DIAGNOSTIC IMAGING
across the table to get a ventrodorsal projection ( Figure 3 ). This works really well for femur fractures too , so you don ' t have to extend the leg and pull on the fracture to get a good diagnostic view of the leg . You can also look for cranial mediastinal masses in a cat with a large volume of pleural fluid by standing the cat upright and obtaining a ventrodorsal view , allowing gravity to move any fluid caudally to allow evaluation of the cranial mediastinum . These techniques have largely been replaced by ultrasound , but if you do not have the equipment or the skill to identify these abnormalities with ultrasound , cross-table imaging can help .
Figure 2B : Ventrodorsal view .
amine the abdomen as well , do it before administering barium as this contrast medium will shadow and can be mistaken for a foreign body .
4
Cross-table radiographs can help , especially in a traumatised patient . Older digital units were built into the x-ray table , so practitioners were not able to take cross-table projections , but today cross-table radiographs can help identify intraperitoneal gas . Do this by placing the animal with the left side on the table so the gas can rise . Then position your x-ray tube
5Positioning is key . The easier it has become to take radiographs with digital technology , the more likely it is for clinicians to cut corners because of the speed with which images are processed . Lost is the art of positioning patients with a straight lateral and using wedge pads and positioning devices . Largely this comes from a lack of willingness to sedate animals because it takes added time . But using sedation to minimize patient stress and provide the ability to use sandbags to minimize technicians ’ exposure to radiation will make radiographs go faster in the long run and provide a better image to interpret . The more oblique the position , the more likely we as radiologists are to miss lesions .
There are many great reasons to embrace the glittering world of digital imaging , the best of which is the ability to get nearly instantaneous feedback from specialists all over the world with telemedicine . But also , the degree of clarity and the absence of poor exposures seen with conventional radiographs make digital imaging as revolutionary to veterinary medicine as cell phones were to communication . Just make sure you take multiple views to get as much information about the patient as possible !
Figure 3 : This image shows the horizontal beam projection to look for free gas in the abdomen . It is basically a ventrodorsal projection with the patient on its left side . Note the marker in the upper left corner of the cassette is an " R ," indicating the right side of the patient , which is the up side .
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Issue 04 | AUGUST 2017 | 28