Applications of echography to the reproduction of the cow Professor Ch. Hanzen Université de Liège...

Applications of echography to the reproduction of the cow

Professor Ch. Hanzen

Université de LiègeFaculté de Médecine Vétérinaire

Service de Thériogenologie des animaux de productionCourriel : [email protected]

Site : http://www.therioruminant.ulg.ac.be/index.htmlPublications : http://orbi.ulg.ac.be/

Facebook : https://www.facebook.com/Theriogenologie

Some background

Ovary

Uterine horn

cervixVagina

Rectum

In Descoteaux et al. 2010

Bladder

General data

ProbeEchograph

Animal

Vet

Screen


Probe

Ultrasounds

Received Send out

Structure

Echos

Screen

Picture

Analyse

Echograph

Animal

Vet

The probes

Probes and ultrasound fields

LS

L

L

L

The probes : linear and sectorial

Ultrasound field of the cristal

Linear probe

128 à 256 cristals (900 ou 3000)

Sectorial probe Linear probe

Ultrasound field

Ultrasound field

Probe semi-convex

The ultrasounds

Echo = interaction of ultrasound with a structure

Three frequencies are distinguished

0 - 20 Hz: infra-sounds

20 - 20000 Hz (20 KHz): les sounds (audibles)

> 20 KHz : les ultrasounds (US) : MHz

In bovine reproduction : 3 à 7.5 MHz

Acoustic impedance : level of resistance of the tissu to the US.

Interface : zona between two tissuses with a different acoustic impedance

Attenuation level of US during the propagation through the tissues

Tissues Coefficient (à 1 MHz en dB/cm)

Water 0.002Blood 0.18Liver 0.95Kidney 1Bone 3-10Lung 40

Air Jelly if transabdominal

Echo Diffusion Réfraction AbsorptionDiffusion

From Ginther in Descoteaux et al. 2010

Importance of the perpendicularity of the field beside the examined tissue

Interactions of US

3.5 MHz 7,5 MHz

20 cm 7 cm

The depth of examination decreases when the frequency increases

5 MHz

12 cm

3.5 MHz 7,5 MHz

The resolution power increases with the frequency

5 MHz

Lateral resolution 0,9 à 3,0 mm

Axial resolution 0,6 à 1,2 mm

Echographic picture

Echogenicity of the tissues

Hyperechogenic Isoechogenic Hypoechogenic Anechogenic

BoneStonesGaz

Homogenous if no echogenics spotsNon homogenous if echogenic spots (pus …)

Liquides

Some examples

2. anechogenic picture (bladder)

3. anechogenic picture (cavity of the CL)

1. anechogenic picture (follicule)

4. Isoechogenic picture (CL)

2

1

5

3

5. hyperechogenic picture (pubis bone)

4

2

1

2 : anechogenic (non homogenous) poicture (uterine cavity : endometritis)

1. isoechogenic picture (uterine wall)

1 : isoechogenic picture (pus in case of pyometra)

1

The artifact

1 : Posterior enhancement : when the US cross some liquids, they are less attenuated

1

1 : Reverberation effect (pneumo-vagina)

1

1

1 . shadow artefact

The echograph

Echographic material (transrectal probes)

http://www.echomedic.be/ MINDRAY DP2200VET : linear probe KX 5200VET : linear probe

http://www.draminski.fr/ Draminski Animalprofi L : linear probe Draminski Animalprofi L : sectorial probe

http://www.vtrade.be/fr/main/ : Modèle Agroscan : linear and sectorial probe Modèle SIUI : linear probe

http://www.international.bcftechnology.com/ Easi scan : linear probe

http://www.esaote-fr.be/modules/core/page.asp?p=TRINGALINEARVET Tringa : linear probe

Echographe Pie Medical 860

The veterinarian

Basic principles

Anatomical and echographic knowledge are necessary…. Experience of manuel palpation Restraint of the animal and adequate brightness Ways : Transrectal > Transabdominal > Transvaginal Probes : lineaie > sectorial (7,5 MHz > = 5 MHz > 3 MHz) Method

Extraction of feces Palpation of the genital tract Identification of the vagina, cervix and bladder with US Identification of the uterine horns Rotation of the probe to identify the ovaries

Position R/L or L/R

Transrectal way

How to manipulate the probe ...

