COMPUTED TOMOGRAPHY OF NECROTIZING MENINGOENCEPHALITIS IN 3 YORKSHIRE TERRIERS

A necrotizing meningoencephalitis of Yorkshire terriers has recently been reported in 6 dogs in Switzerland, 1 dog in Japan and 1 dog in the United States. The purpose of this report is to describe the computed tomographic (CT) findings in 3 dogs with this disease, and to correlate the CT abnormalities with the clinical and pathologic findings in each case. Three Yorkshire Terriers between 2 and 10 years old were evaluated. Physical and neurologic examinations, complete blood count (CBC), serum biochemistry profile, cerebrospinal fluid analysis, and CT scan were performed on all 3 dogs. Brainstem auditory evoked responses (BAER) were evaluated for 2 dogs. Two dogs were euthanized at the owners' request and necropsies were performed. Neurologic examination findings were consistent with a multifocal/diffuse encephalitis involving the cerebrum and brainstem in all 3 dogs. Complete blood count and biochemistry profiles were normal. Elevated protein concentration and a mononuclear pleocytosis were demonstrated in 2 of 3 dogs on cerebrospinal fluid evaluation. Multifocal, extensive areas of decreased opacity throughout the cerebral hemispheres, asymmetric ventriculomegaly, and lack of contrast enhancement were appreciated on CT images of all three dogs. No mass effect was seen. These findings correlated well with pathologic findings at necropsy, which included multiple malacic cavitations within the brain, representing areas of locally extensive necrosis. CT abnormalities in combination with signalment, clinical findings and cerebrospinal fluid analysis should facilitate a presumptive diagnosis of Yorkshire Terrier necrotizing meningoencephalitis.     

POSITRON EMISSION TOMOGRAPHY OF THE EQUINE DISTAL LIMB: EXPLORATORY STUDY

Positron emission tomography (PET) is a highly sensitive, noninvasive imaging technique for quantifying biological functions of tissues. However, at the time of this study, PET imaging applications had not been reported in the horse. The aim of this exploratory study was to determine whether a portable high‐resolution PET scanner could be used to image the equine distal limb. Images of the front feet and fetlocks of three research horses, with known lesions localized to the distal front limbs, were acquired under general anesthesia after administration of ¹⁸F‐fluorodeoxyglucose (¹⁸F‐FDG), with doses ranging from 1.5 to 2.9 MBq/kg. The radiation exposure measured during imaging was slightly higher than ^99mTechnetium scintigraphy. However, the use of general anesthesia allowed the proximity and the contact time with the patient to be minimized for the staff involved. ¹⁸F‐FDG uptake was evident throughout the soft tissues, with the highest uptake in the coronary band and the lowest uptake in the tendons. Anatomic structures could be discriminated due to the high contrast between soft tissue and bone. Detected lesions included lysis of the flexor cortex of the navicular bone, lesions of flexor tendons and suspensory ligament, and abnormal uptake through the lamina of a laminitic subject. Findings indicated that tomographic molecular imaging is feasible in the equine distal limb and could be useful as a future diagnostic technique for clinical and research studies, especially those involving tendinopathy/desmopathy and laminitis.     

MAGNETIC RESONANCE IMAGING AND COMPUTED TOMOGRAPHY CHARACTERISTICS OF INTRACRANIAL INTRA-ARACHNOID CYSTS IN 6 DOGS

Magnetic resonance imaging (MRI) and computed tomographic imaging (CT) characteristics of intracranial intra-arachnoid cysts in six dogs are described.Of the six dogs, three were less than one year of age and 4 were males. Five of the six dogs weighed less than 11 kg. Five cysts were located in the quadrigeminal cistern.On CT images, the intracranial intra-arachnoid cysts had sharply defined margins, contained fluid isodense to CSf and did not enhance following IV administration of contrast. On MRI images, the intracranial intra-arachnoid cysts were extra-axial, contained fluid isointense with CSF and did not enhance following IV contrast. While spinal arachnoid cysts of dogs have been reported in the literature, other than the six dogs contained in this report, intracranial intra-arachnoid cysts have not to our knowledge been described in animals. These six dogs have a similar age, sex, arachnoid cysts.     

