Ultrasound imaging of the canine tympanic bulla

Evidence-Based Advances in Rabbit Medicine

Rabbit medicine has been continuously evolving over time with increasing popularity and demand. Tremendous advances have been made in rabbit medicine over the past 5 years, including the use of imaging tools for otitis and dental disease management, the development of laboratory testing for encephalitozoonosis, or determination of prognosis in rabbits. Recent pharmacokinetic studies have been published, providing additional information on commonly used antibiotics and motility-enhancer drugs, as well as benzimidazole toxicosis. This article presents a review of evidence-based advances for liver lobe torsions, thymoma, and dental disease in rabbits and controversial and new future promising areas in rabbit medicine.

Validation of an ultrasound imaging technique of the tympanic bullae for the diagnosis of otitis media in calves

Background

Otitis media is a common disease in calves that can be subclinical, making antemortem on‐farm diagnosis challenging.

Objectives

To evaluate the sensitivity and specificity of ultrasonography of tympanic bullae for the diagnosis of clinical and subclinical otitis media and to evaluate the reproducibility of the technique.

Animals

Forty calves 19–50 days of age were selected from a veal calf farm.

Methods

Prospective study. Ultrasonography was first performed on the farm by ultrasonographer A (US A). Ultrasonography was repeated by ultrasonographer A (US A') and another ultrasonographer (US B) at the Centre Hospitalier Universitaire Vétérinaire. Images were later reread by both examiners and a diagnosis was recorded. The calves were euthanized and submitted for necropsy, and histopathologic diagnosis was used as the gold standard.

Results

Forty‐five bullae were affected by otitis media and 35 bullae were normal. Sensitivity and specificity of the ultrasound technique ranged from 32 to 63% and 84 to 100%, respectively, depending on the examiner and classification of suspicious ultrasonography results. Kappa analysis to evaluate interobserver agreement between A' and B yielded a к value of 0.53. Agreement within the same examiner (A versus A') yielded a к value of 0.48, and real‐time ultrasound versus rereading of recorded images for A' and B yielded к values of 0.58 and 0.75, respectively.

Conclusions

Sensitivity and specificity of the ultrasound imaging technique are, respectively, low and high for diagnosis of clinical and subclinical otitis media in calves, with moderate reproducibility.

Optimising magnetic resonance image quality of the ear in healthy dogs

The aim of this study was to develop an examination protocol for magnetic resonance imaging, in order to display diagnostically important information of the canine middle and inner ear. To ensure that this protocol could also be used as a basis for determining pathological changes, the anatomical structures of the ear were presented in detail. To minimise stress through anaesthesia in live animals, preliminary examinations were carried out on four dog cadavers. During these initial examinations, three-dimensional (3D) sequences proved to be superior to two-dimensional ones. Therefore, only 3D sequences were applied for the main examinations performed on six clinically healthy Beagles. The anonymised MR images were rated by three experienced reviewers using a five-point scale. The most valuable sequence was a T2-weighted CISS sequence (TR = 16.7 ms, TE = 8.08 ms). This sequence proved to be most suitable for illustrating the inner ear structures and enabled good tissue contrasts. The sequence ranked second best was also a T2-weighted DESS sequence (TR = 19 ms, TE = 6 ms), allowing the imaging of the tympanic cavity and enabling 3D reconstruction due to its isotropic voxels. Due to low contrast and strong noise, the other sequences (TSE, FISP, MP RAGE) were not suitable for anatomical illustration of the middle and inner ear.

Anatomy and ultrasonographic appearance of the tympanic bulla and associated structures in the rabbit

Otitis media is a relatively common condition in the rabbit although it can be difficult to evaluate clinically. Diagnostic imaging of the rabbit has traditionally involved radiography and there are few reports regarding the use of ultrasound. The aim of this study was to determine if the tympanic bulla (TB) and associated structures could be evaluated in the rabbit using currently available ultrasound equipment. The normal anatomy of the region was established using gross dissection and emascerated specimens and compared with the dog and cat. Ten New Zealand white rabbit cadavers were examined using two ultrasound machines and four transducers from a variety of locations. A 12 MHz linear transducer was found to be most appropriate. From a lateral approach the external ear canal could be visualized to the level of the external acoustic meatus while the TB itself could only be visualized from a ventral approach. The jugular and mastoid processes in the rabbit are very prominent and interfered with imaging of the TB from all approaches. Water-soluble lubricant introduced into the TB could be identified through the ventral bone wall of the TB and allowed the lumen and far wall to be visualised. Further work is required to determine whether ultrasound examination of the TB can be performed in live rabbits and to evaluate its benefits in the evaluation of clinical cases of otitis media.

