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.     

Fibrocartilaginous embolic myelopathy in five cats

Five cats had clinical signs, radiographic findings, and cerebrospinal fluid analyses consistent with fibrocartilaginous embolic myelopathy. All cats had an acute onset of nonpainful, asymmetrical spinal cord signs (paresis or paralysis of one or more limbs). Magnetic resonance imaging was performed in three cats. On T2-weighted images, an intramedullary lesion was revealed that was hyperintense to normal spinal cord gray matter. On T1-weighted images, the lesion was isointense. Three of the cats were euthanized, and postmortem examination confirmed myelomalacia with intralesional fibrocartilaginous emboli. Two cats survived and were clinically improved within 3 weeks.     

Rostral cerebellar arterial infarct in two cats

A 10-year-old female neutered domestic shorthair (DSH) cat and a 6-year-old female neutered Siamese cat were presented following a peracute onset of decerebellate rigidity and a cerebellar vestibular syndrome, respectively. In both cats, physical examination and routine blood tests were unremarkable, as was routine analysis of cerebrospinal fluid obtained from the DSH cat. Based on the magnetic resonance imaging (MRI) features - focal wedge-shaped lesion in the cerebellum characterised by hyperintensity in T2-weighted, T2( *)-gradient echo and fluid attenuated inversion recovery (FLAIR) images - a presumptive diagnosis of cerebellar infarct was made in both cases. In the DSH cat, the post-mortem examination confirmed the diagnosis of cerebellar infarct and additionally found acute renal infarcts and a pulmonary neoplasia. In the Siamese cat, ultrasonographic evaluation of the heart revealed a probable low-grade chronic valvular endocarditis which was thought to be a potential source of thromboembolism. This paper describes the first two cases - one confirmed and the other suspected - of cerebellar infarct in the cat. The in vivo potential diagnostic value of the MRI study is highlighted. Cerebellar infarcts should be included in the differential diagnosis of cat with a peracute onset of cerebellar signs regardless of the severity of neurological deficits.     

Results of magnetic resonance imaging in 14 cats with meningoencephalitis

Medical records and magnetic resonance (MR) images of 14 cats with inflammatory diseases affecting the central nervous system (CNS) were reviewed retrospectively. Cases included eight cats with feline infectious peritonitis and two cats with toxoplasmosis. Abnormalities affecting the CNS were observed in MR images in 10 (71%) cats. Intracranial lesions appeared as slightly hypointense foci in T1-weighted images in two (14%) cats, as hyperintense foci in T2-weighted images in seven (50%) cats and as hyperintense foci after intravenous administration of a gadolinium-based contrast medium in 10 (71%) cats. In six cats with lesions in T1- and/or T2-weighted images, additional lesions were visible in T1-weighted images obtained after gadolinium-based contrast medium administration. In three cats, lesions were visible only after contrast medium administration. In our study, MR imaging (MRI) did not appear to detect all cases of CNS inflammation in the population of cats with inflammatory cerebrospinal fluid (CSF); however, MRI adds information about the sites and morphology of intracranial lesions that should help to distinguish between neoplasia and inflammatory conditions and, possibly, between different inflammatory conditions.     

Acute intraparenchymal spinal cord injury in a cat due to high-rise syndrome

A 9-year-old spayed female Bengal Red cat was evaluated for high-rise syndrome. The cat had paraplegia of the hind limbs, intact reflexes and pain perception, and hyperesthesia in the caudal thoracic area. Mentation, cranial nerve function, forelimb proprioceptive responses, and spinal reflexes were normal. There were no abnormalities on radiographs or computed tomography scan, but magnetic resonance imaging revealed a hyperintense intraparenchymal spinal cord lesion on T2-weighted and T2 fat saturation images.     

Medulloblastoma in a cat: clinical and MRI findings

A two-year-old, castrated crossbred cat presented with loss of balance and anorexia. A mass of the caudal aspect of the cerebellum was revealed by magnetic resonance imaging (MRI). The mass was hypointense on T1-weighted images, iso- and hyperintense on T2-weighted images and was enhanced by intravenous gadolinium contrast medium. The MRI characteristics of this case were similar to those of medulloblastoma of the cerebellar vermis in humans. The authors were able to remove almost all of the tumour. The cat was discharged from hospital on day 22 after surgery, but died on day 45. The excised tissue was histologically diagnosed as medulloblastoma.     

Intramedullary epidermoid cyst in the thoracic spine of a dog

A 5 yr old female spayed mastiff was evaluated for a 3-4 mo history of paraparesis and 3 days of acutely worse paraparesis and incontinence. On magnetic resonance imaging, a spinal cord lesion was present at the ninth thoracic vertebra. The lesion was hyperintense on T2-weighted images (T2-W), and a hyperintense rim was present on T1-weighted postcontrast images. Histologic examination showed a cystic mass lined by squamous epithelial cells. Histopathologic diagnosis was an intramedullary epidermoid spinal cyst. Epidermoid cyst should be a differential diagnosis in young dogs with a myelopathy and an intramedullary spinal cord lesion on magnetic resonance imaging examination.     

