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Imaging of the liver and pancreas
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Imaging of the liver and pancreas can offer invaluable information when investigating possible diseases linked to these organs; Laurent Blond reviews the options.
Laurent Blond
DVM, MSc, Dipl. ACVR, Le Centre Hospitalier Vétérinaire, Languedocia, Montpellier, France.
Dr. Blond graduated from the National Veterinary School of Toulouse in 1999 and undertook an internship at the University of Montreal, Quebec, Canada before doing a residency in medical imaging at the North Carolina State University, USA. He was professor of medical imaging at the University of Montreal before joining the Languedocia veterinary hospital team in 2012. He is interested in all aspects of diagnostic imaging and has authored numerous scientific articles and book chapters on the subject.
Key Points:
- Radiography allows assessment of liver size and contours, but does not allow evaluation of parenchymal changes unless gas or mineralization is present.
- Ultrasound is a very useful modality to complete evaluation of the liver as it is cost-effective and non-invasive, and in most cases can be accomplished without sedation.
- Computed tomography requires the patient to be under general anesthesia but is very helpful to image the entire liver, especially in large dogs where ultrasound may be limited.
- Ultrasound is useful for imaging of the pancreas, although thorough evaluation and interpretation requires some experience.
Introduction
The various imaging modalities now available in small animal practice permit exceptional opportunities for the diagnosis of many conditions involving the liver and the pancreas. This paper briefly reviews the anatomy of both organs and discuss the pros and cons for each technique.
The liver
The liver is the largest organ within the abdomen, occupying most of its cranial aspect. Located between the diaphragm and the stomach, the liver is divided in several lobes: the right lateral and medial lobes, the left lateral and medial lobes, the quadrate lobe, and the caudate lobe, which has a papillar process and a caudate process. The liver has two venous systems, portal and systemic.
The liver is closely associated to the gallbladder, which is located between the right medial and quadrate lobes, and the right kidney is in contact with the caudate process of the liver.
Radiography
Radiographs allow evaluation of liver size and contours, but do not allow evaluation of parenchymal changes unless associated with gas or mineralization. Two orthogonal views of the patient’s abdomen are necessary (lateral and ventrodorsal) and should be taken on expiration. It is important to include the cranial margin of the diaphragm on abdominal radiographs to entirely evaluate the liver. [...]
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