DIFFUSION‐WEIGHTED MAGNETIC RESONANCE IMAGING OF THE NORMAL CANINE BRAIN

Diffusion‐weighted imaging (DWI) MRI has been primarily reported as a method for diagnosing cerebrovascular disease in veterinary patients. In humans, clinical applications for diffusion‐weighted MRI have also included epilepsy, Alzheimer's, and Creutzfeld–Jakob disease. Before these applications can be developed in veterinary patients, more data on brain diffusion characteristics are needed. Therefore, the aim of this study was to evaluate the distribution of diffusion in the normal canine brain. Magnetic resonance imaging of the brain was performed in ten, clinically normal, purpose‐bred beagle dogs. On apparent diffusion coefficient maps, regions of interest were drawn around the caudate nucleus, thalamus, piriform lobe, hippocampus, semioval center, and cerebral cortex. Statistically significant differences in mean apparent diffusion coefficient were found for the internal capsule, hippocampus, and thalamus. The highest apparent diffusion coefficient (1044.29 ± 165.21 μm²/s (mean ± SD (standard deviation)) was detected in the hippocampus. The lowest apparent diffusion coefficient was measured in the semioval center (721.39 ± 126.28 μm²/s (mean ± SD)). Significant differences in mean apparent diffusion coefficients of the caudate nucleus, thalamus, and piriform lobe were found by comparing right and left sides. Differences between brain regions may occur due to differences in myelination, neural density, or fiber orientation. The reason for the differences between right and left sides remains unclear. Data from the current study provide background for further studies of diffusion changes in dogs with brain disease.     

RETROSPECTIVE STUDY EVALUATING ASSOCIATIONS BETWEEN MIDLINE BRAIN SHIFT ON MAGNETIC RESONANCE IMAGING AND SURVIVAL IN DOGS DIAGNOSED WITH MENINGOENCEPHALITIS OF UNKNOWN ETIOLOGY

Difficulty has been encountered when trying to identify ante mortem prognostic indicators for dogs with meningoencephalitis of unknown etiology (MUE). Identifying MRI imaging parameters associated with prognosis may impact treatment decision‐making for clinician and owner. Our hypotheses for this retrospective cohort study are that dogs diagnosed with MUE that had midline shift on brain MRI would have a poorer survival compared to dogs without midline shift; and that younger age, lower weight, and low cerebrospinal fluid (CSF) cell count would be correlated with improved survival. Medical records were reviewed from two institutions. Inclusion criteria included: clinical signs referable to intracranial disease, brain MRI at presentation, abnormal CSF analysis, and negative infectious disease testing. Magnetic resonance imaging scans were evaluated for midline shift using the T2‐weighted transverse image at the interthalamic adhesion and at the site of maximal deviation. Fifty‐two dogs met the inclusion criteria. Median midline deviation was 0.12 cm. Median survival for dogs with no shift was 906 days and with shift was 84 days. Survival was not significantly different between groups (P = 0.11). This remained true when correcting for age (P = 0.22) and CSF TNCC (total nucleated cell count) (P = 0.12). Age at the time of diagnosis (P = 0.02) and CSF TNCC (P = 0.03) were significantly associated with survival. Cerebrospinal fluid protein value (P = 0.84) and weight (P = 0.82) were not significantly associated with survival. In this study of 52 dogs with MUE, MRI evidence of midline brain shift between 0.04 and 0.3 cm at the level of the interthalamic adhesion was not associated with shorter survival.     

