MAGNETIC RESONANCE IMAGING CHARACTERISTICS OF PERIPHERAL NERVE SHEATH TUMORS OF THE CANINE BRACHIAL PLEXUS IN 18 DOGS

Magnetic resonance imaging (MRI) examinations from 18 dogs with a histologically confirmed peripheral nerve sheath tumor (PNST) of the brachial plexus were assessed retrospectively. Almost half (8/18) had a diffuse thickening of the brachial plexus nerve(s), six of which extended into the vertebral canal. The other 10/18 dogs had a nodule or mass in the axilla (1.2-338 cm3). Seven of those 10 masses also had diffuse nerve sheath thickening, three of which extended into the vertebral canal. The majority of tumors were hyperintense to muscle on T2-weighted images and isointense on T1-weighted images. Eight of 18 PNSTs had only minimal to mild contrast enhancement and many (13/18) enhanced heterogeneously following gadolinium DTPA administration. Transverse plane images with a large enough field of view (FOV) to include both axillae and the vertebral canal were essential, allowing in-slice comparison to detect lesions by asymmetry of structures. Higher resolution, smaller FOV, multiplanar examination of the cervicothoracic spine was important for appreciating nerve root and foraminal involvement. Short tau inversion recovery, T2-weighted, pre and postcontrast T1-weighted pulse sequences were all useful. Contrast enhancement was critical to detecting subtle diffuse nerve sheath involvement or small isointense nodules, and for accurately identifying the full extent of disease. Some canine brachial plexus tumors can be challenging to detect, requiring a rigorous multiplanar multi-pulse sequence MRI examination.     

IMAGING DIAGNOSIS — UNILATERAL TRIGEMINAL NEURITIS MIMICKING PERIPHERAL NERVE SHEATH TUMOR IN A HORSE

A 16‐year old Warmblood gelding presented with a nonhealing corneal ulcer and absent corneal sensation in the left eye. A lesion affecting the maxillary and ophthalmic branches of the left trigeminal nerve was suspected. Magnetic resonance (MR) imaging identified marked thickening of the ophthalmic and maxillary branches of the left trigeminal nerve. The nerve was iso‐ to hypointense on T1‐weighted and T2‐weighted images with heterogeneous enhancement. A peripheral nerve sheath tumor was suspected, however granulomatous neuritis was histopathologically confirmed. These inflammatory changes can result in severe nerve enlargement and should be considered with MR findings suggestive of peripheral nerve sheath tumor.     

Brain and spinal cord haemorrhages associated with Angiostrongylus vasorum infection in four dogs

Multifocal haemorrhages associated with Angiostrongylus vasorum infection were observed in the central nervous system of four dogs with neurological signs including depression, seizures, spinal pain and paresis. In magnetic resonance images the majority of the lesions were isointense or slightly hyperintense in T1-weighted images, hyperintense in T2-weighted images and hypointense in T2*-weighted (gradient echo) images, compatible with haemorrhages more than seven days old. Lesions were found in the brain of three of the dogs and in the spinal cord of two. The cerebrospinal fluid contained high concentrations of protein and evidence of erythrophagia. All the dogs had coagulopathy and pulmonary haemorrhage of varying severity. A vasorum larvae were detected in the faeces of each of the dogs. Neural A vasorum was confirmed at postmortem examination in two dogs.     

Magnetic resonance imaging of a brain abscess in a 10-month-old filly

The purpose of this paper was to correlate the magnetic resonance imaging (MRI) characteristics of a mature brain abscess in a horse with histopathologic alterations of brain tissue. Eight months after the onset of clinical signs, MRI of the brain of a 10-month-old filly was performed. A large space-occupying lesion in the right cerebral hemisphere was identified. This space-occupying lesion was delineated by a thick and well-defined capsule that was isointense to brain parenchyma on the T1-weighted images and with a markedly hypointense on the T2-weighted images. The identification of such a capsule is highly diagnostic of a mature brain abscess. The lesion seen on MR images was confirmed at necropsy where a large abscess of the right hemisphere was observed. Streptococcus zooepidemicus and Pseudomonas aeruginosa were isolated from the abscess. Based on histopathologic examination, the signal characteristics of the capsule on T1-weighted and T2-weighted images were found to be due to the presence of numerous hemosiderin-laden macrophages. These results are in agreement with previous studies on human patients. This report confirms the value of MRI in the diagnosis of equine brain diseases.     