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 APPEARANCE OF SUSPECTED ISCHEMIC MYELOPATHY IN DOGS

Ischemia and infarction of the spinal cord is a known cause of acute spinal injury in dogs. Currently, the diagnosis of spinal cord infarction in small animals is based on history, clinical signs, and the exclusion of other differentials with radiography and myelography. It is a diagnosis only confirmed through necropsy examination of the spinal cord. The aim of this paper is to describe the Magnetic resonance imaging (MRI) findings of the spinal cord of dogs with suspected spinal cord infarcts to utilize this technology for antemortem support of this diagnosis. This retrospective study evaluated the spinal MR examinations of 11 dogs with acute onset of asymmetric nonpainful myelopathies. All patients except one (imaged at 2 months) were imaged within 1 week of clinical signs and managed conservatively with minimal medical and no surgical intervention. They were followed clinically for a minimum of 4 months after discharge. MR findings in all dogs were characterized by focal, intramedullary, hyperintense lesions on T2-weighted images with variable contrast enhancement similar to what is reported in humans. Though it could not be used to diagnose spinal cord infarction definitively, MRI was useful in excluding extramedullary spinal lesions and supporting intramedullary infarction as a cause of the acute neurologic signs. Together with the history and clinical examination findings, MRI is supportive of a diagnosis of spinal cord infarction.     

Acute intervertebral disc extrusion in a cat: clinical and MRI findings

A 5 year old, neutered male, domestic shorthaired cat had acute left hemiparesis and Horner's syndrome. Magnetic resonance imaging (MRI) revealed a loss of the normal signal from the nucleus pulposus of the intervertebral disc at C3/4, narrowing of the ventral subarachnoid space and slight dorsal displacement of the spinal cord and a focal hyperintense lesion affecting the left side of the spinal cord at the same level. The presumptive diagnosis was focal spinal cord oedema associated with intervertebral disc extrusion. A traumatic aetiology was suspected. The cat was treated conservatively and improved gradually over a period of 6 months.     

Magnetic resonance imaging findings and clinical associations in 52 dogs with suspected ischemic myelopathy

BACKGROUND: The magnetic resonance imaging (MRI) features of ischemic myelopathy have been described in the human literature and in a small number of cases in the veterinary literature. HYPOTHESIS: The aims of this study were to identify associations among MRI findings, timing of imaging, and presenting neurologic deficits in a large series of dogs with a presumptive diagnosis of ischemic myelopathy. ANIMALS AND METHODS: The medical records and MR images of dogs with a presumptive diagnosis of ischemic myelopathy (2000-2006) were reviewed retrospectively. Inclusion criteria were acute onset of nonprogressive and nonpainful myelopathy, 1.5-tesla MRI of the spine performed within 7 days of onset, and complete medical records and follow-up information. Presumptive diagnosis was based on history, as well as clinical, MRI, and cerebrospinal fluid (CSF) findings. The extent of the lesion on MRI was assessed as the following: (1) the ratio between the length of the hyperintense area on sagittal T2-weighted images and the length of C6 or L2 vertebral body, and (2) the maximal cross-sectional area of the hyperintense area on transverse T2-weighted images as a percentage of cross-sectional area of the spinal cord. RESULTS: Fifty-two dogs met the inclusion criteria. MRI findings were abnormal in 41 dogs and normal in 11 dogs. The presence of MRI abnormalities was not significantly associated with the timing of imaging (P = .3) but was associated with ambulatory status on presentation (P = .04). Severity of signs on presentation was associated with extent of the lesion on MRI (P = .02). CONCLUSION AND CLINICAL IMPORTANCE: The severity of signs on presentation is associated with the presence and the extent of the lesion on MRI.     

Medulloblastoma in a cat: clinical and MRI findings

A two-year-old, castrated crossbred cat presented with loss of balance and anorexia. A mass of the caudal aspect of the cerebellum was revealed by magnetic resonance imaging (MRI). The mass was hypointense on T1 -weighted images, iso- and hyperintense on T2-weighted images and was enhanced by intravenous gadolinium contrast medium. The MRI characteristics of this case were similar to those of medulloblastoma of the cerebellar vermis in humans. The authors were able to remove almost all of the tumour. The cat was discharged from hospital on day 22 after surgery, but died on day 45. The excised tissue was histologically diagnosed as medulloblastoma.     

Magnetic resonance imaging of a giant frontal hemorrhagic mucocele with intracranial extension in a cat

A 6‐year‐old domestic short‐haired cat was presented with an acute onset of right cortical encephalopathy. Magnetic resonance imaging (MRI) performed 4 days after the onset of clinical signs revealed a lesion originating from the right frontal sinus with intracranial extension and compression of the right frontal lobe. The lesion was T1‐weighted hypointense and T2‐weighted and fluid‐attenuated inversion recovery hyperintense. Signal voids within the lesion were observed on T2* images, consistent with hemorrhage. Peripheral ring enhancement was visible on postcontrast sequences. These features were consistent with a giant hemorrhagic mucocele. To the authors’ knowledge, this is the first report of MRI characteristics of this lesion in a cat.     

