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Lung lobe torsion in 15 dogs: Peripheral band sign on ultrasound
Author(s) -
Belmudes Audrey,
Gory Guillaume,
Cauvin Eddy,
Combes Anaïs,
GalloisBride Hélène,
Couturier Laurent,
Rault Delphine N.
Publication year - 2020
Publication title -
veterinary radiology and ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.541
H-Index - 60
eISSN - 1740-8261
pISSN - 1058-8183
DOI - 10.1111/vru.12918
Subject(s) - medicine , lung , lobe , peripheral , radiology , parenchyma , ultrasound , pathology
The diagnosis of lung lobe torsion in dogs is usually based on radiological, endoscopic, and CT features. Few ultrasonographic descriptions have been published. The purpose of this multicenter, retrospective, and prospective observational study was to investigate the presence of a hypoechoic area forming a pulmonary band or line at the periphery of the twisted lobe on ultrasonography and assess its significance by comparing it to CT and histological findings. Fifteen dogs with lung lobe torsion confirmed surgically or postmortem were included. All had received ultrasonography and CT examinations; 13 had additional histopathological examination performed. In 14 cases, thoracic ultrasonography revealed a peripheral hypoechoic band, overlying areas of scattered, hyperreflecting interfaces in the affected lobe. On CT, central emphysema was surrounded by a peripheral, soft tissue attenuation band, affecting the periphery in 14 cases. No band was observed in one case, in which the lobe was entirely consolidated. Histological examination yielded a comparable peripheral band, consisting of a thickened visceral pleura with or without hemorrhagic necrosis of the underlying pulmonary parenchyma. This peripheral band may be related to the specific fractal organization of airways and vessels, which plays an important role in lung perfusion and ventilation and makes the lung periphery more prone to ischemia. Our findings suggest that the presence of a peripheral hypoechoic band, associated with central emphysema in a noncollapsed lung lobe on ultrasonography, is suggestive of compromised blood supply and air flow, and lung lobe torsion should therefore be suspected.