Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th International Conference. College
of Veterinary Medicine. University of Basrah. Iraq.
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ULTRASONOGRAPHIC EXAMINATION OF LIVER OF CATTLE IN
MOSUL, IRAQ
Osamah Muwaffag Al-Iraqi*, Medhat Khalid, Younis Masoud
*Department of Internal & preventive medicine, College of Veterinary Medicine, University of Mosul,
Iraq.
Corresponding author: [email protected]
Keywords: Ultrasound, liver, cattle, Mosul, Iraq
ABSTRACT
The objective of the study was to examine the normal liver using ultrasound technique for
measuring liver thickness, portal and hepatic veins diameter in clinically normal cattle, furthermore to
determine some liver lesions. Ultrasonography was used to evaluate the liver in 20 local cattle breeds of
different ages 10 of them have exhibited clinical signs of chronic emaciation, icteric mucous
membranes and decrease in milk production moreover, the other 10 cows were clinically normal. Liver
position, diameter and texture were explored from the right side of the abdominal wall in standing
position, without anesthesia by using 3.5 MHz transducer, after hair moistening by alcohol. The largest
liver thickness was measured at the 10 and 12 intercostal space and it was decreased gradually forward.
Normal liver has an echogenic appearance of equally distributed white dots and had a uniform mild
echogenicity, there were an anechoic round and tubular vascular structures, representing hepatic and
portal veins while abnormal liver has multi-hypoechoic circles. It has been concluded that, Sonography
of normal liver can be utilized as a good diagnostic references in animals with liver diseases.
INTRODUCTION
Ultrasonography is an active technique, which need interaction between the veterinary
sonologist, the animal, the ultrasound machine and the transducer to obtain best ultrasound images.
Transducer send a series of ultrasound waves to the tissues that reflect and processed by the ultrasound
unite into sequences of dots that form the image on the screen (1, 2). Ultrasonography of the liver have
been done in human, rabbits, goats, sheep, cattle and buffaloes and consider the first step in diagnosis
of chronic liver diseases (3, 4, 5, 6, 7, 8). In veterinary medicine there are many diagnostic tools have
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th International Conference. College
of Veterinary Medicine. University of Basrah. Iraq.
57
been used however, ultrasound still one of the best imaging methods used in the diagnosis and followup
of patient with liver diseases (9, 10, 11). Ultrasonography considers as a very important technique in
the diagnosis of liver diseases in cattle, as a noninvasive technique provides excellent image for liver
parenchyma and vessels without damaging the tissue (11, 12 13). A different in ultrasound velocities in
different tissues make a different density of spikes on the screen and this helpful in the discrimination
of internal alive normal or diseased organs (14). Ultrasonography has markedly enhanced the diagnosis
of various hepatic diseases such as hepatic abscess, hepatic lipidosis, fascioliasis and caudal vena cava
(CVC) thrombosis, Hematomas, cysts, neoplasms, nodules and abscess although these disorders do not
have specific signs they can be diagnosed through ultrasonography and ultrasound-guided liver biopsy
(3, 9 10, 11, 12 13). Studies in cattle have demonstrated that the presence of ultrasonographic features
of hepatic fatty infiltration is a reliable indicator of hepatic lipidosis (9, 15, 16, 17). (18) Showed that
hepatic ultrasonography is a more sensitive and specific method than biochemical analysis for
diagnosis of diseased liver in the cattle. Hydatid cysts and liver fluke were recorded in local Iraqi cattle
(19, 20). This study was planned to find out the usefulness of ultrasound in the liver examination and to
diagnosis some liver lesions furthermore to demonstrating liver thickness and portal and hepatic veins
diameter in clinically normal local cattle breed in Mosul, Iraq.
MATERIALS AND METHODS
Animals: Study included twenty local cattle breeds 2-9 years old, divided into two groups: first group
included 10 clinically normal cows and other 10 diseased cows suffered from a chronic debility, icteric
mucous membranes and decrease in milk production at local farms in Mosul city, Iraq. All animals
submit to clinical examinations according to (21), whereas postmortem examination of the liver was
done for 2 hopeless cows after slaughtered by their owner.
Ultrasonographic examination:The examination was done in standing position, without sedation.
Sites were prepared by spraying alcohol then applying ultrasound gel on the 15-20 cm long areas
caudal to costal arch and on the 12th, 11th, 10th and 9th intercostal spaces of the right flank according
to (10, 22, 23) 3.5 MHz convex transducer was applied on the exploring area using B-mode grey-scale
equipment (KX5100Vet, KeeboMed, USA) ultrasound machine. Several hepatic B-mode
ultrasonograms were recorded as static images on the memory equipped on the instrument.
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th International Conference. College
of Veterinary Medicine. University of Basrah. Iraq.
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RESULTS
Ultrasonographical examination showed that liver was situated under the skin and muscles layer
about 5 centimeter from the right lateral abdominal wall, and can be evaluated in the upper third of the
10th, 11th and 12th ICS while it could not be seen in the 9th ICS (figure 1). It appeared as homogenous
equally scattered mild echoic dots, liver thickness was 105, 134, 141 mm in the 12th, 11th and 10th ICS
respectively (table 1). A variable sizes hpoechoic circle, oval and triangle shape represented the portal
vein, caudal vena cava (cvc) and hepatic vessels respectively. The cvc appeared as triangle shape in the
dorsal part of the liver and it was largest diameter 20.33 mm in the 11th ICS and the smallest 19.1 mm
in the 10th ICS and could not be imaged in the 9th ICS, while the portal vein appeared as circle shape in
the ventral part of liver and it was largest diameter 24.08 mm appeared in the 11th ICS and the smallest
22.3 mm in the 10th ICS and could be seen in only in one cow in the 9th ICS (table 1).
