Low‐Field Magnetic Resonance Imaging and Multislice Computed Tomography for the Detection of Cervical Syringomyelia in Dogs

Background

Syringomyelia (SM) is defined as the presence of fluid‐containing cavities within the parenchyma of the spinal cord. Sagittal magnetic resonance (MR) images have been described as the preferred technique for visualizing SM in dogs and humans.

Objective

To investigate whether computed tomography (CT) can be used to diagnose SM.

Animals

Thirty‐two client‐owned dogs referred for investigation of the cervical spine on magnetic resonance imaging (MRI) and CT.

Methods

Two reviewers retrospectively analyzed sagittal and transverse T1‐weighted spin echo (T1WSE) MR images and CT images from each dog for the presence of SM and, if SM was present, the width (mm, syrinx width [SW]) was measured. The results were analyzed statistically.

Results

For the presence of SM there was a moderate interobserver agreement for MR (81%, κ = 0.54) and almost perfect agreement for CT (94%, κ = 0.87). There was a moderate intramodality agreement for both observers (observer 1 81%, κ = 0.59; observer 2 81%, κ = 0.57). For measurement of SW the repeatability was the best on the midsagittal T1WSE images (95% repeatability coefficient <0.52 mm) and the reproducibility was the best on midsagittal images in both modalities (95% limits of agreement −0.55–0.45; P = 0.002).

Conclusion and Clinical Importance

Both techniques can be used to detect SM. Midsagittal MR and CT images are best used for measuring SW. Computed tomography can be used as a diagnostic tool for SM when MRI is not available, but CT cannot replace MRI as the standard screening technique for the detection of SM in Cavalier King Charles Spaniel for breeding purposes.     

Platelet-rich Plasma Combined With a Sterile 3D Polylactic Acid Scaffold for Postoperative Management of Complete Hoof Wall Resection for Keratoma in Four Horses

Keratoma is a nonmalignant horse tumor that grows in the space between the horn of the hoof and the distal phalanx. Keratoma causes lameness in the horse, and surgical excision is the treatment of choice. Four horses underwent removal of a keratoma by complete hoof wall resection. The remaining wound was treated with platelet-rich plasma (PRP) combined with a sterile three-dimensional polylactic acid scaffold. The PRP was applied at 3, 6, 9, 12, 15, and 18 days postoperatively. The surgical site was cleaned with gauzes and swabs soaked in Ringer’s lactate solution before applying PRP and the foot bandage. Healthy granulation tissue developed at 6–21 days postoperatively. The hoof wall defect was completely filled with new hoof wall within 6–8 months after surgery. All horses returned to their previous exercise level, and no recurrence of lameness was reported by the owner.     

Radiography,Computed Tomography and Magnetic Resonance Imaging of Craniofacial Structures in Pig

The pig has recently become popular as a large animal experimental model in many fields of biomedical research. The aim of this study is to evaluate the basic anatomical structures in the head region of the pig to lay the groundwork for its practical clinical usage or pre‐clinical research in the future. We used three different diagnostic imaging methods: radiography, computed tomography (CT) and magnetic resonance imaging (MRI). The analysis showed that radiographic imaging is suitable only for general evaluation of the facial area of the pig skull. CT images showed excellent spatial definition of bony structures of the whole craniofacial area, and MRI images revealed fine soft tissue details. Radiography is preferentially suited to general assessment of bone structures of the facial skeleton; however, the thick layer of adipose tissue in the craniofacial region of the pig makes the imaging of some parts difficult or even impossible. CT is useful for revealing morphological details of mineralized tissues, whereas MRI is more suitable for soft tissue analysis and the detection of subtle pathologic changes in both bone and soft tissues. Therefore, before using pigs as an experimental model in craniofacial research, it is necessary to evaluate the suitability and disadvantages of potential imaging methods and how appropriate they are for accurate visualization of desired structures.     

Computed Tomography and Magnetic Resonance Anatomy of the Normal Orbit and Eye of the Horse

Traumatic and infectious diseases of the eye and orbit can occur in horses. For diagnosis and monitoring of such diseases, medical imaging is useful including computed tomography (CT) and magnetic resonance imaging (MRI). The aim of the current study was to describe CT and MRI anatomy of the equine orbit and ocular globe. The heads from four adult horses were scanned with a 6‐slice Emotion 6 CT (Siemens, Erlangen), and a 3.0 Tesla Siemens Verio 6 MRI using T1 and T2‐weighted sequences. To validate CT and MR reference images, these were compared with anatomical models and gross anatomical sections. The bony limits of the orbital cavity, the relationship of the orbit with sinuses and foramina of the skull were well identified by CT. MRI was useful to observe soft tissues and was able to identify adnexae of the ocular globe (eyelids, periorbital fat, extraocular muscles, lacrymal and tarsal glands). Although MRI was able to identify all components of the eye (including the posterior chamber), it could not differentiate sclera from choroid and retina. The only nerve identified was the optic nerve. Vessels were not seen in this series of cadaver heads. This study showed that CT and MRI are useful techniques to image the equine orbit and eye that can have clinical applications.     

