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.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING OF DIFFUSE LEPTOMENINGEAL OLIGODENDROGLIOMATOSIS IN A DOG WITH “DURAL TAIL SIGN”

A case of diffuse leptomeningeal oligodendrogliomatosis affecting the brain and spinal cord of a dog is presented. A 7.5‐year old, male neutered Staffordshire bull terrier presented for evaluation of a chronic history of tetraparesis and seizures, with a multifocal neuroanatomical localization was determined. Extra‐axial intradural lesions with an atypical presentation of a dural tail sign were seen on MRI. Histologically, the lesions were consistent with leptomeningeal oligodendrogliomatosis. To the authors’ knowledge, a dural tail sign has not previously been reported as an MRI characteristic of diffuse leptomeningeal oligodendrogliomatosis in dogs.     

LOW-FIELD MAGNETIC RESONANCE IMAGING OF A PYOCEPHALUS AND A SUSPECTED BRAIN ABSCESS IN A GERMAN SHEPHERD DOG

Magnetic resonance imaging was performed on an eight-year-old, neutered female German Shepherd dog with a history of acute depression, inappetence, and hyperthermia. A lesion in the cerebrum was suspected. Possible differential diagnoses were meningoencephalitis, neoplasia, and vascular lesion (infarction, bleeding). A ring enhancing lesion was found in the basal ganglia on the left side with edema of the surrounding brain tissue. A similar mass lesion was present in the right pterygoid musculature. With inversion recovery sequences an altered composition of the cerebrospinal fluid (CSF) in the left lateral ventricle could be detected. CSF analysis confirmed a pyocephalus, probably due to rupture of a brain abscess into the left lateral ventricle.     

IMAGING DIAGNOSIS—SPINAL CORD HISTIOCYTIC SARCOMA IN A DOG

A 12‐year‐old mixed breed dog was presented for evaluation of progressive paraparesis and ataxia. Magnetic resonance (MR) imaging was performed and identified multifocal intradural spinal cord mass lesions. The lesions were hyperintense in T2‐weighted sequences, isointense to mildly hyperintense in T1‐weighted sequences with strong contrast enhancement of the intradural lesions and spinal cord meninges. Spinal cord neoplasia was suspected. A diagnosis of intramedullary spinal cord histiocytic sarcoma, confined to the central nervous system, was confirmed histopathologically. Spinal cord histiocytic sarcoma is a rare neoplasm, but should be included in the differential diagnosis for dogs with clinical signs of myelopathy.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FEATURES OF A MULTIFOCAL OLIGODENDROGLIOMA IN THE SPINAL CORD AND BRAIN OF A DOG

An 8‐year‐old neutered male Toy Poodle was presented with chronic, progressive tetraparesis, and possible seizures. Magnetic resonance images demonstrated an extensive, T1 and T2 hyperintense contrast enhancing mass in the cervical spinal cord. Three nodules were present on the surface of the thalamus, with enhancement most evident on delayed images. A diagnosis of high‐grade oligodendroglioma was confirmed with postmortem histopathology and immunohistochemical labeling. Oligodendroglioma should be considered as a differential for T1 hyperintense intraaxial or intramedullary lesions with contrast enhancement. If enhancement is not visualized on postcontrast images, delayed images may be beneficial.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING OF A NEURONAL HETEROTOPIA IN THE BRAIN OF A CAT

A domestic shorthair kitten was presented for evaluation and further treatment of seizures. Magnetic resonance imaging of the brain revealed a large multilobulated mass in the third ventricle extending into the right lateral ventricle with secondary obstructive hydrocephalus. The mass was homogeneously isointense to gray matter on T2W, T2‐FLAIR, T2^*W, T1W, and ADC images, and hyperintense on DW‐EPI. There was no appreciable contrast enhancement. Seizures were managed medically and with subsequent ventriculoperitoneal shunt placement. Clinical status later deteriorated and the cat was euthanized. Histopathology confirmed that the mass was the result of neuronal heterotopia. To the authors’ knowledge this is the first report of neuronal heterotopia in a cat.     

