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Ultrasonography

Ultrasonography. Urinary Bladder VCA 341 Dr. LeeAnn Pack lpack@upei.ca. Indications for U/S. Urinary calculi Cystitis Cystocentesis Hemorrhage Evaluate bladder wall thickness & mucosal surface. U/S Technique. Use high-resolution transducers (7-12 MHz) Located very superficially

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Ultrasonography

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  1. Ultrasonography Urinary Bladder VCA 341 Dr. LeeAnn Pack lpack@upei.ca

  2. Indications for U/S • Urinary calculi • Cystitis • Cystocentesis • Hemorrhage • Evaluate bladder wall thickness & mucosal surface

  3. U/S Technique • Use high-resolution transducers (7-12 MHz) • Located very superficially • Pressing too hard distorts the image

  4. Normal Anatomy • Bladder • Ovoid shape (slightly elongated caudally) • 3 parts: apex, body, trigone • Bladder wall has 3 layers (hard to see) • Mucosa: hyperechoic (outlined with urine) • Submucosa: hypoechoic • Serosa: hyperechoic

  5. Normal Anatomy

  6. Normal Anatomy • Bladder wall thickness (1-2mm) • Dog: 1.6 mm • Cat: 1.7 mm • Wall thickness changes with bladder size • Ureters & urethra not visible unless filled with urine

  7. Pathology • Intraluminal changes • Urinary calculi • Gas bubbles • Cellular and crystalline debris • Blood clots • Bladder wall changes • Cystitis • Neoplasia • Polyps

  8. Urinary Calculi • Calculi very hyperechoic • Large calculi can cause acoustic shadowing • Ballotment doesn’t usually make calculi move, but standing the animal will

  9. Urinary Calculi Calculi

  10. Cystic Calculi

  11. Cystic Calculi

  12. Debris • Variable echogenicity • Can become thick enough to form confluent layer with bladder wall • Vigorous ballotment will cause a swirling pattern – looks like snow globe

  13. Blood Clots • Associated with severe hematuria • Mobile non-shadowing, usually hyperechoic mass • May be attached to the wall • Severe acute hemorrhage • can fill bladder and give hypoechoic lacey pattern independent of stance or movement

  14. Blood Clots

  15. Cystitis • Chronic cystitis leads to diffuse thickening of wall • Small mucosal masses sometimes present • Muscular hypertrophy caused by chronic partial lower urinary tract obstruction • Emphysematous cystitis

  16. Cystitis

  17. Chronic Cystitis

  18. Neoplasia • Single or multiple masses • Irregularly shaped, broad-based hypo or hyperechoic masses protruding into bladder lumen • Transitional cell carcinoma most common

  19. Neoplasia

  20. Neoplasia

  21. Polyps • Stalked mass arising from bladder wall

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