Laparoscopic ultrasonography identifies more liver lesions in dogs compared to transabdominal ultrasonography

To describe the use of laparoscopic ultrasound (LUS) for evaluation of the liver in dogs with clinical liver disease and to compare the findings of LUS to transabdominal ultrasound (TUS).

8 client-owned dogs presenting for laparoscopic liver biopsies due to clinical liver disease were enrolled. All dogs underwent TUS, and liver lesions were identified, localized, and quantified per presumed liver lobe. Laparoscopic examination and LUS of the liver were performed, and liver lesions were identified, localized, and quantified. Laparoscopic liver biopsies were obtained and submitted for histopathological analysis, copper analysis, and culture and susceptibility.

The median time to perform hepatobiliary TUS was 10 minutes (IQR, 7.5 to 12 minutes), and the median time to perform LUS and laparoscopic examination of the liver was 19.5 minutes (IQR, 17.8 to 23.5 minutes). The number of lesions identified on LUS versus TUS was significantly different, with 5 dogs having an additional 28 lesions identified on LUS that were not found on TUS. The diameter of lesions identified on TUS and LUS ranged from 0.3 to 4.5 cm and 0.1 to 4.1 cm, respectively. In 2 dogs, LUS was used to guide the biopsy of liver lesions that were not grossly appreciable on laparoscopic examination.

LUS identifies more liver lesions compared to TUS and can be used to guide the biopsy of lesions that are not grossly appreciable laparoscopically.

LUS should be considered when staging patients with hepatobiliary neoplasia and may result in the identification of additional liver lesions missed on preoperative imaging.