Accuracy of Computed Tomographic Signs for the Detection of Severe Adhesions in Dogs with Abdominal Masses

The preoperative detection of abdominal adhesions could influence surgical planning; however, imaging features of abdominal adhesions are minimally described in the veterinary literature. The purpose of this retrospective, diagnostic case-control study is to determine the preoperative CT imaging signs associated with surgically-confirmed, severe adhesions in dogs with abdominal masses. Dogs undergoing contrast-enhanced CT and surgery for abdominal masses from 2012 to 2022 were included in the study. Surgical records were evaluated and retrospectively reviewed by a board-certified surgeon to determine the severity of adhesions as pertaining to surgical planning and/or complications. The CTs of dogs with severe adhesions were mixed with age and weight-matched controls for review by a board-certified veterinary radiologist. A review of the literature on both people and animals determined the imaging features tested. The signs tested were fat stranding, fat stranding with vascular enhancement or vascular crowding, loss of fat planes (properitoneal fat sign), focal peritoneal enhancement with or without an alteration in visceral contour, loculation of fluid, and enhancing peritoneal bands. The presence of fat stranding (sensitivity 60.5; specificity 72.1), fat stranding with vascular enhancement (sensitivity 53.5, specificity 81.4), and loculation of peritoneal effusion (sensitivity 25.5; specificity 95.3) were significantly associated with the presence of adhesions at surgery. Loculation of peritoneal effusion surrounding the nondependent margin of an abdominal mass can alert imagers to the presence of severe adhesions. The absence of any of the signs tested does not exclude the presence of adhesions, especially in the retroperitoneum.