title: Evaluation of liver parenchyma and perfusion using dynamic contrast-enhanced computed tomography and contrast-enhanced ultrasonography in captive green iguanas (Iguana iguana) under general anesthesia.
abstract: BACKGROUND
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Veterinary Clinic Modena Sud, Spilamberto, MO 41057, Italy. giordano.nardini@gmail.com.
authors.forename: Giordano
authors.initials: G
authors.lastname: Nardini
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Girolamo
authors.forename: Stefania
authors.initials: S
authors.lastname: Leopardi
authors.forename: Irene
authors.initials: I
authors.lastname: Paganelli
authors.forename: Anna
authors.initials: A
authors.lastname: Zaghini
authors.forename: Francesco C
authors.initials: FC
authors.lastname: Origgi
authors.forename: Massimo
authors.initials: M
authors.lastname: Vignoli
mesh_terms: D000768:Anesthesia, General / Q000662:veterinary; D000818:Animals; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D007076:Iguanas / Q000033:anatomy & histology*; D008099:Liver / Q000098:blood supply* / Q000502:physiology*; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000662:veterinary*; D014463:Ultrasonography / Q000379:methods / Q000662:veterinary*
chemical_list: D003287:Contrast Media