read the article that is in the images and write the most important data 11:50 p. m. Mar 28 mar.246 de 633web.whatsapp.comositioning for the abdomen is relatively straightforward,but visualization can be difficult owing to its similarityin densities and the presence of multiple organ systems.There are subtle differences in tissue density of the abdomen,with significantly less natural contrast than found in thethorax. The abdomen depends on the gas within the gastro-intestinal (GI) tract and the fat in the peritoneal and retro-peritoneal areas for contrast. Contrast media are oftenrequired to visualize differences.Radiographic Concerns• Appropriate kilovolt peak (kVp) and milliampere-seconds(mAs) should be used to differentiate the various shadesof gray between organs and structures (generally use ahigher kVp for the abdomen and thorax which providesmore shades of grey, and a lower mAs (for shorter expo-sure and thus less motion artifacts). Because of thedifference in thickness between the chest and caudalabdomen, deep-chested dogs exhibit a marked differencein density between the cranial and caudal halves of theabdomen. This is especially evident in the ventrodorsal(VD) view. Two separate exposures measured at thethickest part of each site may be needed. If there is onlya minimal difference in anatomical thickness, a compro-mise can be made. Using the same technique with digitalradiography may be possible for the full abdomen ofsuch dogs.The two positions commonly viewed are the right or leftlateral and ventrodorsal (Box 18-1). It is important to beconsistent so that abnormalities can quickly be spotted.Contrast studies and other situations may also requirefurther views.If a right lateral view is used, the animal is lying on itsright side. Technically the correct terminology is left-right lateral (Le-RtL), if one considers, "point of entranceof the beam to point of exit;" however, this term is notgenerally used.Take advantage of the heel effect (the thickest part towardthe cathode) to help reduce density differences, especiallyin the VD or DV views.Use a 14 in x 17 in image receptor for large dogs. A verylarge dog will likely require two radiographs-measure atthe respective cranial and caudal abdomen.A grid must be used if the measurement exceeds 11 cm,to prevent scatter that causes fogging, which furtherdecreases the contrast.To help prevent motion artifacts, use as high a milliam-perage setting as possible, to produce the shortest expo-sure setting.• Take the radiograph at the end of expiration, when a briefpause often occurs.CHAPTER 18 Small Animal AbdomenBOX 18-1 Protocol for Abdominal RadiographyRoutine ViewsRight or left lateralVentrodorsalOptional ViewsDorsoventralLateral decubitusModified lateral/lateral oblique185• To minimize intestinal artifacts and prevent misdiagnosis,fast the patient (if possible) about 12 hours before andadminister a cleansing enema about 3 to 4 hours prior totaking a radiograph, to clear the intestinal tract of fecalmatter. This preparation is more important for contraststudies. See Chapter 25.• To minimize radiation exposure to the personnel restrain-ing a patient, nonmanual restraint should be utilizedwhenever possible. Use of a sedative or tranquilizer maybe needed. The use f nonmanual restraint is illustratedin most of the following positions. Try to give the patientthe illusion that it is being held by appropriate use ofsandbags, tape, and so on. For further suggestions, pleasesee Chapter 17.Abdominal compression may be utilized to reduce thethickness of the anatomical part. Compression moves anunderlying organ to improve the visualization of a sus-pected lesion, as well as reducing the thickness whichdecreases scatter radiation. Remeasure the patient aftercompression has been applied, and use this new thicknessto obtain the new kVp.TECHNICIAN NOTESposition in which it is to beMeasure the animal in theimaged.TECHNICIAN NOTES Have everything ready priorto taking the exposure. This includes measuring the animal,turning on the machine, setting the main voltage calibrationif required, having proper source-image distance, andsetting the exposures. Have the image receptors ready.Positioning devices should be close at hand, but removeany objects or distractions not utilized, to minimize scatterradiation.The patient should be clean, should have no artifacts inthe area of interest, and should be chemically restrained ifpossible.46% ( 11:50 p. m. Mar 28 mar.186Positionsweb.whatsapp.comPART TWO Radiographic Positioning and Related AnatomyLateralPositioningPlace in: Right lateral recumbency. This tends to be theconventional position.Head: Keep in a natural position; hold appropriately witha sandbag over the neck. Be careful not to restrictbreathing.Forelimbs: Pull cranially and sandbag. Place a small foampad between the forelimbs to help eliminate rotation ofthe cranial abdomen.Hind Limbs: Pull together caudally and sandbag, to preventsuperimposition of the femoral muscles, which can maskportions of the urinary bladder and prostate. Place a foampad of suitable thickness between the femurs to helpeliminate rotation of the caudal abdomen and pelvis.Sternum: Elevate with wedged sponges so the sternum is atthe same plane as the thoracic vertebrae.Comments and TipsPlace any ID or markers on the ventral aspect of theabdomen.MEASURE: Caudal aspect of 13th rib-at the thickest area(unless interested in a specific region).CENTRAL RAY: Canine: Over caudal aspect of 13th rib atlevel of L2-L3.Feline: Two to three fingerbreadths caudal to 13th rib.BORDERS: Collimate cranially from the caudal aspect of T7(full diaphragm and heart apex) and caudally to the greatertrochanter to include the coxofemoral joints.FIGURE 18-1 Proper positioning for the lateral abdomen view of acanine.• Ensure that the sternum and spine are on the same planeand parallel to the image receptor; the central ray is per-pendicular to both.Expose immediately at the end phase of expiration.During expiration there is maximum amount of space forthe abdominal contents as the lungs contract and thediaphragm relaxes.Focal radiographs using gentle pressure with a compres-sion paddle such as a wooden spoon or plastic paddlemay effectively isolate organs such as the kidneys in a VDposition. Remember to remeasure the patient becausethe decreased thickness will allow for a lower kVp andthus more contrast.• There is better longitudinal separation of the kidneys' ina right lateral view, and the spleen is more consistentlyidentified. Left lateral is preferable in vomiting patients,because gas is moved to the pyloric antrum and canpotentially highlight a foreign body.• A left lateral view may also be required in contrast studies,after the administration of contrast media.TECHNICIAN NOTES Remember to go throughyour mental check list before pushing the exposure button.See Chapter 17.TECHNICIAN NOTES To get maximum expiration:• If the patient is panting, cup or blow on the nose tomomentarily stop breathing.• Put light pressure on theexpiration.abdomen to facilitateBreathe with the animal for few breaths to determineproper point of exposure. Have the rotor depressed(initial button of a two-step process) so that the momentbreathing is paused the exposure can be taken.46%

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