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.     

18FDG-PET IMAGING IN CANINE LYMPHOMA AND CUTANEOUS MAST CELL TUMOR

Positron Emission Tomography (PET) using the glucose analog 2-deoxy-2-[¹⁸F]fluoro- d -glucose (¹⁸FDG) is a common imaging modality for diagnosis and management of many human malignancies. We evaluated ¹⁸FDG-PET in dogs with either multicentric lymphoma (LSA) or cutaneous mast cell tumor (MCT). A prototype large field-of-view PET scanner was used to collect whole-body images in nine dogs with LSA or MCT. Both tumors were characterized by avidity for ¹⁸FDG. In dogs with LSA, ¹⁸FDG-PET correctly identified involvement of superficial and internal lymph nodes, liver, and spleen. Repeated PET scans after induction chemotherapy demonstrated resolution of abnormal ¹⁸FDG uptake within these sites. In dogs with MCT, ¹⁸FDG-PET correctly identified MCT metastasis to regional lymph nodes in all dogs in which this was suspected or confirmed with cytology or biopsy before the PET scan. In two dogs, additional sites of mast cell disease were identified with ¹⁸FDG-PET that were undetected on physical examination and/or regional lymph node cytology. ¹⁸FDG-PET holds promise as a whole-body staging method for canine LSA and MCT.     

SPINAL MAST CELL TUMORS IN DOGS: IMAGING FEATURES AND CLINICAL OUTCOME OF FOUR CASES

Published information regarding canine vertebral column mast cell tumors (MCTs) is limited. The objectives of this study were to report clinical and advanced imaging findings for a group of dogs with confirmed spinal MCT. Inclusion criteria for this retrospective case series were dogs with spinal magnetic resonance imaging (MRI) or computed tomography (CT) scans and a histological diagnosis of spinal MCT. Clinical, imaging, treatment, and outcome data were recorded. Four dogs met inclusion criteria. One dog had primary spinal MCT and three dogs had metastatic spinal MCT. All four dogs presented for paraspinal hyperesthesia and subacute progressive or acute myelopathy. All CT and MRI lesions were extradural. Two cases exhibited distinct masses in the epidural space. In one case, an epidural tumor invaded from the paravertebral musculature. One case exhibited polyostotic lesions indistinguishable from multiple myeloma by MRI. One dog with a primary epidural low‐grade MCT remains clinically normal 4 years postoperatively, following adjunctive lomustine. An epidural high‐grade MCT, metastatic from a cutaneous tumor, recurred within 2 months of surgery despite adjunctive vinblastine. Two high‐grade cases with concurrent visceral involvement were euthanized immediately after imaging. In dogs, MCT should be considered as a differential diagnosis for a progressive painful myelopathy and CT or MRI evidence of an extradural spinal lesion (epidural, paravertebral, or polyostotic). While more often associated with cutaneous or disseminated disease, MCT may also occur as a primary tumor of the epidural space in dogs.     

MAGNETIC RESONANCE IMAGING OF ACQUIRED TRIGEMINAL NERVE DISORDERS IN SIX DOGS

The medical records and magnetic resonance (MR) images of dogs with an acquired trigeminal nerve disorder were reviewed retrospectively. Trigeminal nerve dysfunction was present in six dogs with histologic confirmation of etiology. A histopathologic diagnosis of neuritis (n=2) or nerve sheath tumor (n=4) was made. Dogs with trigeminal neuritis had diffuse enlargement of the nerve without a mass lesion. These nerves were isointense to brain parenchyma on T1-weighted (T1W) precontrast images and proton-density-weighted (PDW) images and either isointense or hyperintense on T2-weighted (T2W) images. Dogs with a nerve sheath tumor had a solitary or lobulated mass with displacement of adjacent neuropil. Nerve sheath tumors were isointense to the brain parenchyma on T1W, T2W, and PDW images. All trigeminal nerve lesions enhanced following contrast medium administration. Atrophy of the temporalis and masseter muscles, with a characteristic increase in signal intensity on T1W images, were present in all dogs.     

