Abstract

Contrast‐enhanced ultrasonography (CEUS) is increasingly available for veterinary patients, however limited studies describe the use of this method for characterizing intrathoracic mass lesions. The aim of this prospective, observational study was to describe CEUS enhancement patterns for intrathoracic mass lesions in a sample of cats and dogs. Sixty patients (36 dogs, 24 cats) were included. Standardized CEUS examinations were performed for 41 pulmonary masses (68%) and 19 mediastinal masses (32%). Final diagnosis was based on cytology and/or histopathology. Absolute time to enhancement (TTE) values were recorded for the intrathoracic mass lesions and spleen. The spleen was used as a reference parenchymal organ to calculate relative TTE (rTTE) values. Absolute TTE of the spleen and intrathoracic mass lesions differed for dogs and cats (P = 0.001). The rTTE values significantly differed between lesions of neoplastic versus non‐neoplastic origin (P = 0.004). The majority of neoplastic pulmonary masses were supplied by bronchial arteries (63%), while most nonneoplastic pulmonary masses were supplied by pulmonary arteries (78%). The sensitivity and specificity for detecting pulmonary neoplastic masses with rTTE were 63% and 78%, respectively. Enhancement patterns for mediastinal thymomas and lymphomas significantly differed (P = 0.002). Thymomas enhanced heterogeneously in a centripetal pattern (86%), whereas lymphomas typically enhanced uniformly in a centrifugal pattern (75%). Findings indicated that CEUS is a feasible method for characterizing intrathoracic mass lesions in dogs and cats, however, the diagnostic sensitivity for detecting neoplastic pulmonary masses was low.

Highlights

  • Mass lesions are defined as solitary lesions larger than 3 cm in size.[1]

  • Findings from the current study supported our hypothesis that Contrast-enhanced ultrasonography (CEUS) enhancement and vascularization patterns are different in a portion of neoplastic and nonneoplastic pulmonary and mediastinal mass lesions

  • The exact time of contrast enhancement within a lesion depends on the patient's individual circulation time, which is why a systemic organ was used as reference in each patient

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Summary

Introduction

Mass lesions are defined as solitary lesions larger than 3 cm in size.[1]. Mass lesions in lung parenchyma can be caused by primary and metastatic neoplastic or nonneoplastic disorders. The most common mass lesions in the mediastinum are lymphoma, thymoma, bronchogenic and idiopathic mediastinal cysts, ectopic thyroid, chemodectoma, and some rare neoplasms.[4]

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