Ko Jaeeun, Hwang Jeongyeon, Yoon Hakyoung, Eom Kidong, Kim Jaehwan
Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul, South Korea.
Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Jeonju, South Korea.
Front Vet Sci. 2020 Nov 24;7:581922. doi: 10.3389/fvets.2020.581922. eCollection 2020.
This study describes the multimodal imaging characteristics of pedunculated liver masses in seven dogs [Cocker Spaniel ( = 2), Maltese ( = 1), Shih-Tzu ( = 2), and Schnauzer ( = 2)]. These masses are anatomic variants of hepatic masses in which the center of the mass lies outside the liver contour. Prior to referral, only one dog had been diagnosed with a hepatic mass, four had been diagnosed with mid-abdominal masses of unknown origin, and two had been misdiagnosed with splenic head and pancreatic masses. Using radiographs, the mass locations were classified as cranioventral ( = 3), mid-abdominal ( = 2), or craniodorsal ( = 2). The gastric axis was deviated in various directions in four cases. Based on computed tomography (CT) findings, the masses were noted to originate from every liver lobe (two from the left lateral lobe) and to possess parenchymal ( = 6) or vascular ( = 1) pedicles. The histopathological results showed that three masses were benign [hepatic adenoma ( = 1) and nodular hyperplasia ( = 2)] and four were malignant [hepatocellular carcinoma ( = 3) and cholangiocarcinoma ( = 1)]. For three dogs, triple-phase CT maximum intensity projection images in the arterial phase clearly showed that the masses were connected to the hepatic artery. We propose that a pedunculated liver mass should be considered as a differential diagnosis when a mass is located in the mid-abdomen, even if it is separated from the liver and with the gastric axis deviated in various directions. We consider CT imaging to be a useful tool for diagnosis, evaluation, and surgical planning in dogs with a pedunculated liver mass.
本研究描述了7只犬(可卡犬2只、马尔济斯犬1只、西施犬2只、雪纳瑞犬2只)带蒂肝肿块的多模态成像特征。这些肿块是肝脏肿块的解剖变异,肿块中心位于肝脏轮廓之外。转诊前,仅1只犬被诊断为肝肿块,4只被诊断为不明来源的中腹部肿块,2只被误诊为脾头和胰腺肿块。通过X线片,肿块位置分类为颅腹侧(3只)、中腹部(2只)或颅背侧(2只)。4例胃轴向不同方向偏移。根据计算机断层扫描(CT)结果,肿块起源于各肝叶(2个来自左外叶),具有实质蒂(6个)或血管蒂(1个)。组织病理学结果显示,3个肿块为良性[肝腺瘤(1个)和结节性增生(2个)],4个为恶性[肝细胞癌(3个)和胆管癌(1个)]。对于3只犬,动脉期三相CT最大强度投影图像清晰显示肿块与肝动脉相连。我们建议,当肿块位于中腹部时,即使其与肝脏分离且胃轴向不同方向偏移,也应将带蒂肝肿块视为鉴别诊断。我们认为CT成像对于带蒂肝肿块犬的诊断、评估和手术规划是一种有用的工具。