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Published on: January 27, 2011
Intra-arterial versus intra venous contrast-enhanced computed tomography of the equine head
Casper P Crijns1, Yseult Baeumlin2, Lieve De Rycke3
1Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium. caspercrijns@me.com.
Insights
Comparing intravenous and intra-arterial contrast-enhanced computed tomography (CT) in horses, the intra-arterial technique uses less contrast medium and better evaluates lesions with increased blood flow. Normal and abnormal enhancement patterns were described for equine head diagnosis.
Area of Science:
- Veterinary Radiology
- Equine Diagnostic Imaging
Background:
- Radiography has limitations in diagnosing equine head pathology due to anatomical complexity.
- Contrast-enhanced computed tomography (CT) is increasingly utilized for equine head diagnoses.
Purpose of the Study:
- To compare intravenous (IV) and intra-arterial (IA) contrast-enhancement techniques in horses.
- To describe normal and abnormal contrast enhancement patterns in the equine head.
Main Methods:
- Twenty-four horses underwent IV and IA contrast-enhanced CT procedures.
- Statistical analysis compared contrast enhancement between pre- and post-contrast studies for both techniques.
Main Results:
- Both IA and IV techniques showed significant contrast enhancement in various head structures, including the pituitary gland, nasal mucosa, salivary glands, and cerebrum.
- Significant enhancement was observed in specific muscles (rectus capitis, temporal, masseter) with IA, and brainstem with IV.
- No significant enhancement was noted in the eye or tongue with either technique.
- Three categories of abnormal enhancement were identified: highly vascularized masses, rim enhancement, and inflamed structures.
Conclusions:
- Intra-arterial (IA) technique achieves comparable contrast enhancement with less contrast medium and is advantageous for evaluating hypervascular lesions.
- Intravenous (IV) technique yields symmetrical, homogenous enhancement, with timing and dosage being critical; it is advantageous for evaluating lesions with increased vascular permeability.
- Understanding normal contrast enhancement patterns is crucial for identifying abnormal findings in equine head CT scans.
Background:
The anatomical complexity of the horse's head limits the abilities of radiography. Computed tomography (CT) in combination with contrast enhanced CT is used more often for diagnosing various head pathology in horses. The objective of this study was to compare intravenous and intra-arterial contrast-enhancement techniques and describe normal and abnormal contrast enhancement in the horse's head.
Results:
All 24 horses included in the study recovered without complication from the procedures. Compared to the pre-contrast studies, post-contrast studies showed significant contrast enhancement in the pituitary gland (IA: p < 0.0001; IV: p < 0.0001), IA nose septum (p = 0.002), nose mucosa (IA: p < 0.0001; IV: p = 0.02), parotid salivary gland (IA: p < 0.0001; IV p < 0.0001), cerebrum (IA: p < 0.0001; IV: p < 0.0001), rectus capitis muscle (IA: p < 0.0001; IV p = 0.001), IA temporal muscle (p < 0.0001), IA masseter muscle (p <0.0001) and IV brainstem (p = 0.01). No significant contrast enhancement was seen in the eye (IA: p = 0.23; IV p = 0.33), tongue (IA p = 0.2; IV p = 0.57), IA brainstem (p = 0.88), IV nose septum (p = 0.26), IV temporal muscle (p = 0.09) and IV masseter muscle (p = 0.46). Three different categories of abnormal enhancement were detected: a strong vascularised mass, an enhanced rim surrounding an unenhanced structure and an inflamed anatomical structure with abnormal contrast enhancement.
Conclusion:
Using the intra-arterial technique, similar contrast enhancement is achieved using less contrast medium compared to the intravenous technique. And a potential major advantage of the IA technique is the ability to evaluate lesions that are characterized by increased blood flow. Using the intravenous technique, a symmetrical and homogenous enhancement is achieved, however timing is more crucial and the contrast dosage is more of influence in the IV protocol. And a potential major advantage of the IV technique is the ability to evaluate lesions that are characterized by increased vascular permeability. Knowing the different normal contrast enhancement patterns will facilitate the recognition of abnormal contrast enhancements.
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