Comparison of ultrasonography, radiography and a single computed tomography slice for fluid identification within the feline tympanic bulla

Evaluation of the tympanic bulla (TB) in cases of acute feline otitis media can be a diagnostic challenge, although a feature often associated with this condition is the accumulation of fluid or material within the middle ear cavity. A technique is reported allowing optimum imaging of the feline TB using ultrasound (US) and recording of the appearance of gas and fluid-filled TB. A random number of bullae in 42 feline cadavers were filled with lubricant and rostroventral-caudodorsal oblique radiographs, single slice computed tomography (CT) images and US images were created and interpreted by blinded operators. The content (fluid or gas) of each TB was determined using each technique and the cadavers were then frozen and sectioned for confirmation. CT remained the most accurate diagnostic method, but US produced better results than radiology. Given the advantages of US over other imaging techniques, these results suggest that further work is warranted to determine applications of this modality in the evaluation of clinical cases of feline otitis media.

Assessment of middle ear disease in the dog: a comparison of diagnostic imaging modalities

OBJECTIVES

To compare radiography and ultrasound for the assessment of the tympanic bulla against computed tomography results.

METHODS

Thirty-one dogs had dorsoventral, left and right lateral oblique and rostrocaudal open mouth radiographs compared with ultrasound images and computed tomography scans of the tympanic bullae.

RESULTS

Radiography was superior to ultrasonography for the evaluation of the middle ear. However, computed tomography assessment was best predicted by a combination of radiographic and ultrasonographic findings.

CLINICAL SIGNIFICANCE

A combination of radiography and ultrasound can provide a more accurate assessment of the bulla than either of them alone. Ultrasound may have a role in the evaluation of middle ear disease in the dog. Results are operator dependent and not reproducible with current recording techniques.

Development, advances and applications of diagnostic ultrasound in animals

Ultrasound has many industrial applications but it was first introduced as a medical diagnostic aid in the 1940s with its first veterinary application, the detection of ovine pregnancy, being reported in 1966. Since then, improvements in equipment quality combined with an increased awareness of the benefits of ultrasound as an imaging technique have led to its widespread use in the veterinary field. Recent advances in computer technology have significantly influenced equipment design and the miniaturization of transducers allows intra-operative and intra-vascular applications. Software advances have improved the ability to manipulate and process data, leading to an increased amount of information being obtained from each examination and the advent of 'remote diagnosis'. Ultrasound guided interventional techniques can now be used for diagnostic or therapeutic purposes. Many of these developments have been introduced by equipment manufacturers but have found specific applications in the veterinary field. Ultrasound is currently employed in a very diverse range of situations, not just as a diagnostic tool in the routine clinical workup of a range of species, but also for disease screening, conservation projects, commercial services, herd management and clinical research.

Ultrasonographic evaluation of the external ear canal and tympanic membrane in dogs

Ultrasonographic imaging of the canine external ear canal, tympanic membrane, and tympanic bulla was described in five healthy beagle dogs before and after infusion of saline into the ear canal. Saline served as an acoustic window. With this method, the external ear canal, and tympanic bulla were visible in the same imaging plane and the integrity of the tympanic membrane could be evaluated indirectly by confirming an intact tympanic membrane, which appeared at the end of the ear canal as a hyperechoic line with reverberation. Experimentally, perforated tympanic membrane could be evaluated by identifying anechoic saline in the tympanic bulla lumen. The air and fluid-filled tympanic bulla were also visualized. Ultrasonography with saline as an acoustic window appears to be helpful for the evaluation of the external ear canal, tympanic membrane, and tympanic bulla and it may have the potential to be a useful clinical tool in evaluation of integrity of the tympanic membrane.

Comparison of ultrasonography, radiography and a single computed tomography slice for the identification of fluid within the canine tympanic bulla

Fluid accumulation within the tympanic bulla (TB) is an important diagnostic indicator in clinical cases of canine otitis media although its identification can be a challenge using currently available imaging techniques. The aim of this study was to compare ultrasound with radiography and a single computed tomography (CT) slice for the identification of fluid within the TB of canine cadavers. A random number of TB in 66 cadavers were filled with ultrasound gel. Rostrocaudal open mouth (RCdoM) radiographs and CT images were interpreted by 2 blinded radiologists and ultrasound examinations were performed by 2 blinded sonographers. The heads were then frozen and sectioned to confirm the contents of each TB. Although CT remained the most accurate method, comparable results were obtained by one of the sonographers and even the inexperienced sonographer produced results superior to radiography. Ultrasound has several advantages over the other imaging techniques and this study suggests that it may have an application in the investigation of canine otitis media although further work in live animals would be required to confirm this.