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Contrast-enhanced ultrasonographic evaluation of adrenal glands in dogs with pituitary-dependent hyperadrenocorticism

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Abstract
Objective-To assess vascular changes induced by hyperadrenocorticism of hyperplastic adrenal glands in dogs via contrast-enhanced ultrasonography. Animals-12 dogs with pituitary-dependent hyperadrenocorticism (PDH) and 7 healthy control dogs >= 7 years old. Procedures-Dogs were assigned to the PDH and control groups and to small-breed (n = 6), medium-breed (4), and large-breed (9) subgroups. Contrast-enhanced ultrasonography of both adrenal glands in each dog was performed with IV injections of contrast agent. Time-intensity curves for the adrenal cortex, adrenal medulla, and ipsilateral renal artery of both adrenal glands were generated. Perfusion variables (time to peak [TTP], upslope of wash-in phase, and downslope of washout phase) were calculated. Results-Contrast-enhanced ultrasonography revealed no qualitative difference between PDH and control groups. Quantitatively, TTPs were longer in the adrenal cortex and adrenal medulla of the PDH group, compared with values for the control group, particularly in the adrenal cortex and adrenal medulla of the small-breed subgroup. Washout downslopes were lower for the renal artery, adrenal cortex, and adrenal medulla of the small-breed subgroup between the PDH and control groups. No other perfusion variables differed between groups. Conclusions and Clinical Relevance-Contrast-enhanced ultrasonography of the adrenal glands in dogs with PDH revealed a delayed UP in the adrenal cortex and adrenal medulla, compared with values for control dogs. Contrast-enhanced ultrasonography was able to detect vascular changes induced by hyperadrenocorticism. Further studies are needed to evaluate whether reference ranges for clinically normal dogs and dogs with PDH can be determined and applied in clinical settings.
Keywords
ASSAY, TESTS, HYPERTENSION, TUMORS, ULTRASOUND, SPLENIC LESIONS, CUSHINGS-SYNDROME, ADRENOCORTICOTROPIC HORMONE, FOCAL LIVER-LESIONS

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Chicago
Pey, Pascaline, Sylvie Daminet, Pascale Smets, Luc Duchateau, Pauline De Fornel-Thibaud, Dan Rosenberg, and Jimmy Saunders. 2013. “Contrast-enhanced Ultrasonographic Evaluation of Adrenal Glands in Dogs with Pituitary-dependent Hyperadrenocorticism.” American Journal of Veterinary Research 74 (3): 417–425.
APA
Pey, P., Daminet, S., Smets, P., Duchateau, L., De Fornel-Thibaud, P., Rosenberg, D., & Saunders, J. (2013). Contrast-enhanced ultrasonographic evaluation of adrenal glands in dogs with pituitary-dependent hyperadrenocorticism. AMERICAN JOURNAL OF VETERINARY RESEARCH, 74(3), 417–425.
Vancouver
1.
Pey P, Daminet S, Smets P, Duchateau L, De Fornel-Thibaud P, Rosenberg D, et al. Contrast-enhanced ultrasonographic evaluation of adrenal glands in dogs with pituitary-dependent hyperadrenocorticism. AMERICAN JOURNAL OF VETERINARY RESEARCH. 2013;74(3):417–25.
MLA
Pey, Pascaline, Sylvie Daminet, Pascale Smets, et al. “Contrast-enhanced Ultrasonographic Evaluation of Adrenal Glands in Dogs with Pituitary-dependent Hyperadrenocorticism.” AMERICAN JOURNAL OF VETERINARY RESEARCH 74.3 (2013): 417–425. Print.
@article{3222167,
  abstract     = {Objective-To assess vascular changes induced by hyperadrenocorticism of hyperplastic adrenal glands in dogs via contrast-enhanced ultrasonography. 
Animals-12 dogs with pituitary-dependent hyperadrenocorticism (PDH) and 7 healthy control dogs {\textrangle}= 7 years old. 
Procedures-Dogs were assigned to the PDH and control groups and to small-breed (n = 6), medium-breed (4), and large-breed (9) subgroups. Contrast-enhanced ultrasonography of both adrenal glands in each dog was performed with IV injections of contrast agent. Time-intensity curves for the adrenal cortex, adrenal medulla, and ipsilateral renal artery of both adrenal glands were generated. Perfusion variables (time to peak [TTP], upslope of wash-in phase, and downslope of washout phase) were calculated. 
Results-Contrast-enhanced ultrasonography revealed no qualitative difference between PDH and control groups. Quantitatively, TTPs were longer in the adrenal cortex and adrenal medulla of the PDH group, compared with values for the control group, particularly in the adrenal cortex and adrenal medulla of the small-breed subgroup. Washout downslopes were lower for the renal artery, adrenal cortex, and adrenal medulla of the small-breed subgroup between the PDH and control groups. No other perfusion variables differed between groups. 
Conclusions and Clinical Relevance-Contrast-enhanced ultrasonography of the adrenal glands in dogs with PDH revealed a delayed UP in the adrenal cortex and adrenal medulla, compared with values for control dogs. Contrast-enhanced ultrasonography was able to detect vascular changes induced by hyperadrenocorticism. Further studies are needed to evaluate whether reference ranges for clinically normal dogs and dogs with PDH can be determined and applied in clinical settings.},
  author       = {Pey, Pascaline and Daminet, Sylvie and Smets, Pascale and Duchateau, Luc and De Fornel-Thibaud, Pauline and Rosenberg, Dan and Saunders, Jimmy},
  issn         = {0002-9645},
  journal      = {AMERICAN JOURNAL OF VETERINARY RESEARCH},
  keyword      = {ASSAY,TESTS,HYPERTENSION,TUMORS,ULTRASOUND,SPLENIC LESIONS,CUSHINGS-SYNDROME,ADRENOCORTICOTROPIC HORMONE,FOCAL LIVER-LESIONS},
  language     = {eng},
  number       = {3},
  pages        = {417--425},
  title        = {Contrast-enhanced ultrasonographic evaluation of adrenal glands in dogs with pituitary-dependent hyperadrenocorticism},
  url          = {http://dx.doi.org/10.2460/ajvr.74.3.417},
  volume       = {74},
  year         = {2013},
}

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