HIPRA 29-30 mei / 2 juni...HIPRA 29-30 mei / 2 juni 3 3. Tissues and technique • Screening of...

HIPRA 29-30 mei / 2 juni

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Ramon Armengol DVM, PhD Lleidavet, S.L. Dairy Veterinarians

Associate Professor Animal Science Dept

Universitat de Lleida (UdL)

Introduction to Ultra

Sound Scanning of

Respiratory System:

Thoracic Ultra Sound

(TUS)

SUMMARY

1. Material

2. Anatomy

3. Tissues and technique

4. TUS Images

5. “Scoring” for TUS

6. Advantages and Disadvantages

7. Conclusions

8. Practical cases

2017 Ramon Armengol

1. Material

• Linear Probe (same ultrasound system used for

repro check).

– Low Frequency for lung consolidation is needed.

• Alcohol 70º if young animals (pre weaned).

• Shaving of intarcostal spaces (4-11 ribs) is needed

+ Eco Gel if older animals (weaned and adults).

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BUT…

WE NEED TO REMEMBER A BIT OF

BOVINE ANATOMY…

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2. Anatomy


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Anatomy Background…


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C

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Anatomy Background…

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3. Tissues and technique

• Screening of visceral/parietal pleura.

• Lung tissue is NOT ecogenic (full of air).

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Buckzinsky., 2012

APPROACH

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Olivett and Buczinsky, 2016. Vet Clin Food Anim 32 (2016) 19–35. http://dx.doi.org/10.1016/j.cvfa.2015.09.001

2017 Ramon Armengol

2017 Ramon Armengol

Olivett and Buczinsky, 2016. Vet Clin Food Anim 32 (2016) 19–35. http://dx.doi.org/10.1016/j.cvfa.2015.09.001

2017 Ramon Armengol


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Video

2017 Ramon Armengol

Both sides?

• Always!

• Be consistent on the method…

• Anatomical limits

– Left:

• Craneal: Heart/ Timus

• Caudal: Spleen

– Right:

• Craneal: Heart (Big Vessels)

• Caudal: Liver

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2017 Ramon Armengol

What will we see in a BRD positive animal?

“Lesions resulting from BRD in feedlot calves occur in

the cranioventral lung lobes and are characterized by

bronchopneumonia or its sequelae, including

collapse/consolidation, pleural adhesions,

abscesses, parenchymal fibrosis, or emphysema.”

(Bryant et al., Bovine Pract 1999)

2017 Ramon Armengol

• Pleural disorders

• Lung tissue lesions

– Abscess

– Consolidation

• Ecographic artefacts

– Reverberation

– Comet Tails

4. TUS Images

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Normal lung tissue.

• Echoic

• Pleural line

• Reverberation

artifacts.

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• Acute neumonia?

• Edema?

• Normal?

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Comet tails and “B lines” Consolidation of lung tissue.

• Hypoechoic

– Atelectasia

– Cumuled gas

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Video

2017 Ramon Armengol

Video

2017 Ramon Armengol

5. Scoring for TUS (Adams & Buckzinski., JDS 2015)

1. No abnormalities, the reverberation

artifact (Rev) allows observation of A-lines

(reverberation lines; panel A);

2. Multiple comet tails (arrows in B) on

the pleural surface or B-lines

(coalescence of multiple comet tails

without significant lung consolidation)


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3. One or more location of lung

consolidation ≥1 cm but 1 cm; panel E), where P

= pleural line, and Plef = pleural effusion

Data to take into account… (not published)

• IDEAL 20% of calves score 3-4

2017 Ramon Armengol

Easier “On farm” diagnosis…

• 2 cut-offs defined a priori :

– ≥1cm previously reported to define lung

lesions Buczinski et al., Prev Vet Med, 2015

– ≥3cm associated with decreased average

daily gain (ADG) (-50g/d during preweaning

period). Ollivett et al., AABP 2014.

2017 Ramon Armengol

Olivett and Buczinsky, 2016. Vet Clin Food Anim 32 (2016) 19–35

http://dx.doi.org/10.1016/j.cvfa.2015.09.001

6. Adv and Disadv in individuals

Advantages

• Easy.

• Accurate detection of

lung lesions.

• Monitoring efficacy of

treatments.

Disadvantages

• Only superficial lesions.

• Difficult to classify cases

(clinical, subclinical,

chronic). Unless repeated

• Only in intercostal space.

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Why TUS in a herd level?

Advantages

• Easy and fast.

• Protocol.

• Good combination with other

scoring systems

• Detection of lack of control of

BRD/ Management?!

• Productive evaluation of

animals (culling?).

• Good monitoring of data.

Disadvantages

• Further research is needed…

2017 Ramon Armengol

7. Conclusions

• TUS is fast, accurate and practical.

• Subclinical and chronical cases of BRD are

included.

• Perfect for combination with other scoring systems.

• Evaluation of treatment, management changes, etc.

DATA!

• Business opportunity.

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8. Practical Cases




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Ultrasonographic image of both

lungs taken from the left second

ICS. The thick

arrow indicates the right lung.

The thin arrow indicates the left

lung. The asterisk marks

the thymus. Do not confuse the

thymus with hypoechoic

consolidation. Rarely, the thymus

is visible ventrally in the first ICS

on the right. Olivett and Buczinsky, 2016

Vet Clin Food Anim 32 (2016) 19–35

http://dx.doi.org/10.1016/j.cvfa.2015.09.001

2017 Ramon Armengol

1900’s 2000’s

Thank You!

Ramon Armengol

[email protected]

HIPRA 29-30 mei / 2 juni...HIPRA 29-30 mei / 2 juni 3 3. Tissues and technique • Screening of...

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