MEASUREMENT OF TUMOR HYPOXIA IN SPONTANEOUS CANINE SARCOMAS

We used positron emission tomography (PET) with [18F]fluoromisonidazole ([18F]FMISO) to study tumor hypoxia in six dogs with spontaneous sarcomas. The tumors were regarded as hypoxic if [18F]FMISO uptake exceeded normal tissue radioactivity by 40% (tumor/muscle ratio > 1.4) or if kinetic analysis indicated a positive [18F]FMISO tissue influx rate (Ki > 0) by a Patlak plot. Using these criteria, we found hypoxia in a fibrosarcoma grade II, an undifferentiated sarcoma, and an ostoeosarcoma, but not in a fibrosarcoma grade I, another osteosarcoma, and a myxosarcoma. In three animals, the tumor oxygen partial pressure (pO2) was also measured invasively using Eppendorf needle electrodes. In these cases, the Eppendorf measurements were confirmed by the [18F]FMISO PET results. In addition, [15O]H2O PET was performed in four dogs in order to assess tumor perfusion. Comparisons of the [18F]FMISO with [15O]H2O PET images in two cases showed that tumor hypoxia occurred in the tumor center with low perfusion, whereas perfusion was heterogeneous in a nonhypoxic tumor.     

MAGNETIC RESONANCE IMAGING OF CANINE DEGENERATIVE LUMBAR SPINE DISEASES

Degenerative lumbar spine diseases, i.e., sacrolumbar stenosis, intervertebral disk degeneration and protrusion and spondylosis deformans of the canine lumbar spine were studied in eleven canine patients and three healthy controls using radiography and 0.02 T and 0.04 T low field magnetic resonance imaging. The T1 and T2 weighted images were obtained in sagittal and transverse planes. The loss of hydration of nucleus pulposus, taken as a sign of degeneration in the intervertebral disks, could be evaluated in both T1 and T2 weighted images. As a noninvasive method magnetic resonance imaging gave more exact information about the condition of intervertebral disks than did radiography. Sacrolumbar stenosis and compression of the spinal cord or cauda equina and surrounding tissue could be evaluated without contrast medium.     

TOMY OF THE CANINE BRAIN USING HIGH RESOLUTION OMPUTED TOMOGRAPHY*

High resolution computed tomography (CT) was used to determine the normal appearance of the brain of an adult Beagle dog. Objects as small as 0.6 mm for bony structures (high contrast) and 1.5–2.0 mm for soft tissue structures (low contrast) could be resolved in the CT images. Multiplanar imaging using direct transverse and reformatted dorsal and sagittal images made it possible to obtain a three dimensional presentation of anatomy. Selective viewing, where CT number window and level settings were varied, was used to optimize visualization of specific brain structures. Normal high contrast components, cerebrospinal fluid, and osseous land-marks, were important aids in identification of various intracranial structures. Quantitative densitometry was performed to characterize various regions of the brain in terms of their x-ray attenuation values or CT numbers. This study indicated that high resolution CT provides a qualitative and quantitative appraisal of the canine brain that is unavailable using conventional radiographic technics.     

IMAGING DIAGNOSIS—NECROTIZING MENINGOMYELITIS AND POLYARTHRITIS

A vaccinated 2-year-old female neutered Weimaraner had bilateral pelvic limb ataxia that progressed over 12 h. The dog became nonambulatory, with signs of pain on palpation of the lumbar spine. The dog also developed multiple joint effusions. On magnetic resonance (MR) imaging, there was a diffuse, asymmetric T2-hyperintensity in the thoracolumbar spinal cord which was characterized by contrast enhancement. Lumbar cerebrospinal fluid (CSF) analysis had an elevated white blood cell count and protein. On the basis of MR images and CSF analysis, a presumptive diagnosis of diffuse myelitis was made. The dog became paraplegic and was euthanized. Postmortem examination confirmed the presence of myelitis with vasculitis and nonerosive polyarthritis.     

LOW-FIELD MAGNETIC RESONANCE IMAGING OF THE CANINE MIDDLE AND INNER EAR

A series of low-field magnetic resonance images of the normal canine middle and inner ear are presented to serve as a reference. A completely balanced steady-state gradient echo pulse sequence with a slice thickness of 0.9 mm can be used to acquire images of the relevant structures within and neighboring the inner ear. These were the cochlear duct, semicircular ducts, vestibule, facial and vestibulocochlear nerves, as well as the temporal sinus. Within the middle ear, no applied sequence was able to allow identification of the auditory ossicles or the tympanic membrane.     