Computed Tomography and Magnetic Resonance Imaging of an Epidermoid Cyst in a Foot of a Horse

An 18-year-old Quarter Horse mare was evaluated because of moderate left forelimb lameness of 4 weeks’ duration. The clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. There was swelling on the dorsal and lateral aspect of the coronary band. Radiography, ultrasound, magnetic resonance imaging, and computed tomography of the foot revealed circumscribed well-capsulated soft tissue mass causing a focal deformation of the dorsolateral border of the middle phalanx. The treatment aimed to remove the mass surgically and stabilized the interphalangeal joint, but the owner elected human euthanasia before treatment attempt. Histopathology diagnosis was an epidermoid cyst, which was characterized by multilayers of keratin surrounded by stratified squamous epithelium. Although rare, an epidermoid cyst should be considered as a differential diagnosis for space-occupying mass in horses’ foot that develops chronic lameness after trauma. This report describes the multimodality appearance of the epidermoid cyst.     

Video‐Assisted Thoracoscopic Resection of Noninvasive Thymomas Using One‐Lung Ventilation in Two Dogs

Objective— To report the technique and outcome of video‐assisted thoracoscopic surgery (VATS) for resection of cranial mediastinal thymoma in 2 dogs. Study Design— Case report. Animals— Eleven‐year‐old Labrador Retrievers (n=2). Methods— Two dogs had VATS resection of thymoma. Preoperative computed tomography (CT) scans revealed well‐circumscribed cranial mediastinal masses with dimensions of 4.5 cm × 4.2 cm × 3.7 cm and 2.1 cm × 2.1 cm × 4.1 cm (at the time of resection) without CT evidence of vascular invasion. One‐lung ventilation (OLV) was achieved using a bronchoscopically placed double‐lumen endobronchial tube. A 3‐portal technique was used for VATS access to the thorax. Thymomas were dissected from the tissues of the cranial mediastinum with the aid of a harmonic scalpel and retrieved in specimen retrieval bags. Results— Two cranial mediastinal thymomas were resected successfully, with their capsules intact, using a VATS technique. One dog developed aspiration pneumonia postoperatively which resolved with treatment and remains healthy 18 months postoperatively with no radiographic evidence of tumor recurrence. The second dog was diagnosed with myasthenia gravis, megaesophagus, and aspiration pneumonia preoperatively and despite recovering well from the procedure had a second episode of aspiration pneumonia 5 days postoperatively and was euthanatized. Conclusions— VATS resection of modestly sized noninvasive thymoma is possible in dogs. Careful case selection and preoperative imaging are the keys. Clinical Relevance— Thoracoscopic resection of modestly sized mediastinal masses forms part of an increasingly expansive set of indications for minimally invasive surgery in select veterinary patients.     

Agreement and Repeatability of Linear Vertebral Body and Canal Measurements Using Computed Tomography (CT) and Low Field Magnetic Resonance Imaging (MRI)

Objective— To evaluate agreement and repeatability of vertebral column measurements using computed tomography (CT) and magnetic resonance imaging (MRI).
Study Design— Retrospective observational study.
Animals— Dogs (n=18) with disc associated wobbler syndrome; Dog cadavers (n=3).
Methods— Five measurements of the 5th cervical vertebra were performed: vertebral body length (VBL), vertebral canal height (VCH), vertebral body height (VBH), vertebral canal width (VCW), and vertebral body width (VBW). Measurements were performed independently twice by 2 observers. Bland-Altman plots were created to evaluate agreement. Cadaveric vertebrae with soft tissue removed had the same variables and actual dimensions measured.
Results— The largest discrepancy between CT and MRI measurement was for VBL (mean difference±SD=1.262 mm±1.245; P <.001), with the difference for all the other variables being acceptable. The 1st measurement was significantly higher than the 2nd only for VBL using CT (mean difference=0.476 mm±1.120; P =.009), with all other variables having acceptable differences. Mean difference for all measurements between 2 observers was small, except for VBL using CT (mean difference=0.762 mm±1.042; P <.001). Only the difference for VBL between CT and cadaver specimens was statistically significant.
Conclusions— Our results suggest high repeatability and good agreement for most vertebral measurements of interest. VBL measurement using CT was considered problematic.
Clinical Relevance— Provided limitations are understood, linear measurements of vertebral dimensions from CT and MRI images can be used clinically.     

Computed Tomography Atlas of the Normal Cranial Canine Abdominal Vasculature Enhanced by Dual‐phase Angiography

This study was performed to provide a detailed atlas of the normal arterial and venous canine vasculature in the cranial abdomen by dual‐phase computed tomographic angiography. Five adult beagles were positioned in dorsal recumbency on a multislice helical CT scanner. An unenhanced survey CT scan from the diaphragm to the pelvic inlet was performed. Bolus‐tracking software was used for the dual‐phase angiogram, and contrast medium was administered in a cephalic vein. The arterial phase was scanned from the mid‐abdomen to the cranial aspect of the diaphragm; the portal phase was scanned a few seconds after the arterial phase in the opposite direction. The DICOM studies from all dogs were analysed. Representative images were selected and anatomic structures labelled. Maximum intensity projections and three‐dimensional images were generated using software techniques. A detailed atlas of the venous and arterial vasculature of the cranial canine abdomen was created with the help of bolus‐tracking dual‐phase computed tomographic angiography (CTA). Practitioners can use this anatomic atlas with its detailed venous and arterial phase CT angiograms of the canine cranial abdomen to compare normal versus abnormal vascular anatomy.