Gripping the probe between thumb, forefinger and middle finger Palpation of TG with ring and little fingers Move the probe slowly (25 à 30 pictures/sec) Firm movement of the probe to optimize contact with the rectal, vaginal

or abdominal wall (use jelly or fantom for skin) Some classical movements :

To slide along To rotate To roll

A device to manipulate the probe

http://www.eimedical.com/new-ice-ibex-customizeable-extension

Applications of echography to the non pregnant animal

Transrectal palpation vs echography in the non-pregnnat animal

Physiological situations

MP US+ Position of the cervix -

+ Diameter of the cervix +

+ Position of the horns -

+ Diameter of the horn +

+ Consistency of the horns -

+ Size of the ovaries ++

>1cm Identification of the follicles >2 mm

+ Identification of the CL ++

+ Confirmation of the absence of CL ++

- Identification of a cavitary CL ++

Pathological situations

MP US

+ Pneumovagina +

+ Mucocolpos +

+ Inflammatory reactions (adhesions around uterine horns or ovaries)

-

+ Ovarian cysts ++

- Differentiel diagnosis of ovarien cysts ++

+ Tumors +

- 2nd clinical endometritis ++

+ Pyometra vs pregnancy ++

+ Mucometra (WHD) ++

The bladder

2

1

2 : Cavity of the bladder

1 . Bladder wall

Image échographique du Dr. B. Gabriel

Non pregnant uterus (Cervix and horns)

Physiological aspects

1

2

3 : vessie

1 .Col utérin (coupe longitudinale)

2

3 4

1

2. Tiers inférieur de la corne

3. Tiers médian de la corne

1 . Limite de l’utérus

4. Tiers supérieur de la corne

3

1

2

2 : Contour plus spécifique du ligament large

3 : Vascularisation

1 . Limite de la corne utérine en coupe longitudinale

Pathological aspects

3

2

1

2 : More specific outline of one part of the horn

3 : Outline of the uterine cavity (presence of pus : more echogenic spots)

1. Rectal wall

3

2

1

2 : Outline of the uterine cavity

3 : Accumulation ou pus (pyometra)

1 . More specific outline of one part of the horn


The ovary

Why to use echography to examine the ovaries

Follow up of the follicular growth : waves Identification of follicular caracteristics

Diameter Shape Wall thickness

Control of ovulation Follow up of superovulation treatment Differential diagnosis of ovarien cysts : how to choose a treatment Identification of luteal structures

treatement with PGF2a Before an embryo transfer

The ovaryPhysiological structures

The follicles

Cavitary

> 2 mm if 5 MHz

Do’nt confuse with blood vessels

IF > 10 mm22 à 28 % identified by manual palpation

76 à 89 % identified by echography

2. Follicles

3. Artifact : air between the probe and the rectal wall

1. Limit of the ovary

12

3


2. Limit of the follicle

1 . Limit of the ovary

21

The corpus luteum

Dioestrus corpus luteum

Non incised ovary Ovary and CL incised

2. Outline of the CL


3. Follicle : anechogenic

3

21


1

32


1 . Outline of the ovary

3. Follicle


1

2

3


2. Outline of the bladder

1 . Outline of the CL

3. Part of the bladder wall

Accuracy of the CL diagnostic

Manual palpation / progesterone + predictive value (presence) : 79 % - predictive value (absence) : 75 %

Echography / dissection of the ovaries + predictive value (presence) : 81 à 100 % - predictive value (absence) : 98 %

Palpation and echography No interest to diagnose CLH or atretic CL

http://hdl.handle.net/2268/8976

The CL with a cavity

5. Hyperechogenic limit of the ilium

1

3

24

5




4. Follicle : anechogenic

3. Outline of the CL cavity

43 2 1




4. Fibrine

3. Outline of the CL cavity

The ovarian cysts

Luteinized cyst

32 4

5

1

6

7

2. External outline of the wall of the luteinzed cyst

3. Internal outline of the wall of the luteinzed cyst

4. Follicle 6. Fibrine

1 . Outline of the ovary

5. Artifact 7. Pubic area


2. External outline of the wall of the follicular cyst

3. Internal outline of the wall of the follicular cyst

4. Follicle

5. Artifact

1. Outline of the ovary

3

2

45

1

Applications of echography to the pregnant animal

General data

- 0 h : zygote : 0.1 mm+ 72 à 96 h : embryo is coming in the uterine horn+ 5 J : morula+ 6 J : young blastocyst : 100 cells+ 7 J : blastocyste : 0.16 mm9 J : hatching (embryon is coming out the membrane pellucida)+ 16 J : embryonic vesicule : elongation phase+ 20 J : binucleate cells : adhesion phase+ 21 J : pregnancy diagnosis with P4+ 25 J : pregnancy diagnosis by echography+ 35 J : pregnancy diagnosis with PAG+ 50-60 J : end of organogenesis : embryo : 50 mm