MAGNETIC RESONANCE IMAGING APPEARANCE OF THE CISTERNA CHYLI

Thoracolumbar spinal magnetic resonance imaging (MRI) examinations in dogs frequently include the region of the cisterna chyli within the field of view. It is important to be aware of the appearance and location of this structure to avoid confusing it for a pathologic periaortic lesion. MRI examinations of the thoracolumbar spine were reviewed in 30 dogs. The cisterna chyli was identified in 26 dogs and was most commonly located caudal to the diaphragmatic crura at the level of L4; afferent and efferent lymphatics were seen in all dogs. Transverse T2-weighted images were the most useful to locate the cisterna chyli. It was isointense to fluid on T2-weighted images and isointense to muscle on T1-weighted images. Mild contrast enhancement was seen in three dogs. The cisterna always wrapped around the aorta, but varied in shape, with the most common being the wide right dorsolateral ellipse. The thoracic duct was also visible in 30 dogs. MRI may have potential for noninvasive evaluation of the abdominal and thoracic lymphatic ducts in dogs.     

MAGNETIC RESONANCE IMAGING AND PATHOLOGIC FINDINGS ASSOCIATED WITH NECROTIZING ENCEPHALITIS IN TWO YORKSHIRE TERRIERS

Two young adult Yorkshire terriers had neurologic signs consistent with forebrain and brainstem involvement or forebrain involvement alone. On magnetic resonance imaging studies there were asymmetric bilateral lesions mainly in the cerebral cortex, and in the diencephalon. These areas were hyperintense on T2-weighted and FLAIR images, but hypointense or isointense on T1-weighted images. Lesions had a varying degree of contrast enhancement. Areas which were isointense on T1-weighted images had no contrast enhancement or only foci of contrast enhancement. Lesions with hypointensity in T1-weighted images had no enhancement or more frequently ring-like enhancement around the lesion. Necrotizing encephalitis was confirmed pathohistologically in both dogs. The degree of contrast enhancement appeared to be related to the degree of lymphohistiocytic inflammation on histologic examination.     

MAGNETIC RESONANCE IMAGING FEATURES OF THE TEMPOROMANDIBULAR JOINT IN NORMAL DOGS

Evaluation of the canine temporomandibular joint (TMJ) is important in the clinical diagnosis of animals presenting with dysphagia, malocclusion and jaw pain. In humans, magnetic resonance imaging (MRI) is the modality of choice for evaluation of the TMJ. The objectives of this study were to establish a technical protocol for performing MRI of the canine TMJ and describe the MRI anatomy and appearance of the normal canine TMJ. Ten dogs (one fresh cadaver and nine healthy live dogs) were imaged. MRIs were compared with cadaveric tissue sections. T1‐weighted (T1‐W) transverse closed‐mouth, T1‐W sagittal closed‐mouth, T1‐W sagittal open‐mouth, and T2‐W sagittal open‐mouth sequences were obtained. The condylar process of the mandible and the mandibular fossa of the temporal bone were hyperintense to muscle and isointense to hypointense to fat on T1‐W images, mildly hyperintense to muscle on T2‐W images, and were frequently heterogeneous. The articular disc was visible in 14/20 (70%) TMJs on T1‐W images and 13/20 (65%) TMJs on T2‐W images. The articular disc was isointense to hyperintense to muscle on T1‐W images and varied from hypointense to hyperintense to muscle on T2‐W images. The lateral collateral ligament was not identified in any joint. MRI allows evaluation of the osseous and certain soft tissue structures of the TMJ in dogs.     

MAGNETIC RESONANCE IMAGING AND ULTRASONOGRAPHY IN THE DIAGNOSIS OF A MALIGNANT PERIPHERAL NERVE SHEATH TUMOR IN A DOG

A 9-year-old male neutered mixed breed dog had a two-month history of progressive left thoracic limb lameness. There was electromyographic evidence of denervation potentials in all muscles of this limb. In magnetic resonance images a multilobulated, hyperintense mass was visible caudal to the middiaphysis of the left humerus on T-2 weighted images. The mass, which was isointense with surrounding tissue on T1 weighted images, extended proximally towards the brachial plexus. The mass was also visible as a fusiform structure of mixed echogenicity sonographically, although fine-needle aspiration performed at this time was nondiagnostic. A malignant peripheral nerve sheath tumor was diagnosed histopathologically.     

