Falta de associação entre os achados ultrassonográficos e o diagnóstico histopatológico das lesões do parênquima hepático de cães / Lack of associations between ultrasonographic appearance of parenchymal lesions of the canine liver and histological diagnosis

Lack of associations between ultrasonographic appearance of parenchymal lesions of the canine liver and histological diagnosis

1. C. M. R. Warren-Smith¹, 
2. S. Andrew², 
3. P. Mantis¹, 
4. C. R. Lamb¹

Article first published online: 5 MAR 2012

DOI: 10.1111/j.1748-5827.2011.01184.x

© 2012 British Small Animal Veterinary Association

Issue

Journal of Small Animal Practice

Volume 53, Issue 3, pages 168–173, March 2012

Additional Information(Show All)

Objective: To assess if there are any ultrasonographic features that may enable tentative diagnosis of hepatic parenchymal disease.

Methods: Records of 371 dogs that had abdominal ultrasonography and abnormal liver on biopsy or necropsy were reviewed.

Results: Histological diagnoses were hepatitis (n=77), nodular hyperplasia (n=47), vacuolar change (n=45), fibrosis (n=32), primary hepatic carcinoma (n=30), lymphoma (n=28), metastatic neoplasia (n=27), necrosis (n=21), lipidosis (n=17), haemangiosarcoma (n=13), round cell tumour (n=9), hepatocellular adenoma (n=8), degenerative change (n=6), steroid hepatopathy (n=7) and extramedullary haematopoiesis (n=4). The most prevalent ultrasonographic features were multifocal lesions (63% livers with haemangiosarcoma and 43% livers with hepatocellular carcinoma), diffuse lesions (71% livers with steroid hepatopathy, 44% livers with fibrosis and 40% livers with vacuolar hepatopathy), hyperechoic lesions (71% livers with steroid hepatopathy, 41% livers with lipidosis and 38% livers with fibrosis), heterogeneous lesions (62% livers with haemangiosarcoma), hepatomegaly (43% livers with steroid hepatopathy) and peritoneal fluid (62% livers with haemangiosarcoma). Target lesions were associated with malignancy in 67% instances. Marked variability in ultrasonographic appearance of lesions was observed for all diagnoses, and no statistically significant associations between ultrasonographic appearance and diagnosis were found.

Clinical Significance: Histological examination remains essential for diagnosis of canine hepatic disease.

Table 1.  Summary of hepatic diagnoses in 371 dogs

Histological diagnosis	n (%)	Sensitivity* (%)
*Proportion of affected dogs in which the liver appeared abnormal ultrasonographically
Hepatitis	77 (21)	37/77 (48)
Nodular hyperplasia	47 (13)	33/47 (70)
Vacuolar hepatopathy	45 (12)	30/45 (67)
Fibrosis	32 (9)	22/32 (69)
Hepatocellular carcinoma	30 (8)	24/30 (80)
Lymphoma	28 (8)	19/28 (68)
Metastasis	27 (7)	15/27 (56)
Necrosis	21 (6)	13/21 (62)
Lipidosis	17 (5)	13/17 (76)
Haemangiosarcoma	13 (4)	11/13 (85)
Round cell neoplasia	9 (2)	4/9 (44)
Hepatocellular adenoma	8 (2)	6/8 (75)
Steroid hepatopathy	7 (2)	6/7 (86)
Degeneration	6 (2)	4/6 (67)
Extramedullary haematopoiesis	4 (1)	3/4 (75)