Echocardiographic, thoracic ultrasonographic, and CTA diagnosis of pericardial neoplasia in a dog

A 12-year-old male neutered Yorkshire Terrier presented for coughing and respiratory distress. Transthoracic echocardiography initially misdiagnosed the patient with pericardial effusion; repeat echocardiography increased suspicion for neoplasia. A definitive diagnosis was not apparent. Findings on thoracic computed tomography and thoracic ultrasound were consistent with a diffusely thickened, heterogenous, hypoechoic soft tissue structure surrounding the heart. Fine needle aspirates were obtained using ultrasound guidance and routine cytology of the intrapericardial mass was consistent with neoplasia, with pericardial mesothelioma most likely. These novel findings highlight the importance of thoracic ultrasound and potential limitations of echocardiography in diagnosis of pericardial neoplasia.

Dual-energy X-ray absorptiometry versus single photon absorptiometry of the radius

Radial diaphyseal bone mineral density (BMD) was measured at the standard one-third site by dual-energy X-ray absorptiometry (DEXA) and by 125I single photon absorptiometry (SPA) in 70 consecutive subjects, aged 12-86 years, with metabolic disorders of the skeleton. Each patient was measured once by the DEXA (Hologic QDR-1000) instrument and four times by the SPA (Norland 2780) instrument on the same day by one or the other of 2 technicians. The DEXA and SPA measurements were linearly related and highly correlated (r = 0.975, P less than 0.0001) over a range from severe osteopenia to high normal BMD. Ninety-five percent of the variation in the BMD determined by SPA was accounted for by DEXA, so that the BMD(SPA) = 1.035 +/- 0.027 (SEM) x BMD(DEXA)-0.007 +/- 0.019 (SEM). This permits continued use of previously accumulated SPA data-bases. The coefficient of variation for repeat measurements by DEXA was 1.2% and by SPA 1.6%. Examination time by DEXA was 6-7 minutes, about 45% shorter than the corresponding SPA determinations. DEXA is the superior method for evaluation of the radius, as it provides faster and more precise measurements in clinical practice.