Embryonic vesicule and embryo 26 days Embryonic vesicule and embryo 26 days

In Ginther 1998

Evolution of the height of embryonic vesicule

Embryonic hearth rate of embryo and fetus

In Ginther 1998

Chronology of embryonic vesicule and embryo

n Moy (d) Ecart--------------------------------------------------------------------------------------------------------------------------- Embryo 15 20 19-24 Heart beat 15 21 19-24 Allantoïde 9 23 22-25 C aspect of embryo 11 25 22-30 Vertebral column 14 29 26-33 First signs of forelimbs 14 29 28-31 Amnios 14 30 28-33 Orbitary cavities 14 30 29-33 First signs of hindlimbs 13 31 30-33 L aspect of embryo 12 33 29-39 Placentomes 6 35 33-38 Cristallin 12 40 37-44 Fetal movements 9 45 42-50 Ribs 7 53 51-55------------------------------------------------------------------------------------------------------------------------------

The uterine horn is not straight

One vesicule but 4 sections

Echographic pictures of embryonic vesicule,

embryo and fetus

2b2a 2c1

3

4

2a,2b,2c : transverse section of the uterine horn

3. Outline of embryonic vesicule

4. Embryo (26 d)

1. Outline of the uterine horn

2. Outline of the allantoïc cavity

4. Head of embryon (43 d)

3. Amniotic membrane

43

1

2

5

67

5. Forelimbs

6. Thorax - abdomen

7. Hindlimbs


1. Outline of the uterine horn (longitudianl section)

2. Outline of the embryonic vesicule

4. Head of embryo (60 d)


3

4

12

3

5

6

5. Cervical column

6. Thorax - abdomen Image échographique du Dr. B. Gabriel

1. Outline of the uterine horn (longitudianl section)

1: Outline of the uterine horn


4. Stomachs

3. Outline of the fetus (80 d)

2

5

1

34

5. Thoraco-lumbar vertebraImage échographique du Dr. B. Gabriel

3b

3a

3d

4

1

3c

5

2. Outline of the fetus (60 d)

3a. Head

4. Ribs

5. Vertebral column

1. Outline of the uterine cavity

2

3b. Neck 3c.Thorax 3d. Abdomen


Placentomes pictures

1 . Placentomes at different stages of pregnancy (From Ginther)

1

Pregnancy (105 days)

1

1

2. Placentomes (90 days)

1 . Outline of the uterine horn

Determination of the age of the fetus

Parameters LCR : lenght between crown and rump Thoracic diameter Orbital cavity

Variation factors Breed of the parents Sex of embryo or fetus Errors of the placement caliper Anatomical parameter considered Physiological variations of the pregnancy lenght

Programs be present into the devices

Determination of the fetal sex

Why ? Economical : commercialization of animals bearing males Management of calvings (nutrition) Embryo transfer (induction of abortion if males)

Principel d 55 to d 70 : identification of the position of the genital tubercule (the

GT will give pénis or clitoris) > d 70-80 to d < J120-130 : identification of the scrotum or the

mammary gland Descent of the testes between d 90 and d 130 Mammary gland : 0.6 à 3 mm between d 80 and d 130 > d 120 - d130 : difficult

Remarks

Great experience is necessary (200 diagnostics) Good resolution power of the probe Good conditions for examination Time : 2 minutes on average Accuracy level : 100 % between da 52 and d 54

J40 Not differenciated

J55 Male

J55 Female

1. Umbilical cord2. Genital tubercule


Foetus male 80 days

3. Urachus

2. Outline of the vesicule

1. Uterine horn

Male

3

2

1

4. Genital tubercule

4

6

5

4

3

21

3. Membres postérieurs

2. Membres antérieurs

1. Tête

4. Queue

5. Cordon ombilical

Fœtus mâle

6. Tubercule génital

2. Hindlimbs

1. Forelimbs

3. Tail

4. Umbilical cord

5. Genital tubercule

1

43

2

5

Female

Bibliography

2010

Ginther OJ Ultrasonic Imaging and Animal Reproduction. Cattle. Equiservices 1998ISBN 096472 6 6

Applications of echography to the reproduction of the cow Professor Ch. Hanzen Université de Liège...

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