肝脏诊断评估的特定肝脏灌注参考范围。