MAGNETIC RESONANCE IMAGING FEATURES OF INTRACRANIAL GRANULAR CELL TUMORS IN SIX DOGS

Magnetic resonance (MR) imaging characteristics of intracranial granular cell tumors (GCTs) have been previously reported in three dogs. The goal of this retrospective study was to examine a larger number of dogs and determine whether distinctive MR characteristics of intracranial GCTs could be identified. Six dogs with histologically confirmed intracranial GCTs and MR imaging were included. Tumor location, size, mass effect, T1‐ and T2‐weighted signal intensity, and peritumoral edema MR characteristics were recorded. In all dogs, GCTs appeared as well‐defined, extra‐axial masses with a plaque‐form, sessile distribution involving the meninges. All tumors were located along the convexity of the cerebrum, the falx cerebri, or the ventral floor of the cranial vault. All tumors were mildly hyperintense on T1‐weighted images, and iso‐ to hyperintense on T2‐weighted images. A moderate‐to‐severe degree of peritumoral edema and mass effect were evident in all dogs. Findings indicated that, while several MR imaging characteristics were consistently identified in canine cerebral GCTs, none of these characteristics were unique or distinctive for this tumor type alone.     

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.     

Canine insulinomas appear hyperintense on MRI T2‐weighted images and isointense on T1‐weighted images

Clinical and imaging diagnosis of canine insulinomas has proven difficult due to nonspecific clinical signs and the small size of these tumors. The aim of this retrospective case series study was to describe MRI findings in a group of dogs with pancreatic insulinomas. Included dogs were presented for suspected pancreatic insulinoma, MRI was used to assist with localization of the primary lesion, and the diagnosis was confirmed with surgical exploratory laparotomy and histopathology. The MRI studies for each dog were retrieved and the following data were recorded: T1‐weighted and T2‐weighted signal intensities, type of contrast enhancement, size and location of the primary lesion, and characteristics of metastatic lesions (if present). A total of four dogs were sampled. In all patients, the insulinoma displayed high‐intensity signal on T2‐weighted fat saturation images, similar to human studies. On postcontrast T1‐weighted fat saturation images, the tumors were primarily isointense to normal pancreatic tissue, in contrast to human studies where a low‐intensity signal is typically identified. Abnormal islet tissue was detected with MRI in all four dogs and metastases were identified in three dogs. Variations in the MRI appearance of primary and metastatic lesions were identified and could have been related to the variation of tissue composition, including the presence of neoplastic cells, hemorrhage, and fibrovascular stroma, and to the transformation of this tissue throughout the disease process.     

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).     

Pilot study to evaluate the efficacy of lymphotropic nanoparticle enhanced MRI for diagnosis of metastatic disease in canine head and neck tumours

This pilot study is designed to determine if lymphotropic nanoparticle enhanced MRI (LNMRI) is a viable technique for staging of naturally occurring canine malignant head and neck tumours. Previous imaging studies in veterinary medicine have shown variable sensitivity and specificity for determining metastasis for local lymph nodes in head and neck tumours. LNMRI utilizes ultra‐small superparamagnetic iron oxide nanoparticles (USPIOs) to help in the detection of metastatic disease in lymph nodes. USPIOs are phagocytized and localized to normal lymph nodes where they assist in evaluation for regions of effacement by cancerous cells. Six dogs underwent LNMRI for the diagnosis of metastatic lymph nodes. A truncated MRI consisting of transverse images of T2, T1 pre‐ and post‐contrast and T2* sequences were evaluated for presence of metastasis. Sentinel lymph nodes and lymph nodes with possible metastatic lesions were surgically excised for histological evaluation. In the initial phase of this study, 24 lymph nodes were included in analysis. Subjective observation by the primary investigator had a calculated sensitivity and specificity of 100% and 88% based on histological results. There were no negative side effects to the USPIOs noted in the limited number of patients in this study. Percentage signal intensity loss was calculated and found to be significantly different between metastatic and non‐metastatic lymph nodes (P‐value = .038). In conclusion, this pilot study shows that LNMRI has the potential to be a sensitive and specific method of diagnosing lymph node metastasis. Further research is warranted to determine if this method is clinically applicable and accurate.     

Material in the middle ear of dogs having magnetic resonance imaging for investigation of neurologic signs

The aim of this study was to determine the prevalence and potential significance of finding material in the middle ear of dogs having magnetic resonance (MR) imaging. Of 466 MR studies reviewed, an increased signal was identified in the tympanic bulla in 32 (7%) dogs. Cavalier King Charles spaniels, Cocker spaniels, Bulldogs, and Boxers were over-represented compared to the population of dogs having MR imaging. Five (16%) dogs had definite otitis media and one (3%) had a meningioma invading the middle ear. Of the remaining dogs, 13 (41%) had possible otitis media and 13 (41%) had neurologic conditions apparently unrelated to otitis media. The most common appearance of material in the middle ear was isointense in T1-weighted images and hyperintense in T2-weighted images. There was no apparent correlation between the signal characteristics of the material and the diagnosis. Enhanced signal after gadolinium administration was observed affecting the lining of the bulla in dogs with otitis media and in dogs with unrelated neurologic conditions. In dogs without clinical signs of otitis media, finding an increased signal in the middle ear during MR imaging may reflect subclinical otitis media or fluid accumulation unrelated to inflammation. Brachycephalic dogs may be predisposed to this condition.     

