A “spaghetti sign” in feline abdominal radiographs predicts spleno-systemic collateral circulation

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Specchi S, Panopoulos I, Adrian AM, et al.

Veterinary Radiology & Ultrasound 2018;59:13-17.

A well-defined, tortuous, and tubular soft tissue opaque structure has been observed within the left mid abdominal cavity in digital radiographs of some cats. Authors hypothesized that this radiographic “spaghetti sign” is a predictor for spleno-systemic collateral circulation. The purpose of this multicenter, retrospective, descriptive study was to further characterize radiographic “spaghetti signs” in a group of cats and compare these signs with results of ultrasonography or computed tomography (CT). A multiinstitutional database was reviewed for radiographic reports describing the presence of a tubular tortuous structure within the left abdominal cavity of feline patients. Patients were included if additional abdominal ultrasound or CT studies were available. Imaging studies and medical records were retrieved and reviewed by a board-certified veterinary radiologist, and characteristics were recorded. Eighteen cats met the inclusion criteria. The presence of a tortuous vessel consistent with spleno-systemic collateral circulation was observed by ultrasonography or CT examinations in all patients with a “spaghetti sign” on abdominal radiographs. All patients were spayed females. One cat showed ultrasonographic imaging features consistent with portal hypertension. In conclusion, findings supported the hypothesis that a radiographic “spaghetti sign” is a predictor of spleno-systemic collateral circulation in feline patients and should be distinguished from other signs such as focal loss of serosal detail or a space occupying lesion.