MRI FEATURES OF GASTROCNEMIUS MUSCULOTENDINOPATHY IN HERDING DOGS

Pelvic limb lameness that was localized clinically to the lateral gastrocnemius head was observed in dogs without history of trauma. The aim of this retrospective study was to describe magnetic resonance imaging (MRI) findings of this condition. Nine dogs were identified, eight Border Collies and one Australian Shepherd. They all had chronic pelvic limb lameness; no signs of joint effusion or instability were present. In MR images there was high signal intensity in the lateral head of the gastrocnemius muscle around the sesamoid bone in T2‐weighted, T2^*‐weighted, and STIR images and an iso‐ to mildly hyperintense signal in T1‐weighted images with marked contrast enhancement. The abnormal signal intensity most likely represents a myotendinous strain. The breed affiliation to Border Collies is striking, and a relation to biomechanical forces or motion pattern may be possible. Except for the dog with the most extensive lesion all dogs had an excellent outcome.     

APPEARANCE OF THE CANINE MENINGES IN SUBTRACTION MAGNETIC RESONANCE IMAGES

The canine meninges are not visible as discrete structures in noncontrast magnetic resonance (MR) images, and are incompletely visualized in T1‐weighted, postgadolinium images, reportedly appearing as short, thin curvilinear segments with minimal enhancement. Subtraction imaging facilitates detection of enhancement of tissues, hence may increase the conspicuity of meninges. The aim of the present study was to describe qualitatively the appearance of canine meninges in subtraction MR images obtained using a dynamic technique. Images were reviewed of 10 consecutive dogs that had dynamic pre‐ and postgadolinium T1W imaging of the brain that was interpreted as normal, and had normal cerebrospinal fluid. Image‐anatomic correlation was facilitated by dissection and histologic examination of two canine cadavers. Meningeal enhancement was relatively inconspicuous in postgadolinium T1‐weighted images, but was clearly visible in subtraction images of all dogs. Enhancement was visible as faint, small‐rounded foci compatible with vessels seen end on within the sulci, a series of larger rounded foci compatible with vessels of variable caliber on the dorsal aspect of the cerebral cortex, and a continuous thin zone of moderate enhancement around the brain. Superimposition of color‐encoded subtraction images on pregadolinium T1‐ and T2‐weighted images facilitated localization of the origin of enhancement, which appeared to be predominantly dural, with relatively few leptomeningeal structures visible. Dynamic subtraction MR imaging should be considered for inclusion in clinical brain MR protocols because of the possibility that its use may increase sensitivity for lesions affecting the meninges.     

A REVIEW OF IMAGING TECHNIQUES FOR CANINE CAUDA EQUINA SYNDROME

There are many imaging modalities available for evaluating the canine lumbosacral region. These include conventional radiography, stress radiography, myelography, epidurography, transosseous and intravenous venography, discography, linear tomography, computed tomography, and magnetic resonance imaging. Myelography, epidurography and discography are commonly used, but often lack sensitivity. Myelography is of little value when evaluating the cauda equina because the dural sac is elevated from the vertebral canal floor and frequently ends before the lumbosacral junction. Epidurography will identify a ventrally located compressive lesion and discography can delineate the dorsal extent of the diseased disc; however, both are sometimes difficult to interpret. Therefore, more than one of these imaging techniques must be used in order to make a diagnosis. Computed tomography and magnetic resonance imaging have become valuable in evaluating the lumbosacral region in dogs. These modalities have proven to be both sensitive and specific for determining cauda equina compression in both humans and in dogs.     

MAGNETIC RESONANCE IMAGING FEATURES OF PRIMARY BRAIN TUMORS IN DOGS

Magnetic resonance images of twenty-five dogs with histopathologically confirmed primary brain tumors were evaluated. A lesion was visible in each dog. Meningiomas were extra-axial lesions that enhanced markedly withj gadolinium-DTPA. Glimas were Characteized by intra-axial location, significant mass effect and surrounding edema, and variable enhancement patterns. Choroid plexus tumors and pituitary tumors were differentiated by their location and marked enbancement. Prediction of general typeof tumor was correct in 24 of 25 dogs.     

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.     

