1. 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 of veterinary 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

2. Maggie Mae 3 year old SF Mixed Breed Dog Next Slide

3. 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 Next Slide

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

8. Correct! There are no abnormalities associated with the thoracic wall. Next Slide

9. Sorry! The thoracic body wall, including the extrathoracic structures, are within normal limits Click here to proceed to the next question

10. Based on your assessment of the radiographs, the pleural space is: A. Normal Normal B. Abnormal Abnormal

11. Correct! There are no abnormalities associated with the pleural space. Next Slide

12. Sorry! The pleural space is normal Click here to proceed to the next question

13. Based on your evaluation, the cardiac silhouette is: A. Normal Normal B. Abnormal Abnormal

14. Sorry, Try Again There is an abnormality associated with the cardiac silhouette. Click here Click here to continue

15. Correct! The cardiac silhouette is abnormal. Click on the selection below that correctly identifies the abnormal area. A. The Left Ventricle The Left Ventricle B. The Right Ventricle The Right Ventricle C. The Left Atrium The Left Atrium D. The Right Atrium The Right Atrium E. The Main Pulmonary Artery The Main Pulmonary Artery

16. Sorry, Try Again The left ventricle is normal. Click here to return to the question

17. 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… Click here Click here to continue

18. 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… Click here Click here to continue

19. Nah… The left and right atria are both normal. Continue RA LA LAu RA

20. Correct! The main pulmonary artery is enlarged. Next Slide

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

22. Sorry!  There is an abnormality associated with the pulmonary vessels. Continue

23. Correct! The pulmonary vessels are definitely abnormal. Based on your evaluation, which vessels are affected? A. Pulmonary Veins Pulmonary Veins B. Pulmonary Arteries Pulmonary Arteries

24. 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. Continue

25. 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) Continue

26. 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.questionable enlargement of the right ventricleclick next

27. 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. Continue

28. 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 Return to the beginning