Figure, 1: Ultrasonogram of normal liver of cattle imaged from the eleventh
intercostal space. The abdominal wall (1), liver parenchyma (2), caudal vena
cava (3), Ds, dorsal; Vt, ventral.
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th International Conference. College
of Veterinary Medicine. University of Basrah. Iraq.
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Table 1: Results of ultrasonographic examination of the liver thickness, caudal vena cava and the
portal vein diameter of healthy cows
Variable ICS (mm) No. animals
1 Liver thickness 12 (105) 10
11 (134) 10
10 (141) 9
9 (0) 0
2 CVC diameter 12 (19.6) 4
11 (20.33) 4
10 (19.1) 3
9 (0) 0
3 PO. Vein
diameter
12 (23.92) 4
11 (24.08) 8
10 (22.3) 5
9 (21.4) 1
From results the portal and hepatic veins could be seen within the liver, and their diameter
increases toward the portal vein and the caudal vena cava. The portal vein is site ventrally and laterally
to the caudal vena cava and is usually visible in the twelfth to eighth intercostal spaces. On crosssection
the portal vein, appear circular with stellate ramifications inside liver parenchyma (figure, 2).
The diameter of the portal vein in the twelfth and eleventh intercostal spaces is between 21.4 – 26.3
mm and decreases cranially (table, 1),
The caudal vena cava is site more dorsally and medially than the portal vein and usually denote
in the twelfth, eleventh and tenth intercostal spaces (Figure 3).
The caudal vena cava rarely visualized in the tenth intercostal space and never in the cranial
intercostal spaces, because the lungs hide it. The caudal vena cava embedded in the sulcus of the liver,
so appear as a characteristic triangular shape on cross-section. The diameter of the caudal vena cava
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th International Conference. College
of Veterinary Medicine. University of Basrah. Iraq.
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does not change from the twelfth intercostal space to the tenth intercostal space and measures from 19.1
to 20.33 mm, toward the liver, hepatic veins are seen joining the caudal vena cava (table, 1).
From clinical examination, all diseased cows showed chronic debility, jaundiceand decrease in
milk production with body temperature, respiratory and heart rate within normal range, at
ultrasonographic imaging, liver appeared have irregular edge with many abnormality within
parenchyma include multi-hypoechoic circles in 6 cows (figure 4), multiple small abscesses with
calcified bile duct in 4 cows (figure 5).
Figure, 2: Ultrasonogram of liver
thickness and portal vein diameter
imaged from the twelfth intercostal
space. The abdominal wall (1),
liver (2), portal vein (3) Ds,
dorsal;Vt, ventral.
Figure, 3: Ultrasonogram of liver
thickness and caudal vena cava
diameter imaged from the
eleventh intercostal space. The
abdominal wall (1), liver (2),
caudal vena cava (3).
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th International Conference. College
of Veterinary Medicine. University of Basrah. Iraq.
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-
DISCUSSION
Liver situated directly under the abdominal wall so it is easy to examine by using a low
frequency transducer and depend on the varying ultrasound velocity within tissues a different
echogenicity appeared could differentiate between skin, subcute and liver tissue. The results of the
current study were agreed with others (11, 14, 24). The parenchyma of the liver agree with (10) liver
Figure 4: Ultrasonogram and postmortem of liver of diseased cow with
multi-hypoechoic circles. skin 1, liver 2, multi cysts 3, CVC 4. B: liver
with multi cystic lesion (white arrow)
Figure 5: Ultrasonogram and postmortem of liver of diseased cow. A: skin 1, liver 2, calcified bile
duct (white arrow), abscesses (black arrow). B: small abscesses (black arrow).
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th International Conference. College
of Veterinary Medicine. University of Basrah. Iraq.
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has an echogenic appearance of equally distributed white dots and had a uniform mild echogenicity
within liver tissue, there were an anechoic round and tubular vascular structures seen, representing
hepatic and portal veins. The lumen of these vessels was anechoic and therefor appeared black. In
contrast to hepatic vein, an echoic border characterized the wall of the portal vein, so it is easy to
diagnose.
Mean liver thickness decreases caudally and measured (105, 134, 141) mm in the 12th, 11th,
10th intercostal spaces respectively, these results disagree with (10) and one of the explanation is due to
the small size of the local breed cow were included in this study.
Clinically diseased cattle suffered from jaundice, debility and decrease milk production and on
ultrsonographic examination were display many lesions include 6 cows have encapsulated hypoechoic
cyst and other 4 cows have small abscesses with calcified bile ducts these results agree with (8, 25, 26,
27) which demonstrate ultrasonography has a benefit effect in diagnosis of liver lesions such as
fascioliosis which appeared as heterogeneous parenchyma with calcified hyperechoic lined bile duct
with hyperechoic dots that have distal acoustic shadowing. While hydatid cyst imaging display a circle
capsulated hypoechoic area furthermore postmortem examination confirm the diagnosis of hydatid
cysts and fascioliosis in liver parenchyma in 2 cows, these results agree with (19, 20) they demonstrate
that in fascioliosis there were a hypertrophy, inflammatory cells infiltration with calcium salt
precipitation in bile duct due to migration of liver fluke while hydatid cyst appear as white colored cyst.
Results of the current study of normal liver measurements can be used as references for local
cattle breeds furthermore a diagnostic ultrasound can be used for follow up and give the prognosis of
cattle with liver diseases.
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