title: EVALUATION OF CONTRAST-ENHANCED ULTRASONOGRAPHY AS A METHOD FOR DETECTING GALLBLADDER NECROSIS OR RUPTURE IN DOGS.
abstract: Gall bladder necrosis and rupture are life-threatening conditions in dogs requiring surgical intervention and early diagnosis is essential. Human patients with suspected gall bladder necrosis/rupture are commonly evaluated with contrast-enhanced ultrasonography (CEUS), however this procedure has not been described in dogs with suspected gall bladder necrosis/rupture. In a prospective diagnostic cohort study, CEUS (using SonoVue contrast medium) was performed in 93 dogs with gallbladder lesions identified by abdominal conventional ultrasonography. Necrosis/rupture was identified by CEUS as a focal lack of enhancement of the gallbladder wall. Dogs with positive CEUS finding for necrosis/rupture (complete lack of regional wall enhancement) underwent immediate surgery as did dogs with other biliary disorders requiring surgery. Dogs with negative CEUS findings or those not requiring surgery were managed medically. In cases undergoing surgery, necrosis/rupture was confirmed intraoperatively (and via histopathology). Absence of necrosis/rupture was confirmed either intraoperatively (via histopathology) or was assumed to be absent by complete recovery with medical management. Forty-nine dogs underwent surgery and cholecystectomy: 24 had necrosis/rupture. CEUS was more accurate (100% sensitive and specific) in diagnosing gallbladder wall necrosis/rupture than conventional ultrasonography (75% sensitive and 81% specific) (P < 0.03). In conclusion, CEUS provides accurate characterization of gallbladder wall integrity that can impact decisions regarding clinical management, either surgical or medical.
authors: Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100, Terni, Italy.
authors: Paolo
authors: P
authors: Bargellini
authors: Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100, Terni, Italy. riccardo.orlandi83@hotmail.it.
authors: Riccardo
authors: R
authors: Orlandi
authors: Tyrus Clinica Veterinaria, Via Bartocci 1G, 05100, Terni, Italy.
authors: Chiara
authors: C
authors: Paloni
authors: Ultravet Diagnostic, Via E. Fermi 59, 40017, S. Giovanni in Persiceto, Bologna, Italy.
authors: Giuseppe
authors: G
authors: Rubini
authors: Centro Veterinario Specialistico, Via S. Giovannini 51, 00137, Roma, Italy.
authors: Paolo
authors: P
authors: Fonti
authors: Animal Endocrine Clinic, 21 West 100th Street, New York, NY.
authors: Mark E
authors: ME
authors: Peterson
authors: Veterinary Information Network, 777 W Covell Blvd, Davis, CA.
authors: Mark
authors: M
authors: Rishniw
authors: Dipartimento di Medicina Veterinaria, Università di Perugia, Via S. Costanzo 4, 06126, Perugia, Italy.
authors: Cristiano
authors: C
authors: Boiti
mesh_terms: D000818:Animals; D015331:Cohort Studies; D003287:Contrast Media; D004283:Dog Diseases / Q000000981:diagnostic imaging*; D004285:Dogs; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging / Q000662:veterinary*; D008297:Male; D009336:Necrosis / Q000000981:diagnostic imaging / Q000662:veterinary*; D010743:Phospholipids; D011446:Prospective Studies; D012421:Rupture / Q000000981:diagnostic imaging / Q000662:veterinary*; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods / Q000662:veterinary*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: CEUS; cholecystitis; conventional ultrasonography