hipra 29-30 mei / 2 juni€¦ · hipra 29-30 mei / 2 juni 1 ramon armengol dvm, phd lleidavet, s.l....
TRANSCRIPT
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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
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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
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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
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Video
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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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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)
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• 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
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Video
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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
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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.
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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
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…
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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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Thank You!
Ramon Armengol