Visceral mast cell tumors in dogs: 10 cases (1982-1997)

OBJECTIVE: To characterize the clinical features of visceral mast cell tumors (MCT) without associated cutaneous involvement in dogs. DESIGN: Retrospective study. ANIMALS: 10 dogs with histologically confirmed MCT without associated cutaneous lesions. PROCEDURE: Information on signalment, clinical signs, laboratory examinations, and time from first admission to death was obtained from the medical record of each dog. RESULTS: Purebred male dogs of miniature breeds appeared to have a higher prevalence of visceral MCT. Clinical signs included anorexia, lethargy, vomiting, and diarrhea. Anemia (n = 7), hypoproteinemia (5), and mastocythemia (5) were detected. Treatments, including glucocorticoids, were not successful. Primary sites of tumors were the gastrointestinal tract (n = 6) and the spleen or liver (1); the primary site was not confirmed in the remaining 3 dogs. In 7 dogs, tumors were categorized as grade II or III, on the basis of histologic findings. The prognoses were poor, and all dogs died within 2 months after first admission. CONCLUSIONS AND CLINICAL RELEVANCE: Visceral MCT is uncommon in dogs, and the prognosis is extremely poor. Biological behavior and drug susceptibility of visceral MCT may be different from cutaneous MCT. The lack of specific clinical signs may result in delay of a definitive diagnosis. The rapid progression of clinical signs and difficulty in diagnosis contributes to a short survival time.     

MAGNETIC RESONANCE IMAGING FEATURES OF MULTILOBULAR OSTEOCHONDROSARCOMA IN 3 DOGS

Three dogs with multilobular osteochondrosarcoma of the skull were evaluated using magnetic resonance (MR) imaging. Spin echo T1, T2, proton weighted and post contrast T1W images were obtained with a 1.5 Tesla magnet. The MR imaging findings were similar in all three dogs with mixed signal intensities in the T1W, T2W and proton weighted images and fairly large areas of contrast enhancement in the post contrast T1W images. The extent of brain and soft tissue involvement were well delineated and provided useful information concerning surgical planning. MR imaging provided a useful method of evaluating dogs with skull tumors.     

Magnetic resonance imaging characterization of vertebral endplate changes in the dog

Spinal MR images acquired from canine patients over a 7-year period were reviewed for the presence of vertebral endplate changes. Seventy-five dogs with 76 distinct lesions were identified. Presumptive diagnoses fell into five categories: reactive endplate changes (10 dogs/13.2%), discospondylitis (29 dogs/38.2%), vertebral osteochondrosis (7 dogs/9.2%), intravertebral disc herniation (Schmorl's nodes) (4 dogs/5.3%), and fatty infiltration (26 dogs/34.2%). Fatty infiltration occurred significantly more often in small breed dogs (P < 0.001) and tended to be multifocal. The following features were observed in discospondylitis as well as in other nonfatty endplate pathologies: irregular endplates, endplate hyperintensity in T2w or STIR images, reduced endplate signal intensity in T1w SE, variable T1w GRE signal intensity, and endplate contrast enhancement. Overlap between MR characteristics of nonfatty endplate changes should prompt cautious evaluation of adjacent structures.     

MAGNETIC RESONANCE IMAGING FINDINGS IN THE SPINE OF SIX DOGS DIAGNOSED WITH LYMPHOMA

Lymphoma is one of the most common neoplasms in the dog. Despite its prevalence and the increasing use of advanced diagnostic imaging in veterinary patients only few reports of magnetic resonance imaging (MRI) findings in spinal lymphoma have been published to date. The purpose of this retrospective case series study was to describe the MRI findings in dogs with confirmed lymphoma affecting the spine and/or paraspinal soft tissues. Medical records were searched for patients that had MRI of the spine and a diagnosis of lymphoma during the period of 2005–2015. Data recorded from retrieved MRI studies were presence of focal or multifocal disease, structures involved, and signal characteristics on T2‐W, short tau inversion recovery (STIR), and T1‐W sequences prior to and following intravenous contrast medium administration. Six dogs met the inclusion criteria. Common findings included multifocal disease (4/6), vertebral involvement (5/6), spinal cord compression (4/6), and involvement of more than one spinal compartment (medullary cavity, vertebral canal, paraspinal soft tissues) (6/6). Vertebral changes were confined to the medullary cavity without evidence of cortical osteolysis. There was questionable involvement of the spinal cord in one case. All spinal and paraspinal lesions identified were T2‐W isointense to hyperintense, STIR hyperintense, T1‐W hypointense to isointense, and showed variable moderate to strong contrast enhancement. Additional lesions identified were enlarged intraabdominal lymph nodes, hepatomegaly, splenomegaly, and a splenic nodule. The STIR and T1‐W postcontrast sequences were subjectively the most useful in identification of the spinal and paraspinal lesions.     