IMAGING DIAGNOSIS—SPINAL CORD CHONDROSARCOMA ASSOCIATED WITH SPIROCERCOSIS IN A DOG

A 7‐year‐old neutered female Boerboel cross was examined for progressive left pelvic limb lameness. There was no left patellar reflex but the remaining pelvic limb reflexes were hyperreflexic. Radiographically, there was a poorly mineralized opacity occupying the intervertebral foramen at L4–L5. On computed tomography images there was a hyperattenuating intramedullary lesion at L4–L5 that continued caudally, lateralized to the left and became extramedullary, terminating at L5–L6. In addition, well marginated, hyperattenuating lesions were noted at two muscular sites. The dog underwent euthanasia and a caudal esophageal mass was found at post mortem examination. The tumors in the spinal cord, the esophagus, and the skeletal muscles were diagnosed histologically as low‐grade chondrosarcoma undergoing endochondral ossification. Spirocerca lupi‐induced esophageal chondrosarcoma was believed to be the primary site from which the other, presumably metastatic, lesions originated.     

MAGNETIC RESONANCE IMAGING FINDINGS IN 25 DOGS WITH INFLAMMATORY CEREBROSPINAL FLUID

To describe the signs that may be associated with intracranial inflammatory conditions, magnetic resonance (MR) images of 25 dogs that had inflammatory cerebrospinal fluid (CSF) were mixed with those of a control group of 40 dogs that had CSF negative for inflammatory disease and reviewed without knowledge of the clinical signs or diagnosis. CSF was considered inflammatory if the protein level was > 0.25 g/l and the white cell count was > 5 mm(-3). Abnormalities were found by MR imaging in 19 (76%) dogs with inflammatory CSF. Two dogs had focal lesions, 10 had multifocal lesions, and seven had diffuse lesions. Lesions affected all divisions of the brain. Mass effect was identified in seven (28%) dogs, including one that had a choroid plexus carcinoma. Lesions were hyperintense in T2-weighted images in 18 dogs and hypointense in T1-weighted images in six dogs. Multifocal or diffuse intraaxial lesions that were hyperintense in T2-weighted images were observed in 17 (68%) dogs with inflammatory CSF. Administration of gadolinium resulted in enhancement of intraaxial lesions in nine (36%) dogs and enhancement of meninges in seven (28%) dogs. Six (24%) dogs with inflammatory CSF had images interpreted as normal.     

EPENDYMAL AND PERIVENTRICULAR MAGNETIC RESONANCE IMAGING CHANGES IN FOUR DOGS WITH CENTRAL NERVOUS SYSTEM BLASTOMYCOSIS

Rapid detection of central nervous system (CNS) involvement is important for dogs with blastomycosis, as this can affect antifungal drug selection and has been associated with an increased risk of death. Previous reports describing magnetic resonance imaging (MRI) characteristics of canine CNS blastomycosis primarily identified mass lesions. The purpose of this retrospective study was to determine whether other MRI characteristics of CNS blastomycosis may also occur. Medical records of the Purdue University Veterinary Teaching Hospital were searched and four dogs met inclusion criteria. Magnetic resonance imaging characteristics included periventricular edema, periventricular and meningeal contrast enhancement, and ventriculomegaly. Periventricular lesions most commonly involved the rostral horn of the lateral ventricles and the third ventricle. Increased meningeal contrast enhancement involved the cerebrum, thalamus, sella turcica, and brainstem. Findings indicated that, in addition to mass lesions, MRI characteristics of periventricular hyperintensity, contrast enhancement, and ventriculomegaly may also occur in dogs with CNS blastomycosis.     

Ventricular pneumocephalus and septic meningoencephalitis secondary to dorsal rhinotomy and nasal polypectomy in a dog

CASE DESCRIPTION: A 4-year-old sexually intact female French Bulldog was evaluated because of lethargy, anorexia, and chronic rhinitis-sinusitis. The dog had nasal discharge of 18 months' duration; dorsal rhinotomies were performed 3 months and 2 weeks prior to referral. CLINICAL FINDINGS: On initial evaluation, intraventricular pneumocephalus and sinusitis were diagnosed; CSF analysis revealed high total protein concentration and mononuclear pleocytosis. The dog's condition improved with treatment. Two weeks after discharge, it was treated by a local veterinarian because of upper airway obstruction; 3 days later, the dog was referred because of seizures. Computed tomography revealed a large fluid-filled, left lateral ventricle and a soft tissue mass protruding through a cribriform plate defect. The mass was histologically consistent with brain tissue. Findings of clinicopathologic analyses were unremarkable. Results of cytologic examination of a CSF sample were indicative of septic, suppurative inflammation, and bacteriologic culture of CSF yielded Escherichia coli. TREATMENT AND OUTCOME: Amputation of the herniated olfactory bulb and antimicrobial treatment resolved the septic meningoencephalitis, but neurologic deficits recurred 6 weeks later. Definitive correction of the cribriform plate defect with bone and fascial grafts was attempted. Postoperative rotation of the bone graft resulted in cerebral laceration and hemorrhage, and the dog was euthanized. CLINICAL RELEVANCE: Findings suggest that following dorsal rhinotomy and nasal polypectomy surgery, the dog developed herniation of the left olfactory bulb, intra-ventricular pneumocephalus, and septic meningo-encephalitis because of a cribriform plate defect. Care must be taken to prevent rotation of bone grafts used in cribriform defect repair.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FINDINGS OF AN INTRACRANIAL EPIDURAL TUBERCULOMA IN A DOG

