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- Advancing Canine Liver Ultrasound: Normative Study of Papillary Process and Ligamentum Venosum
Advancing Canine Liver Ultrasound: Normative Study of Papillary Process and Ligamentum Venosum
Veterinary Radiology & Ultrasound 2025
Obi Veterinary Education
November 05, 2025
Aaron Percival, Sarah Slaughter, Peter V. Scrivani
Background
Congenital intrahepatic portosystemic shunts (IHPSS) in dogs often involve abnormal vascular structures, including the ligamentum venosum fissure (LVF) and papillary process. While computed tomography (CT) is widely used for diagnosing these anomalies, ultrasonography offers a more accessible and non-invasive alternative. This study aimed to characterize the normal ultrasonographic appearance of the LVF and adjacent hepatic structures in dogs, providing a reference for detecting intrahepatic shunts.
Methods
Twenty-four healthy dogs under four years old underwent ultrasonographic evaluation of the liver. Four intercostal acoustic windows (two on each side) were used to assess the visibility of key hepatic structures, including the left portal branch, caudal vena cava, papillary process, LVF, and ligamentum venosum. Probe placement was standardized, and imaging frequencies were recorded. Data were analyzed to determine the optimal acoustic windows for liver evaluation.
Results
The LVF was identified in 100% of dogs using the left hypochondriac window and in 79% from the right hypochondriac window. The left lateral liver lobe, LVF, papillary process, and caudal vena cava were consistently visualized in a row, aligned with the left portal branch. The right and left costal windows were less effective, with lower detection rates of the LVF and other hepatic structures. The ligamentum venosum appeared as a hyperechoic band in 96% of cases. These findings suggest that the left hypochondriac window provides the most reliable imaging approach for evaluating the LVF and related structures.
Limitations
This study was limited to a small sample size and healthy dogs, which may not fully represent anatomical variations in dogs with IHPSS. Additionally, the absence of a reference standard, such as post-mortem dissection, limits the validation of ultrasonographic findings. Motion artifacts and patient conformation may have influenced imaging quality.
Conclusions
Ultrasonography is a valuable tool for assessing hepatic anatomy relevant to intrahepatic portosystemic shunts, particularly for identifying the LVF. The left hypochondriac window provides the best visualization of the LVF and adjacent structures. These findings establish a normative reference for ultrasonographic liver assessment and justify further research in dogs with suspected IHPSS.
Transverse-oblique trunk CT angiogram of an adult dog displayed twice with different annotations. The image was oriented to mimic the sonographer's perspective, with the dog's ventrum at the top and the dog's right side at the left of the image. A, All labeled blood vessels were in a short axis except for the left portal branch, which was in a long axis: 1, aorta; 2, caudal vena cava; 3, left portal branch; 4, papillary process hepatic vein; 5, left hepatic vein; GB, gallbladder. The ligamentum venosum fissure was arrowed. Notice the left portal branch was external to the liver, sending branches into the lobes. B, The expected imaging field was highlighted for intercostal probe placement at the right hypochondriac region. On the dog's left side, note that gas in the lungs and stomach could limit the acoustic window. The CT image was acquired in sternal recumbency: window center, 30 HU; window width, 320 HU.
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