Starry sky hepatic ultrasonographic pattern in horses

Area of Science:

• Veterinary Medicine
• Diagnostic Imaging
• Equine Hepatology

Background:

• The
• starry sky
• hepatic pattern is an uncommon ultrasonographic finding in horses.
• It is characterized by numerous hyperechoic foci within the liver parenchyma.
• The etiology and clinical significance of this pattern are not well understood.

Purpose of the Study:

• To describe the signalment, clinical signs, clinicopathological findings, and ultrasonographic features of horses with the
• starry sky
• hepatic pattern.
• To determine the underlying gross and histologic changes associated with this ultrasonographic appearance.
• To assess the clinical significance of the
• starry sky
• hepatic pattern in equine patients.

Main Methods:

• Retrospective review of 18 adult horses diagnosed with the
• starry sky
• hepatic pattern on ultrasonography.
• Evaluation of signalment, clinical signs, clinicopathological data, and ultrasonographic findings.
• Histologic examination of liver tissue to identify the cause of the ultrasonographic pattern.

Main Results:

• The
• starry sky
• hepatic pattern was associated with numerous fibrosing hepatic granulomas in all evaluated horses.
• Most horses had normal liver size and echogenicity, with hyperechoic foci often causing acoustic shadowing.
• Fifteen horses had an underlying disease process unrelated to primary liver disease, suggesting the pattern is often incidental.

Conclusions:

• The
• starry sky
• hepatic pattern in horses is histologically characterized by fibrosing granulomas.
• This ultrasonographic finding is likely incidental in most cases and not indicative of primary hepatic disease.
• Further investigation may help clarify the etiology and clinical relevance of these granulomas.