Magnetic resonance (MR) imaging is highly sensitive for detecting tuberculomas in human patients but the specificity of the MR imaging features is low. Misdiagnosis with intracranial neoplasia is common, especially with dural‐based lesions or lesions located in the epidural space. We describe the MR imaging characteristics of an intracranial epidural tuberculoma caused by Mycobacterium tuberculosis infection in a dog. The intracranial mass and skull flat bone lysis and erosion are similar to those described in human caseating tuberculomas and can mimic intracranial neoplastic disease.     

IMAGING DIAGNOSIS—FDG‐PET/CT OF A CANINE SPLENIC PLASMA CELL TUMOR

An 8‐year‐old Shih Tzu developed abdominal pain and hyperglobulinemia. A round splenic mass was noted radiographically and sonographically. The patient was evaluated by fluorodeoxyglucose positron emission tomography coupled with computed tomography (FDG‐PET/CT). There was no evidence of metastasis or bone marrow involvement on PET/CT images. The standardized uptake value (SUV) of the splenic mass was increased over the reference range (SUV=4.83). The patient was diagnosed as splenic extramedullary plasmacytoma through immunohistopathologic study. After the splenectomy, the globulin level normalized and the patient is alive without complications.     

SUSCEPTIBILITY ARTIFACTS ON T2*‐WEIGHTED MAGNETIC RESONANCE IMAGING OF THE CANINE AND FELINE SPINE

The T2*‐weighted gradient recalled echo sequence is a sensitive means to detect blood degradation products. While not a routine sequence in magnetic resonance imaging of the spine in small animals, it can provide additional valuable information in select cases. The goal of this retrospective, cross‐sectional study was to describe findings when acquiring this sequence during magnetic resonance imaging examination of the spine in small animals. The University of Tennessee's veterinary radiology database was searched for dogs and cats that underwent magnetic resonance imaging for suspect spinal disease in which a T2*‐weighted gradient recalled echo sequence was acquired and susceptibility artifact was identified. The following information was recorded: signalment, clinical signs, location and appearance of susceptibility artifact, and final diagnosis. Thirty‐nine cases were included in the study. Extradural susceptibility artifacts were observed in cases of intervertebral disc herniation with or without associated hemorrhage (n = 28), extradural hemorrhage associated with spinal trauma (n = 2), hemophilia (n = 1), and in a cystic extradural mass (n = 1). Remaining lesions displaying susceptibility artifact were intramedullary and included presumptive acute noncompressive nucleus pulposus extrusion (n = 2), hematoma (n = 1), hemangiosarcoma metastasis (n = 1), intramedullary disc extrusion (n = 1), presumptive meningomyelitis (n = 1), and a mass of undetermined etiology (n = 1). Inclusion of a T2*‐weighted gradient recalled echo sequence may be helpful in spinal magnetic resonance imaging when standard imaging sequences are ambiguous or intramedullary lesions are observed.     

IMAGING DIAGNOSIS—HEMORRHAGIC MENINGIOMA

An 8‐year‐old Labrador Retriever developed acute central vestibular signs. An extra‐axial mass was detected on MR images ventral to the brainstem. The mass was both T1‐ and T2‐hypointense; there was also thin‐rimmed patchy contrast enhancement. These findings were nonspecific, but the extreme T2‐hypointensity was notable and suggested a hemorrhagic mass. The histologic diagnosis was anaplastic meningioma with acute hemorrhage. These findings document an unusual appearance of a meningioma in MR images due to intratumoral hemorrhage.     

IMAGING DIAGNOSIS—METASTATIC HEMANGIOSARCOMA CAUSING CEREBRAL HEMORRHAGE IN A DOG

A 9-year-old male Appenzeller mountain dog had progressive severe ataxia and central vestibular syndrome that was localized clinically to the brain stem. The cerebrospinal fluid characteristics were suggestive of hemorrhage into the subarachnoid space. On computed tomography (CT), hyperattenuating masses were found in the left lateral ventricle extending into the cerebrum, and another involving the cerebellum and brainstem. The hyperattenuation of the masses in noncontrast images and the absence of contrast enhancement were consistent with hemorrhage. The dog underwent euthanasia. A metastatic hemangiosarcoma in the brain, causing acute bleeding in the left lateral ventricle and the brainstem, was found. A solitary mass in the left myocardium was thought to be the primary site. CT characteristics of intracranial hemorrhage are reviewed.     

