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. 2021 Mar 3;11(3):670.
doi: 10.3390/ani11030670.

B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Dogs

Francesco Simeoni  1 , Francesca Del Signore  1 , Giovanni Aste  1 , Paolo Bargellini  2 , Giuseppe Rubini  3 , Rossella Terragni  4 , Roberto Tamburro  1 , Ilaria Falerno  1 , Francesco de Pasquale  1 , Marco Russo  5 , Massimo Vignoli  1
Affiliations

B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Dogs

Francesco Simeoni et al. Animals (Basel). .

Abstract

Canine gastric disorders are common in veterinary clinical practice and among these neoplasms require rapid identification and characterization. Standard ultrasound (US) is the imaging modality of choice for gastric wall assessment. The aim of this prospective study is to describe the specific B-mode and contrast enhanced US (CEUS) features of normal, inflammatory, and neoplastic gastric wall in dogs. B-mode US and CEUS of the stomach were performed in anesthetized dogs with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 41 dogs were included: 6 healthy (HEA) as the control group; 9 gastritis (INF); 8 adenocarcinoma (AC); 8 alimentary lymphoma (AL); 4 leiomyosarcoma (LEIS); 2 gastrointestinal stromal tumor (GIST); 2 leiomyoma; 1 undifferentiated sarcoma; 1 metastatic gastric hemangiosarcoma. Gastric tumors appear as a marked wall thickness with absent layers definition and possible regional lymphadenopathy (AC and AL) and steatitis (AC) while gastritis generally shows no/mild thickening and no other alterations on B-mode US. On CEUS, neoplasm shows a higher and faster wash in if compared to that of gastritis. B-mode and CEUS assessment may be useful in the evaluation of canine gastric disorders in the distinction between gastritis and gastric neoplasms, even if there are no specific features able to discriminate between the different tumor histotypes.

Keywords: b-mode ultrasound; contrast enhanced ultrasound; dogs; gastric inflammation; gastric neoplasia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Box and whisker plot of the gastric wall thickness for healthy (HEA), inflammatory (INF), adenocarcinoma (AC), lymphoma (AL), and leiomyosarcoma (LEIS).
Figure 2
Figure 2
Classification of gastric wall layer definition on B-mode US: (A) normal: all the five layers are easily identified and thickness is normal, (4.1 mm between the cursors (+) in a HEA dog); (B) reduced: the identification of the layers is more difficult; in addition to a mild diffuse wall thickening (6.5 mm between the cursors in a INF dog); (C) absent: it is not possible to recognize the normal wall stratification and layer definition is lost. Here, a focal transmural mass of 37.5 mm between the asterisks in a gastrointestinal stromal tumor (GIST) with mixed echogenicity; (D) pseudolayering: wall, between the asterisk (*), with moderately echogenic line (arrowheads) surrounded by an outer and inner poorly echogenic areas in a dog with gastric adenocarcinomas.
Figure 3
Figure 3
Thickening localization classified as: (A) focal: a transmural, prevalent hypoechoic mass (arrowheads) with loss of layering was identified in a dog with gastric GIST; (B) diffuse: wall hyperechoic thickening (arrowheads) with complete loss of layers definition is present in most of the stomach in this dog affected by adenocarcinoma.
Figure 4
Figure 4
Box and whisker plot of the arrival time (AT) for healthy (HEA), inflammatory (INF), adenocarcinoma (AC), lymphoma (AL), and leiomyosarcoma (LEIS).
Figure 5
Figure 5
Box and whisker plot of the time to peak (TTP) for healthy (HEA), inflammatory (INF), adenocarcinoma (AC), lymphoma (AL), and leiomyosarcoma (LEIS).
Figure 6
Figure 6
Box and whisker plot of the time to fall (TO) for healthy (HEA), inflammatory (INF), adenocarcinoma (AC), lymphoma (AL), and leiomyosarcoma (LEIS).
Figure 7
Figure 7
Box and whisker plot of the peak enhancement (PE) for healthy (HEA), inflammatory (INF), adenocarcinoma (AC), lymphoma (AL), and leiomyosarcoma (LEIS).
Figure 8
Figure 8
Box and whisker plot of the wash-in rate (WiR) for healthy (HEA), inflammatory (INF), adenocarcinoma (AC), lymphoma (AL), and leiomyosarcoma (LEIS).
Figure 9
Figure 9
Gastric lymphoma in a dog: (A) B-mode image of a severe focal transmural hypoechoic mass of 24 mm (between asterisks) with absent layers definition; (B) contrast enhanced ultrasound (CEUS)examination of the same gastric mass during the peak enhancement (17 s) of the time-intensity curve.
Figure 10
Figure 10
Gastric leiomyosarcoma in a dog: (A) B-mode image of a focal hyperechoic wall mass protruding into the gastric lumen (19.3 mm between asterisks) with no layers definition; (B) CEUS examination of the same dog during the peak enhancement of the time-intensity curve.
Figure 11
Figure 11
CEUS examination of the same dog during the peak enhancement of the time-intensity curve. CEUS enhancement pattern in a canine adenocarcinomas: (A) before contrast medium (CM) injection (0 s), the gastric mass (14 mm—arrowheads) and the adjacent liver parenchyma (asterisk) are visualized; (B) after CM injection (13 s), uptake occurs at the same moment at gastric wall and liver and the mass is classified as isoenhancing; (C) at peak enhancement time, contrast uptake is higher at the lesion margins and poor at its center and enhancement homogeneity is classified as heterogeneous; (D) in wash out phase (23 s), the enhancement decreased at gastric wall but persist in the adjacent liver.
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