Dr. Norman Ackerman served the University of Florida, College of Veterinary Medicine with distinction as Professor of Radiology from 1979 to 1994. A concerned teacher of veterinary students and residents of all disciplines, Dr. Ackerman also reached the veterinary scientific community through his writing. His numerous clinically pertinent publications are still today a vital part of the veterinary literature; therefore, it is appropriate this site perpetuates Dr Ackerman’s dedication to teaching.   This site is presented in recognition of Dr. Norman Ackerman and his contributions to the field ofveterinary diagnostic imaging. Sponsorship of the display supports the Dr. Norman Ackerman Memorial Fund, dedicated to the teaching of diagnostic imaging residents at the University of Florida College of Veterinary Medicine. Next Slide

NORMAN ACKERMAN MEMORIAL RADIOGRAPHY CASE CHALLENGE

Maggie Mae3 year old SF Mixed Breed Dog

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Signalment

Maggie Mae presents to your clinic with a 3 month history of progressive exercise intolerance and cough

On physical examination, you hear increased lung sounds

You order thoracic radiographs

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Based on your assessment of the radiographs, the thoracic body wall is:A. NormalB. Abnormal

Correct!

There are no abnormalities associated with the thoracic wall.

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Sorry!

The thoracic body wall, including the extrathoracic structures, are within normal limits

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Based on your assessment of the radiographs, the pleural space is:A. NormalB. Abnormal

Correct!

There are no abnormalities associated with the pleural space.

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Sorry!

The pleural space is normal

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Based on your evaluation, the cardiac silhouette is:A. NormalB. Abnormal

Sorry, Try Again

There is an abnormality associated with the cardiac silhouette.

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Correct!

The cardiac silhouette is abnormal. Click on the selection below that correctly identifies the abnormal area.A. The Left VentricleB. The Right VentricleC. The Left AtriumD. The Right AtriumE. The Main Pulmonary Artery

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The left ventricle is normal.

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Maybe…

On the VD projection, the heart does appear wider, particularly in the region of the right ventricle. However, there is really no evidence of right ventricular enlargement on the lateral projections. There is another abnormality…

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Right Ventricle

On the VD projection, the heart does appear wider, particularly in the region of the right ventricle. However, there is really no evidence of right ventricular enlargement on the lateral projections. There is another abnormality…

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Nah…

The left and right atria are both normal.

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RA

LA

LA LAu

RA

Correct!

The main pulmonary artery is enlarged.

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Based on your assessment of the radiographs, the lungs, including the vessels, are:A. NormalB. Abnormal

Sorry!

There is an abnormality associated with the pulmonary vessels.

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Correct!

The pulmonary vessels are definitely abnormal. Based on your evaluation, which vessels are affected?A. Pulmonary VeinsB. Pulmonary Arteries

Sorry!

The pulmonary veins are normal. Remember, veins are ventral (on the lateral projection) and central (on the VD projection)However, the pulmonary arteries are enlarged, tortuous, and in some areas, appear blunted.

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Correct!

The pulmonary arteries are enlarged, tortuous, and in some areas, appear blunted. Remember, veins are ventral (on the lateral projection) and central (on the VD projection)

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Conclusion

Your findings now include enlarged, tortuous pulmonary arteries, and an enlarged main pulmonary artery. There is questionable enlargement of the right ventricle. Formulate your top differential diagnosis, and click next.

Diagnosis: Canine Heartworm Disease

Tortuous, enlarged, and blunted pulmonary arteries and MPA reflect damage to the intima of the vessels and the presence of thromboemboli.The suspected enlargement of the right ventricle is related to pulmonary hypertension caused by the pulmonary arterial changes, also termed cor pulmonale.

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Dr. Ackerman on Heartworm Disease

In 1987, Dr. Ackerman wrote a review article entitled “Radiographic Aspects of Heartworm Disease*” documenting the imaging findings associated with this disease. With today’s preventatives, we see far fewer cases of this disease today, but it is important for every veterinarian to be familiar with it’s radiographic appearance.*Seminars in Veterinary Medicine and Surgery (Sm Anim). 1987 Feb;2(1):15-27

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