Triple-Phase Multidetector Computed Tomography in Distinguishing Canine Hepatic Lesions.

Ladislav Stehlík,Michaela Paninárová,Angela V De Magistris,Monica Alberti,Andrea Carloni,Morena Di Tommaso,Luisa Pontonutti,Francesca Del Signore,Massimo Vignoli,Rossella Terragni,Tommaso Magni

doi:10.3390/ani11010011

Ladislav Stehlík, Michaela Paninárová + Show 9 more

Open Access

https://doi.org/10.3390/ani11010011

Copy DOI

Abstract

Simple SummaryThe goal of this study was to find any associations between the histologic diagnosis and the radiodensity of liver lesions. Thirty-one dogs with focal or multifocal liver lesions undergoing computed tomography examination were included in the study. Computed tomography examinations were performed before and after the application of a contrast medium, and postcontrast images were obtained in three different vascular phases; the arterial, portal, and delayed venous phases. A histological diagnosis was subsequently obtained for all of the dogs. From the results, no significant differences were identified between the benign and malignant liver lesions, nor between the individual histological types of lesions. The conclusion from this study is that triple-phase contrast-enhanced computed tomography cannot differentiate between benign and malignant liver lesions. Biopsy and further histological analysis are necessary.The liver has a unique vascular supply, and triple-phase contrast-enhanced computed tomography examinations are being performed in order to characterize liver lesions. This study aimed to look for any associations between the attenuation values of liver lesions and their histological classification. The inclusion criteria for this retrospective study were focal or multifocal liver lesions and histological diagnosis. All of the dogs underwent pre-contrast and triple-phase postcontrast computed tomography (CT) examinations with identical timings of the postcontrast series. Thirty-one dogs were included in the study, and various benign and malignant pathologies were identified. The results did not identify any significant differences between the benign and malignant liver lesions, nor between the individual histological diagnoses. Inflammatory lesions were significantly different compared to the normal liver parenchyma, and significant hypoattenuation was found in the portal and delayed venous phases. Hemangiosarcomas were significantly hypoattenuating to the normal liver parenchyma in the pre-contrast and arterial phases, and also to all of the benign lesions in the arterial phase. The other pathologies showed variable attenuation patterns in the different postcontrast phases, and differentiation was not possible. On the basis of this study, triple-phase contrast-enhanced computed tomography cannot differentiate between benign and malignant liver lesions, and biopsy and further histological analysis are necessary.

Highlights

The evolution of multidetector computed tomography (MDCT) has allowed us to scan the entire patient in a short time, and to evaluate the organs in different vascular phases of contrast media distribution [1,2,3]
In a normal healthy liver, about 70–80% of the blood supply is provided by the portal vein, and the rest is provided by the hepatic artery [4]
For this multicentric and retrospective study, the archives of three different veterinary hospitals were reviewed in order to find dogs that had focal or multifocal liver lesions identified on Triple-phase contrast-enhanced MDCT (TP-MDCT) examination between April 2016 and February 2019

Summary

Introduction

The evolution of multidetector computed tomography (MDCT) has allowed us to scan the entire patient in a short time, and to evaluate the organs in different vascular phases of contrast media distribution [1,2,3]. In a normal healthy liver, about 70–80% of the blood supply is provided by the portal vein, and the rest is provided by the hepatic artery [4]. The results of an experimental study on mice with hepatic adenocarcinoma showed that the portal vein was responsible only for 4% of the blood supply [9]. Several papers dealing with multiphase MDCT of the liver were recently published in veterinary medicine [1,2,3,10]. One of those studies confirmed the greater accuracy of triple-phase MDCT compared to ultrasonography in the prediction of benign versus malignant masses [3]. The same study suggested that the vascular dynamics of HCC differ between dogs and humans [2]

Objectives

Methods

Results

Discussion

Conclusion