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Review and the first imaging descriptions
Prior to the above articles there was minimal information available to radiologists on the imaging aspects of spirocercosis. W S Bailey (Department of Pathology and Parasitology, chool of Veterinary Medicine, Auburn University, USA) was the primary worker on spirocercosis and published extensively on its life cycle and pathophysiology from the 1950s through to the 1970s.1,2 These excellent articles, which also had radiograph illlustrations,1 formed the basis for many years on what to look for on radiographs ‐ namely a caudal oesophageal mass and spondylitis. The latter, in its typical location, affecting the caudal thoracic vertebra was considered pathognomonic for spirocercosis by Bailey.1 However at that stage the vertebral reactions appear to have been described using the variable terminology of spondylosis and spondylitis.2 In 1974 an article described the use of angiography to determine aortic displacement by oesophageal masses but no specific mention was made about the diagnosis of aortic aneurysms or mineralisation.3 Scarring of the aorta is a typical result of the larval migration via the aorta to the oesophagus. The end result of the aortic migration is often calcification and ossification of the aortic wall.2 Radiographically this mineralization was first described by Fox in 1998.
The review by v/d Merwe, Kirberger et al brought together the current knowledge on S. lupi in 2008 and is frequently cited as the standard overview reference on spirocercosis. The review included a lot of the Onderstepoort spirocercosis study group’s experiences at that time as well as an extensive section on diagnostic imaging, which included the value o omputed tomography. Many of the statements made in the review have subsequently been corroborated and published by the Onderstepoort group.
The second article in this chapter, published in 2001, was the first to describe in detail the radiographic characteristics of the spondylitis reactions as well as the oesophageal masses, which could be typical or atypical. Aortic aneurysm formations as well as aortic mineralisation visibility were also reported on. Additionally, the 3 cases that underwent CT emphasized the value of this modality to better evaluate many of the changes seen in spirocercosis. The cross sectional CT images lend themselves to detailed mass description, increased sensitivity to detect aortic and mass mineralisation, as well as secondary spirocercosis‐associated thoracic changes such as metastasis, effusion and pneumonia.
Chapter 1 Review and the first imaging descriptions
Chapter 2 Optimizing visibility of S. lupi‐ associated pathology on survey radiographs
Chapter 3 The use of computed tomography and alternative imaging techniques in Spirocerca lupi associated disorders
Chapter 4 Malignancy and metastasis
Chapter 5 Pathophysiology
Chapter 6 Review
Chapter 7 Discussion and conclusion
