Panagiotis Mantis DVM Dip ECVDI FHEA MRCVS
Panagiotis Mantis is one of the speakers at the VC 2023 as part of a double act with Jack Pye RVN. This is certain to be a very interesting combination and worthwhile. I have already reviewed one of Jack’s webinars and I took a look at a previous presentation of Panagiotis. He has moved around since graduating from the Aristotle University of Thessaloniki veterinary school. This included a residency at the RVC, culminating in the award of diplomate status of the European College of Veterinary Diagnostic Imaging. He spent a year at the Uppsala veterinary school in Sweden, before seventeen years at the RVC where he became a senior lecturer in radiology. He joined Dick White referrals in 2017 as a consultant radiologist.
I have had a look at a webinar recorded by Panagiotis on the 3rd. of February 2020 with an interesting title:
What is wrong with this chest? Make sense from the shadows.
The purpose of this lecture is as follows:
- To be familiar with the normal radiographic anatomy of the thorax
- To understand a way to read the whole thoracic radiograph
- To be able to recognise lung patterns with uses and limitations
- To be familiar with common mediastinal and pleural abnormalities
A systematic approach is essential when examining radiographs and Panagiotis emphasises this. All parts of the films are actively examined, with each abnormality being localised to a specific anatomic structure. In this way an appropriately specific diagnosis is made. Radiographic signs are categorised according to their number, size, shape, location, margination and radiographic opacity. Radiographic opacities may be gas, fat, soft tissue, bone or metal.
The approach to radiographic interpretation follows a well -defined path.
- Anatomical method of examining the films
- Identify visual features of the radiographs
- Possible structural changes
- Type of pathology
- Differential Diagnosis
- Combination of findings with clinical data
- Diagnosis
An interesting teaching resource that I haven’t come across before is that Panagiotis adds live hand- written (in pink!) notes superimposing the word slides. This is especially effective when we come to look at the numerous clinical radiographs. Instead of using the cursor to identify points of particular interest Panagiotis outlines them in pink. It works well.
We are taken through normal thoracic radiographic images of dogs and cats. From this we progress to interpreting the chest wall, the diaphragm, the pleural cavity, and mediastinum before dealing with pulmonary patterns in the abnormal lung. We see bronchial, interstitial, alveolar, vascular and mixed patterns. Numerous radiographs of extremely high quality identify the important aspects of each pattern, with considerable detail on each one. If, like me, you have struggled in the past to identify correctly these patterns the webinar is for you. Not only is there a clear explanation of how to identify the lung patterns, there is also the bonus of a differential diagnosis for each one. For example with the interstitial pattern, suggested differentials include pneumonia, oedema, haemorrhage of any cause and neoplasia. For the localised alveolar pattern there are seven differentials listed.
Other themes dealt with in this webinar include lung hyperlucency, calcified lung lesions, pulmonary heterotypic bone formation, (PHBF), pneumothorax, pleural effusions, mediastinal shift, tracheal masses and diaphragmatic rupture.
A slide entitled ‘Prompt’ lists on one side a sign, which on the other side points to a suggested prompt. For example with pneumothorax the prompt advises: –
- Are there other signs of trauma?
- Rib fractures?
- Is the urinary bladder visible?
The prompt slide is worth downloading as an aide memoire ensuring that you don’t miss anything.
The webinar is a tour de force of thoracic radiography and a taster for the VC 2023 presentations of Panagiotis and Jack Pye. Save the date!
- VC2023 Diagnostic Imaging Evening
- Panagiotis Mantis and Jack Pye
- Thursday 9th. February 2023 7.00 pm