INTRACRANIAL INTRA-ARACHNOID CYST WITH INTRACYSTIC HEMORRHAGE IN TWO DOGS

Clinical signs, magnetic resonance imaging (MRI) features, treatment, and outcome of two adult dogs with neurologic dysfunction resulting from hemorrhage into a quadrigeminal intracranial intra-arachnoid cyst are described. In dog 1, the cyst was hyperintense to cerebrospinal fluid (CSF) on T1-weighted MRI and hypointense to CSF on T2-weighted images. In dog 2, the cyst was isointense to CSF on T1- and T2-weighted images. Both dogs were treated with craniotomy and cyst fenestration. A large blood clot was removed from the lumen of the cyst in each dog. Dog 1 is clinically normal 3.5 years post-surgery and has a persistent cyst. Dog 2 had a good initial response to therapy but was euthanized 2.5 years post-operatively due to generalized seizures. The late onset of clinical signs in these dogs most likely resulted from hemorrhage into the cyst. Surgical fenestration and hematoma removal appear to provide a satisfactory treatment for adult dogs with an intracranial intra-arachnoid cyst and intracystic hemorrhage. Persistence of the cyst may occur in some dogs.     

LOW-FIELD MAGNETIC RESONANCE IMAGING OF BONE MARROW IN THE LUMBAR SPINE, PELVIS, AND FEMUR IN THE ADULT DOG

The purpose of this study was to describe the appearance of normal bone marrow in seven adult dogs using low-field (0.3 T) magnetic resonance (MR) imaging. The areas imaged included the lumbar spine, pelvis, and femur. T1-weighted, fast spin-echo T2-weighted, and short tau (T1) inversion recovery (STIR) sequences were obtained at all locations. Histopathology was performed on sections from the sixth lumbar vertebral body, the wing of the ilium, and the femur (head and neck, mid-diaphysis, and condyle) for evaluation of cellularity and fat content. The lumbar spine and pelvic marrow MR images were similar in all dogs. The lumbar vertebral bone marrow was uniform, intermediate signal intensity, and isointense to muscle on all sequences. There was variation between dogs in the bone marrow distribution with MR imaging of the femur. In the proximal and mid-diaphysis of the femur there was patchy high-signal intensity on T1- and T2-weighted images, and hypointense foci on the STIR images. The distal femoral metaphysis had a variable pattern ranging from intermediate-to-high signal on T1- and T2-weighted images and intermediate-to-low signal on STIR images. The femoral condyles were uniformly high signal on T1- and T2-weighted images and hypointense on STIR images. Histopathologically there was a normal variation in the bone marrow cellularity. The marrow was normocellular (25–75% cellularity) for all sites examined except the femoral condyles, which were hypocellular (<25% cellularity).     

MRI features of CNS lymphoma in dogs and cats

The magnetic resonance (MR) imaging features of central nervous system lymphoma in eight dogs and four cats are described. Intracranial lesions affected the rostrotentorial structures in six dogs and caudotentorial structures in two cats. Lesions affected the spinal cord in two dogs and in two cats. One dog and one cat with intracranial lymphoma had signs of local extracranial extension and lymphadenopathy. Lesions were considered extraparenchymal in four dogs and three cats, intraparenchymal in two dogs and one cat, and appeared to have both intra- and extraparenchymal components in two dogs. All lesions were hyperintense in T2-weighted images when compared to white matter, most were hypointense in T1-weighted images (7/12), and most were hyperintense in fluid-attenuated inversion recovery (FLAIR) images (5/9). When compared to grey matter, these lesions appear either isointense (5/12) or hyperintense (7/12) on T2-weighted images, half of them were hypointense in T1-weighted images (6/12), and most were isointense in FLAIR images (7/9). Lesion margins were usually indistinct in T2-weighted images (10/12) and had perilesional hyperintensity in FLAIR images (7/9). The majority of lesions (10/12) had abnormal meninges around the lesion and half (6/12) had generalized contrast enhancement. Mass effect was evident in all lesions. Although not specific, when combined with the history and neurologic signs, MR features aid presumptive diagnosis that should be confirmed by cytology or histopathology.     