COMPUTED TOMOGRAPHY OF CANINE ELBOW JOINTS AFFECTED BY PRIMARY AND CONCOMITANT FLEXOR ENTHESOPATHY

Flexor enthesopathy is an important differential diagnosis for elbow lameness in dogs. The disorder can be a primary cause of elbow lameness or concomitant with other elbow pathology. Since treatment differs for primary and concomitant forms of flexor enthesopathy, a noninvasive method for distinguishing between them is needed. In the current prospective study, computed tomographic (CT) examination was performed before and after IV injection of contrast in 17 dogs with primary flexor enthesopathy, 24 dogs with concomitant flexor enthesopathy, 13 dogs with elbow dysplasia, and seven normal dogs. Dogs were assigned to groups based on results of clinical examination and at least three other imaging modalities. Computed tomographic lesions consistent with flexor enthesopathy were found in all clinically affected joints with primary flexor enthesopathy and in 29 of the 30 clinically affected joints with concomitant flexor enthesopathy. Those lesions were not found in sound elbows or joints affected by elbow dysplasia. Flexor lesions detected in dogs with primary flexor enthesopathy were not significantly different from those detected in dogs with the concomitant form. Findings indicated that CT can be applied to detect flexor enthesopathy, but a distinction between the primary and concomitant forms was not always possible. Authors recommend the use of multiple diagnostic techniques for treatment planning in affected dogs.     

MAGNETIC RESONANCE IMAGING FEATURES OF PARASPINAL INFECTION IN THE DOG AND CAT

The magnetic resonance (MR) imaging findings in 22 dogs and two cats with confirmed paraspinal infection of the thoracolumbar spine were characterized. These findings included extensive T2-hyperintense areas (24/24), abscessation (20/24), mild inherent T1-hyperintensity of muscle and abscesses (18/24), and postcontrast enhancement (24/24). Changes involved the vertebral canal in four patients. The longus coli muscles were affected in one cat. Thoracolumbar changes in the remaining 23 patients involved the iliopsoas and epaxial muscles in 23/23 and 19/23 patients, respectively. Iliopsoas muscle abscessation was unilateral in 12/23, and bilateral in 6/24 patients. Abscessation involved both epaxial and iliopsoas muscles in 2/23 patients and the epaxial muscles alone in one patient. A contrast-enhancing sinus tract within the deep thoracolumbar fascia was present in 10/23 patients. Lumbar vertebrae periosteal reactions were identified in 19/23 patients on MR images compared with 15/17 patients with radiography. A focal area of signal void suspected to represent foreign material was seen in 5/23 patients but foreign material was actually found in only two of these five. There was no recurrence of clinical signs following MR imaging and revision surgery. MR imaging permits the severity and extent of changes associated with paraspinal infection to be characterized and allows the location, number and any communication of sinus tracts to be documented.     

COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING OF CAVERNOUS SINUS ENLARGEMENT IN A DOG WITH UNILATERAL EXOPHTHALMOS

Computed tomography (CT), magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were performed on a dog with a two year history of unilateral exophthalmos occurring two years following head trauma. On CT images, an expansile enhancing mass was present along the right intracranial cavernous sinus and extended through the orbital fissure into the retrobulbar space. With MRI, the structure appeared as a signal void due to the presence of rapidly flowing blood. Gadolinium enhancement of the adjacent brain was not present. A vascular origin of the lesion was confirmed with MRA. Based on the CT and MRI findings, the enlarged cavernous sinus and associated ophthalmic plexus were believed to represent an arterialized aneurysm, most likely the result of traumatic arteriovenous fistulization. Treatment consisted of surgical enucleation. At the time of this report, 29 mouths later, the dog remains free of clinical signs.     

APPEARANCE OF CANINE ABDOMINAL TUMORS WITH MAGNETIC RESONANCE IMAGING USING A LOW FIELD PERMANENT MAGNET

The study was carried out to evaluate the applicability of magnetic resonance imaging (MRI) in detecting tumors in the abdomen of the dog. Abdominal ultrasound and MRI were performed on 8 dogs having a mass lesion on abdominal radiography. MR images were obtained in the transverse, sagittal and dorsal planes using T1- and T2-weighted spin echo pulse sequences. There was good visual correlation of the lesion site by MRI and ultrasonography (US).