Abstract
BackgroundNodular lymphoid hyperplasia (NLH) is one of the most common non-neoplastic splenic lesions in dogs, especially in old ones, showing a splenic enlargement. More recent studies have been focused on Contrast Enhanced Ultrasonography (CEUS) analysis of the spleen for establishing normal perfusion patterns and blood pool phase peculiarities of focal lesions.The aim of the study was to evaluate the qualitative and quantitative CEUS analysis of the canine splenic NLH, characterizing the CEUS pattern of this pathology on 20 clinical cases.ResultsA prospective, observational study was performed using a system equipped with contrast-tuned imaging technology. Mechanical Index was set from 0.08 to 0.11; the contrast medium was a second generation contrast medium composed of sulphur hexafluoride encapsulated of a shell of phospholipids (SonoVue®). Qualitative and quantitative assessment of the enhancement pattern of splenic NLH were performed.Cytology and histology identified 20 splenic NLH. All of the benign hyperplastic lesions assessed were isoechoic with a homogeneous pattern than the surrounding normal spleen, during the wash-in phase (10–20 s) of the CEUS exam. Before finishing the wash-in phase, 20–45 s from the contrast medium inoculation, 19/20 benign nodules became markedly hypoechoic to the adjacent spleen. Sensitivity of hypoechoic pattern for NLH was 95%.ConclusionsThese findings should prove useful in the evaluation of focal splenic masses in dogs. Since enhancement and perfusion patterns of NLH seem to coincide with some neoplastic lesions of the spleen previously reported, in clinical practice attention must be paid to the final diagnosis of canine splenic lesions using only the CEUS exam.
Highlights
Nodular lymphoid hyperplasia (NLH) is one of the most common non-neoplastic splenic lesions in dogs, especially in old ones, showing a splenic enlargement
To testing a previously developed diagnostic criteria, we performed a Contrast Enhanced Ultrasonography (CEUS) examination in 20 dogs affected by NLH, we reported the quantitative CEUS in order to provide the quantification of blood flow parameters of this lesion
On B-mode examination, dogs enrolled had a single focal lesion with a mean diameter of 1,86 cm. 5/20 nodules were located near the splenic capsule, giving an alterated splenic border. 10/20 nodules were homogeneous and hypoechoic than the splenic parenchyma, 8/20 nodules had mixed echogenicity, only 2 lesions were isoechoic with small hypoechoic areas
Summary
Nodular lymphoid hyperplasia (NLH) is one of the most common non-neoplastic splenic lesions in dogs, especially in old ones, showing a splenic enlargement. More recent studies have been focused on Contrast Enhanced Ultrasonography (CEUS) analysis of the spleen for establishing normal perfusion patterns and blood pool phase peculiarities of focal lesions. The aim of the study was to evaluate the qualitative and quantitative CEUS analysis of the canine splenic NLH, characterizing the CEUS pattern of this pathology on 20 clinical cases. Morphological changes of the splenic tissue related to the presence of focal lesions are common in aging dog [1]. Nodular lymphoid hyperplasia (NLH) is one of the most common non-neoplastic focal splenic masses, especially in old animals showing enlarged spleen [2,3,4]. Sometimes the nodules are not immediately detected in the normal parenchyma and their
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