MAGNETIC RESONANCE IMAGING OF THE CANINE BRAIN AT 7 T

The purpose of this study was to describe relevant canine brain structures as seen on T2-weighted images following magnetic resonance (MR) imaging at 7 T and to compare the results with imaging at 1.5 T. Imaging was performed on five healthy laboratory beagle dogs using 1.5 and 7 T clinical scanners. At 1.5 T, spin echo images were acquired, while gradient echo images were acquired at 3 T. Image quality and conspicuity of anatomic structures were evaluated qualitatively by direct comparison of the images obtained from the two different magnetic fields. The signal-to-nose ratio (SNR) and contrast-to-noise ratio (CNR) were calculated and compared between 1.5 and 7 T. The T2-weighted images at 7 T provided good spatial and contrast resolution for the identification of clinically relevant brain anatomy; these images provided better delineation and conspicuity of the brain stem and cerebellar structures, which were difficult to unequivocally identify at 1.5 T. However, frontal and parietal lobe and the trigeminal nerve were difficult to identify at 7 T due to susceptibility artifact. The SNR and CNR of the images at 7 T were significantly increased up to 318% and 715% compared with the 1.5 T images. If some disadvantages of 7 T imaging, such as susceptibility artifacts, technical difficulties, and high cost, can be improved, 7 T clinical MR imaging could provide a good experimental and diagnostic tool for the evaluation of canine brain disorders.     

MAGNETIC RESONANCE IMAGING OF BRAIN INFARCTION IN SEVEN DOGS

Magnetic resonance imaging was performed in seven dogs with histopathologically-confirmed brain infarcts. The infarcts were non-hemorrhagic in four dogs and hemorrhagic in three dogs. Six dogs had single infarcts involving the cerebrum and one dog had multiple infarcts involving the cerebrum and brain stem. Non-hemorrhagic infarcts were typically wedge-shaped, hypointense on T1-weighted images, hyperintense on T2-weighted images, and did not enhance with gadolinium-DTPA. Hemorrhagic infarcts had mixed intensity on T1- and T2-weighted images, with variable patterns of enhancement.     

Magnetic resonance imaging features of spinal epidural empyema in five dogs.

Spinal epidural empyema is defined an accumulation of purulent material in the epidural space of the vertebral canal. Spinal epidural empyema should be considered as a differential diagnosis in dogs with pyrexia, spinal pain, and rapidly progressing myelopathy. Magnetic resonance (MR) imaging is the imaging test of choice in humans. Here, we describe the MR imaging features of five dogs with confirmed spinal epidural empyema. The epidural lesions appeared as high or mixed signal masses in T2-weighted (T2W) images. Increased signal within the spinal cord gray matter at the site of the lesion was detected in T2W images in all dogs. Two patterns of enhancement were detected on postcontrast T1-weighted (T1W) images. Mild to moderate peripheral enhancement was seen in three dogs and a diffuse pattern of enhancement was seen in one. Discospondylitis was identified in three dogs on T1W postcontrast images. Decompressive spinal surgery was performed in all dogs. Bacteria isolated from the abnormal epidural tissue were Enterobacter cloacae, coagulase-positive Staphylococci, Pasteurella multocida, and Escherichia coli. In one dog bacteria were not isolated. These MR imaging features, along with appropriate clinical signs, can allow prompt diagnosis and appropriate treatment planning.     

MRI characteristics of cerebral microbleeds in four dogs

Cerebral microbleeds in people are small foci of hemosiderin-containing macrophages in normal brain parenchyma. They are the remnant of previous hemorrhage and occur with greater frequency in older individuals. Our purpose was to describe the magnetic resonance (MR) appearance of cerebral microbleeds in four dogs. These lesions appeared as round, hypointense foci measuring ≤4 mm on T2*-gradient-recalled echo images. They were less conspicuous or absent on T2-weighting, being iso- or hypointense, and uniformly invisible on T1-weighted images. No contrast enhancement was seen in any of the cerebral microbleeds. Necropsy-derived histopathologic analysis of one brain confirmed these lesions to be chronic cerebrocortical infarcts containing hemosiderin. The MR changes seen in dogs were analogous to what has been described in people and will be helpful in distinguishing cerebral microbleeds from other brain lesions.     

Comparison of magnetic resonance imaging sequences in dogs with multi-focal intracranial disease