IMAGING DIAGNOSIS — MAGNETIC RESONANCE IMAGING OF INTRACRANIAL INFLAMMATORY FIBROSARCOMA IN A MIXED BREED DOG

An 8‐year‐old mixed‐breed dog presented with progressive behavioral changes and altered mentation. Magnetic resonance imaging (MRI) of the brain revealed an olfactory and frontal lobe extra‐axial mass. The mass exhibited the following MRI signal intensity characteristics: T2W mixed, T1W iso‐ to hypointense, FLAIR hyperintense, and strong contrast enhancement. The mass was removed with cavitronic ultrasonic surgical aspirator (CUSA) assisted neurosurgery. Based on histopathological appearance and immunohistochemistry, the diagnosis of inflammatory fibrosarcoma was made. To our knowledge, this is the first report describing MRI characteristics of intracranial inflammatory fibrosarcoma in the veterinary literature.     

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.     

THREE TESLA MAGNETIC RESONANCE IMAGING FINDINGS IN 12 CASES OF CANINE CENTRAL EUROPEAN TICK‐BORNE MENINGOENCEPHALOMYELITIS

Central European tick‐borne encephalomyelitis can be challenging to diagnose in dogs because the virus may not be detected in blood and cerebrospinal fluid (CSF) after the first viremic stage of the disease. The purpose of this retrospective case series study was to describe 3 Tesla magnetic resonance imaging (3T MRI) findings in a sample of dogs with a confirmed diagnosis of tick‐borne encephalomyelitis. Dogs were included if they had neurological signs consistent with tick‐borne encephalomyelitis, history of a stay in endemic areas for tick‐borne encephalomyelitis virus, 3T MRI of the brain and/or spinal cord, cerebrospinal fluid changes compatible with viral infection and positive antibody titers in cerebrospinal fluid or pathologic confirmation of tick‐borne encephalomyelitis. Twelve dogs met inclusion criteria. Ten out of 12 patients had 3T MRI lesions at the time of presentation. One patient had persistent lesions in follow‐up MRI. The 3T MRI findings included bilateral and symmetrical gray matter distributed lesions involving the thalamus, hippocampus, brain stem, basal nuclei, and ventral horn on the spinal cord. All lesions were hyperintense in T2‐weighted sequences compared to white matter, iso‐ to hypointense in T1‐weighted, nonenhancing, and had minimal or no mass effect or perilesional edema. Six patients survived while the remaining six dogs were euthanized. Necropsy revealed neuronophagia and gliosis of the gray matter of the affected regions seen in 3T MRI, in addition to the cerebellum. Findings from the current study indicated that tick‐borne encephalomyelitis should be included in the differential diagnosis list for dogs with the above described 3T MRI characteristics.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FEATURES OF METASTATIC CEREBRAL LYMPHOMA IN A DOG

We describe histopathologically confirmed intracranial metastasis of cutaneous lymphoma. In magnetic resonance (MR) images there was a heterogeneous, contrast‐enhancing, extraaxial mass in the right parietal and piriform lobes at the level of the optic chiasm. Our MR imaging findings are consistent with reports in humans in that lymphoma masses have indistinct borders that are iso‐ to hyperintense relative to adjacent gray matter on T2‐weighted images. Our report varies from findings in humans in that the mass was extraaxial, whereas masses reported in humans are intraaxial. Contrast enhancement can be heterogeneous, as in our report, or homogeneous.     

IMAGING DIAGNOSIS—SPINAL EPIDURAL HEMANGIOSARCOMA IN A DOG

An 8‐year‐old, male Boxer was examined for an acute onset of ambulatory paraparesis. Neurologic examination was consistent with a T3‐L3 myelopathy. Myelography revealed an extradural spinal cord compression in the region of the T10‐T13 vertebrae. On magnetic resonance (MR) imaging, a well‐defined epidural mass lesion was detected. The mass was mildly hyperintense on T1‐weighted, hyperintense on T2‐weighted and STIR images compared to normal spinal cord and enhanced strongly and homogenously. Postmortem examination confirmed a primary epidural hemangiosarcoma. Findings indicated that the MRI characteristics of spinal epidural hemangiosarcoma may mimic other lesions including meningioma and epidural hemorrhages/hematomas of non‐neoplastic etiology.