SEQUENTIAL MAGNETIC RESONANCE IMAGING OF AN INTRACRANIAL HEMATOMA IN A DOG

An 8-year-old Yorkshire terrier developed acute onset coma and seizure after cranial trauma. Intracranial hemorrhage was suspected from the clinical signs and history. Low-field magnetic resonance (MR) imaging revealed a round mass within the right cerebral hemisphere, compressing the right lateral ventricle and displacing the longitudinal fissure to the left. The lesion was hypointense on T1-weighted images and hyperintense on T2-weighted images, consistent with an acute hemorrhage. MR imaging was performed every 24 h for 6 days from 1 h after the injury, and then on day 14 of hospitalization. With time, the signal intensity changed to hyperintense on Ti-weighted images. On T2-weighted images the center of the mass changed to hypointense, and then to hyperintense with a hypointense rim. These changes of signal intensity were related to hemoglobin oxidation.     

Chiari‐like malformation in two cats

Two male, neutered, domestic, shorthaired cats were evaluated for progressive paresis and ataxia. Neurological examinations suggested a spinal cord lesion in each case. Complete blood examination and cerebrospinal fluid analysis were unremarkable in both cats. MRI revealed malformation of the occipital bone with herniation of the cerebellar vermis through the foramen magnum but without syringomyelia. Chiari‐like malformation was suspected in both patients. MRI repeated one year later in both cats because of progression of clinical signs yielded the same findings as the initial scans. Foramen magnum decompression in one cat was associated with resolution of clinical signs.     

Ultrasonographic and magnetic resonance imaging diagnosis of an oropharyngeal wood penetrating injury in a dog

A 5 yr old female intact English setter with a 17 day history of a penetrating oropharyngeal wound was referred for cervical swelling and pain. Physical examination revealed swelling at the left lateral aspect of the cranial cervical region. Pain was elicited upon flexion, extension, and leftward movement of the neck. Neurologic deficits were not identified. Cervical ultrasonography showed a 0.4 cm × 2.3 cm linear, hyperechoic structure in the soft tissues ventrolateral to the first (C1) and second (C2) cervical vertebrae. MRI demonstrated a linear structure 2 cm in length adjacent to the cranial aspect of C2. The foreign material was isointense to hyperintense on precontrast T1-weighted images, isointense on postcontrast T1-weighted images, and hypointense on T2-weighted images relative to adjacent muscle. Abnormalities within the spinal canal were not identified. Upon surgical exploration, a reed foreign body was identified deep to the serratus ventralis muscle. The patient was normal on follow-up evaluations 4 wk postsurgically.     

Radiographic measurements of the trachea in domestic shorthair and Persian cats

Tracheal diameter can be assessed from a thoracic radiograph, with assessment of tracheal diameter in dogs based on ratios between tracheal diameter and a skeletal measurement. Reference intervals are not, however, available for the cat. Tracheal narrowing may cause significant clinical problems, although tracheal hypoplasia in dogs may be clinically silent, and is rarely reported in cats (both mesati- and brachycephalic). The tracheal diameter and trachea:thoracic inlet and trachea:rib ratios were calculated for populations of domestic shorthair (DSH) (n?=?68) and Persian (n?=?40) cats. This gave reference intervals for radiographic tracheal measurements in these breeds. It is proposed that the tracheal diameter in a normal DSH cat should be 18% of the diameter of the thoracic inlet, and compared to 20% in Persian cats.     

MAGNETIC RESONANCE IMAGING FEATURES OF CERVICAL SPINAL CORD MENINGIOMAS

The records of four dogs with cervical spinal cord meningiomas were retrospectively reviewed. Signalment, history, laboratory findings, neurological examination, and histopathological findings were evaluated. Magnetic resonance imaging (MRI) was performed using a 1.0-T superconducting magnet and T2-weighted (W) and noncontrast and postcontrast T1-W spin echo pulse sequences. Meningiomas were located at the level of the second, third, and fifth cervical vertebrae and the C2-3 intervertebral space. All meningiomas appeared as focal masses that were hyperintense to the spinal cord on T2-W images and iso- to hypointense on the T1-W images. They could be identified as intradural and extramedullary in origin based on a broad-based dural margin seen on at least one of the imaging planes and a gradual expansion of the subarachnoid space cranial and caudal to the mass, best noted on the transverse and dorsal plane images. On dorsal plane T2-W images in three dogs, expansion of the subarachnoid space adjacent to the mass appeared similar to the myelographic "golf tee" sign. All meningiomas exhibited moderate, well-defined contrast enhancement with dural tails seen in three of the four dogs. One dog had extension into the intervertebral foramen along the nerve and ipsilateral atrophy of the muscles of the neck. By differentiating the meningiomas from intramedullary tumors and by clearly depicting the extent of the masses, MRI provided valuable information about treatment options and prognosis.