OBJECTIVES: To compare the value of different magnetic resonance sequences in the detection of brain lesions in dogs with multi-focal intracranial neurolocalised lesions and abnormal cisternal cerebrospinal fluid analysis. METHODS: T2-weighted, T1-weighted, T1-weighted-Gd, FLAIR (fluid attenuated inversion recovery) images of 73 dogs with multi-focal intracranial localised lesions were reviewed retrospectively. Control dogs (19) were selected on the basis of normal neurological examination, magnetic resonance images and cerebrospinal fluid analysis. Two board-certified radiologists blindly reviewed the magnetic resonance images. Magnetic resonance sequence sensitivities were compared using the chi-squared test and logistic regression, accounting for clustering at the patient level. Statistical significance was set at the 5 per cent level. RESULTS: The FLAIR sequence was found to have the highest sensitivity (84 per cent, 61 of 73), followed by T2-weighted (63 per cent, 46 of 73), T1-weighted postcontrast (62 per cent, 45 of 73) and T1-weighted (23 per cent, 17 of 73) (P<0.001). FLAIR images were 106.1 times (95 per cent confidence interval 25.2 to 447.5) more likely to correctly identify cerebrospinal fluid-positive patients than T1-weighted, 6.4 times (95 per cent confidence interval 2.2 to 18.2) than T1-weighted postcontrast and 5.8 times (95 per cent confidence interval 2.0 to 16.4) than T2-weighted. FLAIR identified 14 per cent of cases that were classified as normal based on the three others sequences. CLINICAL SIGNIFICANCE: Routine use of FLAIR sequence should be encouraged in dogs undergoing a brain magnetic resonance imaging and probably more specifically in cases of suspected inflammatory brain disease.     

NORMAL CANINE BRAIN MATURATION AT MAGNETIC RESONANCE IMAGING

The normal neonatal canine brain exhibits marked differences from that of the mature brain. With development into adulthood, there is a decrease in relative water content and progressive myelination; these changes are observable with magnetic resonance imaging (MRI) and are characterized by a repeatable and predictable time course. We characterized these developmental changes on common MRI sequences and identified clinically useful milestones of transition. To accomplish this, 17 normal dogs underwent MRI of the brain at various times after birth from 1 to 36 weeks. Sequences acquired were T1‐weighted (T1W), T2‐weighted (T2W), fluid attenuated inversion recovery, short tau inversion recovery, and diffusion weighted imaging sequences. The images were assessed subjectively for gray and white matter relative signal intensity and results correlated with histologic findings. The development of the neonatal canine brain follows a pattern that qualitatively matches that observed in humans, and which can be characterized adequately on T1W and T2W images. At birth, the relative gray matter to white matter signal intensity of the cortex is reversed from that of the adult with an isointense transition at 3–4 weeks on T1W and 4–8 weeks on T2W images. This is followed by the expected mature gray matter to white matter relative intensity that undergoes continued development to a mostly adult appearance by 16 weeks. On the fluid attenuated inversion recovery sequence, the cortical gray and white matter exhibit an additional signal intensity reversal during the juvenile period that is due to the initial high relative water content at the subcortical white matter, with its marked T1 relaxation effect.     

BRAIN MAGNETIC RESONANCE IMAGING CHARACTERISTICS IN DOGS AND CATS WITH CONGENITAL PORTOSYSTEMIC SHUNTS

Animals with a portosystemic shunt (PSS) often have neurologic abnormalities. Diagnostic imaging, including brain magnetic resonance (MR) imaging, is not performed routinely in these animals. In this study, brain MR images were obtained in 13 dogs and three cats with a PSS, and in 15 dogs and five cats that were neurologically normal and used as controls. All animals with a PSS had widened sulci. In addition, 10 out of 13 dogs with a PSS and one out of three cats with a PSS had hyperintense focal areas in the lentiform nuclei on T1-weighted (T1W) images, which did not enhance after intravenous gadolinium. Following surgical correction of the PSS, MR imaging examinations were repeated in one dog and one cat. The hyperintensity of the lentiform nuclei had decreased. This study indicates that MR imaging findings of widened sulci and hyperintensity of the lentiform nuclei on T1W images may be found in dogs and cats with a PSS.     

Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs

The characteristics of magnetic resonance imaging (mri) of the brains and spinal cords of 11 dogs with histologically confirmed granulomatous meningoencephalomyelitis (gme) were determined. The lesions were in the brain of eight of the dogs, in the brain and spinal cord of two, and in the spinal cord alone in one dog. A single lesion was present in four of the dogs and multiple lesions were found in six. In one dog with intracranial signs, no visible lesions could be detected on mri. No meningeal enhancement was detected in T1-weighted images post-contrast, or in fluid attenuation inversion recovery (flair) images, but there were histological lesions in the meninges in nine of the dogs. The T2-weighted images and flair sequences were characterised in all cases by hyperintensity, whereas the signal intensity of the lesions on T1-weighted images was variable. After the administration of paramagnetic contrast, some of the lesions showed no enhancement, but others showed marked patterns of enhancement. The lesions in 10 of the dogs were easily identifiable by mri and the images had several unifying characteristics, but they could not be considered disease-specific.