Magnetic resonance imaging findings of spinal intramedullary spirocercosis

Spirocerca lupi is a nematode infecting dogs in tropical and subtropical areas. Aberrant S. lupi migration to different body organs, including the spinal cord, has been documented. To date, the diagnosis of aberrant spinal cord migration was made at post-mortem examination or as an incidental finding, during spinal surgery. We describe two dogs with acute asymmetric paraparesis that were subsequently diagnosed with spinal cord spirocercosis. In magnetic resonance (MR) images of the spine, T2 hyperintense lesions were seen in the spinal cord of both dogs. The lesions appeared isointense on T1-weighted images and focal enhancement was detected after gadolinium administration. The MR imaging findings were compatible with focal inflammation, presumably along the parasite migration tract. Gross and microscopic pathologic findings confirmed the diagnosis of aberrant spinal intramedullary migration of S. lupi in one dog, and in the other dog, the clinical and imaging findings were supportive of this diagnosis.     

IMAGING DIAGNOSIS: CRANIAL CERVICAL INTRASPINAL SCHWANNOMA IN A DOG

A 3‐year‐old, intact female Golden Retriever was presented with acute tetraplegia. Neurologic examination was consistent with a C1–C5 myelopathy. On magnetic resonance (MR) imaging a well‐defined, extradural mass was detected within the spinal canal at the level of C1–C2. The mass was isointense to normal spinal cord gray matter on T1‐weighted (T1W) images, hyperintense on T2‐weighted (T2W), and gradient‐echo (GE) images, and enhanced homogeneously after intravenous contrast administration. MR imaging features were mainly consistent with a meningioma. Surgical treatment was refused by the owners, and the dog was euthanized. Postmortem examination demonstrated that the intraspinal mass was a schwannoma.     

Magnetic resonance imaging of the femoral head of normal dogs and dogs with avascular necrosis.

The purpose of this study was to describe the appearance of the femoral head of normal, young, small breed dogs, and dogs with avascular necrosis using low-field (0.3 T) magnetic resonance (MR) imaging. Images of the femoral heads were obtained in the dorsal plane, and included T1-weighted spin-echo, T2-weighted fast spin-echo, fast spin echo-inversion recovery, and fluid attenuated inversion recovery pulse sequences. MR imaging features of the asymptomatic femoral heads and necks included uniform high signal intensity compared with muscle on T1- and T2-weighted images. There was either uniform enhancement or no enhancement on postcontrast T1-weighted images. The MR imaging findings of dogs affected with avascular necrosis differed from those of asymptomatic dogs. Typically, the affected dogs had inhomogeneous intermediate to low-signal intensity within the femoral head and neck compared with muscle on T1-weighted images, inhomogeneous enhancement of the femoral head and/or neck on postcontrast T1-weighted images, and inhomogeneous low- to high- signal intensity within the femoral head and neck on T2-weighted images.     

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.     

MAGNETIC RESONANCE IMAGING OF NORMAL CANINE CARPAL LIGAMENTS

Magnetic resonance imaging was conducted on previously frozen left carpi from six normal dogs using a 1.5 Tesla magnet in combination with a transmit/receive wrist coil. Three-millimeter thick T1-weighted spin-echo images and 1-mm thick T2*-weighted gradient-recalled 3-D images were obtained in dorsal and sagittal planes. Carpi were embedded, sectioned, and stained. Anatomic structures on the histologic sections were correlated with the MR images. All of the carpal ligaments plus the radioulnar articular disc and the palmar fibrocartilage were identified on MR images. The accessorio-quartile ligament, which had not been well described previously in dogs, was also identified. It originated on the accessory carpal bone and inserted on the fourth carpal bone. The T2*-weighted gradient echo imaging technique provided better images than T1-weighted technique, largely because thinner slices were possible (1 mm vs. 3 mm), resulting in less volume averaging of thin ligaments with surrounding structures. Although MRI is currently the imaging modality of choice to identify ligamentous injury in humans, further studies are needed to determine if abnormalities can be detected in canine carpal ligaments using MRI.