MR IMAGING OF HISTIOCYTIC SARCOMA OF THE CANINE BRAIN

Histiocytic sarcomas are characterized by proliferation and/or infiltration of neoplastic histiocytes localized to specific organs, unlike malignant histiocytosis which involves many organ systems. Only a few cranial histiocytic sarcomas have been reported. Here we describe four dogs that presented with neurological deficits referable to the forebrain, and were diagnosed histologically as having histiocytic sarcoma. Using magnetic resonance (MR) imaging, the tumors were characterized by a T2-hyperintense and T1-isointense mass in one dog, T2- and T1-isointense extraaxial masses in two dogs, and a diffuse T2-hyperintense lesion over the left cerebral cortex in one dog. All tumors had contrast enhancement. MRI features in three of the four dogs were similar to that of meningioma, supported by the observation of a dural tail in two of these three dogs, and a broad base of attachment in the other. In the other dog the imaging findings were similar to those of encephalitis. Intracranial histiocytic sarcoma does not appear to have specific MR imaging features and can be confused with meningioma or encephalitis.     

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 FINDINGS IN 14 DOMESTIC FERRETS (MUSTELA PUTORIUS FURO) WITH LYMPHOMA

Lymphoma is the most common malignant neoplasia in domestic ferrets, Mustela putorius furo. However, imaging findings in ferrets with lymphoma have primarily been described in single case reports. The purpose of this retrospective study was to describe imaging findings in a group of ferrets with confirmed lymphoma. Medical records were searched between 2002 and 2012. A total of 14 ferrets were included. Radiographs (n = 12), ultrasound (n = 14), computed tomography (CT; n = 1), and magnetic resonance imaging (MRI; n = 1) images were available for review. Median age at the time of diagnosis was 5.2 years (range 3.25–7.6 years). Clinical signs were predominantly nonspecific (8/14). The time between the first imaging study and lymphoma diagnosis was 1 day or less in most ferrets (12). Imaging lesions were predominantly detected in the abdomen, and most frequently included intra‐abdominal lymphadenopathy (12/14), splenomegaly (8/14), and peritoneal effusion (11/14). Lymphadenopathy and mass lesions were typically hypoechoic on ultrasound. Mild peritoneal effusion was the only detected abnormality in two ferrets. Mild pleural effusion was the most common thoracic abnormality (3/12). Expansile lytic lesions were present in the vertebrae of two ferrets with T3‐L3 myelopathy and the femur in a ferret with lameness. Hyperattenuating, enhancing masses with secondary spinal cord compression were associated with vertebral lysis in CT images of one ferret. The MRI study in one ferret with myelopathy was inconclusive. Findings indicated that imaging characteristics of lymphoma in ferrets are similar to those previously reported in dogs, cats, and humans.     

MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF CANINE INFLAMMATORY MYOPATHIES IN THREE DOGS

In humans affected with inflammatory myopathies, regions of altered signal intensity are found on magnetic resonance (MR) images of affected muscles. Although electromyography (EMG) is more practical for muscle disease evaluation, and a muscle biopsy is the only manner in which a definitive diagnosis can be made, MR imaging has proven useful if a specific anatomic localization is difficult to achieve. Three dogs with focal inflammatory myopathy diagnosed with the assistance of MR imaging are discussed and the findings are compared with those found in humans. MR images of the affected muscles in each dog were characterized by diffuse and poorly marginated abnormal signal on T1- and T2-weighted images. Marked enhancement was noted in these muscles after contrast medium administration. An inflammatory myopathy was confirmed histologically in all three dogs. A good association existed between the MR images and muscle inflammation identified histopathologically. MR imaging may be a useful adjunctive procedure for canine inflammatory myopathies.     

IMAGING DIAGNOSIS — UNILATERAL TRIGEMINAL NEURITIS MIMICKING PERIPHERAL NERVE SHEATH TUMOR IN A HORSE

A 16‐year old Warmblood gelding presented with a nonhealing corneal ulcer and absent corneal sensation in the left eye. A lesion affecting the maxillary and ophthalmic branches of the left trigeminal nerve was suspected. Magnetic resonance (MR) imaging identified marked thickening of the ophthalmic and maxillary branches of the left trigeminal nerve. The nerve was iso‐ to hypointense on T1‐weighted and T2‐weighted images with heterogeneous enhancement. A peripheral nerve sheath tumor was suspected, however granulomatous neuritis was histopathologically confirmed. These inflammatory changes can result in severe nerve enlargement and should be considered with MR findings suggestive of peripheral nerve sheath tumor.     

MR IMAGING FEATURES OF SURGICALLY INDUCED CORE LESIONS IN THE EQUINE SUPERFICIAL DIGITAL FLEXOR TENDON

Tendon injuries are common in athletic humans and horses. Ultrasonography is the diagnostic method of choice in horses with tendon injuries but there is increasing application of magnetic resonance (MR) imaging to monitor and follow‐up tendon healing. A core lesion was created in the superficial digital flexor tendon (SDFT) of each forelimb of four horses. One of the four horses was euthanized at 2, 4, 8, and 12 weeks after creation of the lesion. MR examinations of the SDFT were performed immediately post mortem in a 1.5 T Siemens Symphony magnet and compared with histologic findings. Measurements from the MR images were also compared to ultrasonographic measurements available from the same lesions. Tendon lesions appeared as well‐circumscribed hyperintensities in the core of the SDFT on all pulse sequences. Lesions were most conspicuous on fat‐suppressed fast low angle shot (FLASH) sequences and least conspicuous on T2 transverse dual turbo spin echo (T2 TSE) sequences. The signal‐difference‐to‐noise ratio decreased with the age of the lesion in all sequences in this study. Twelve‐week‐old lesions were not visible on T2 TSE images but in all other sequences the lesion remained hyperintense. The lesion volume and maximum cross‐sectional area of core lesions were significantly smaller in T2 TSE images than in other MR sequences. The lesion volume and maximum cross‐sectional area of core lesions were significantly larger in proton density, T1, and FLASH sequences and significantly smaller in T2 sequences than when measured from ultrasonographic images. Through comparison between sequences, MR imaging may be able to provide information on various stages of tendon healing.     

IMAGING DIAGNOSIS—IMAGING AND HISTOPATHOLOGIC CHARACTERISTICS OF A VERTEBRAL HAMARTOMA IN A CAT

A 9‐month‐old domestic shorthair cat had progressive ambulatory paraparesis, proprioceptive ataxia, and thoracolumbar hyperesthesia. An extradural mass affecting the left pedicle and lamina of the second lumbar vertebra (L2) causing marked spinal cord impingement was identified in magnetic resonance (MR) images. The mass was predominantly calcified in computed tomographic (CT) images. A hemilaminectomy was performed to resect the mass. Clinical signs were greatly improved at 12‐month follow‐up. The histopathologic diagnosis was vascular hamartoma. To our knowledge, this is the first report describing the MR characteristics of a vascular hamartoma associated with the vertebral column.     

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.     

REVERSIBLE MAGNETIC RESONANCE IMAGING ABNORMALITIES IN DOGS FOLLOWING SEIZURES

Reversible magnetic resonance (MR) imaging lesions have been described in humans following seizures. This condition has not yet been reported in animals. This paper describes reversible abnormalities identified in 3 dogs using MR imaging that was performed initially within 14 days of the last seizure and follow-up imaging that was performed after 10 to 16 weeks of anticonvulsant therapy. All three dogs had lesions in the piriform/temporal lobes, characterized by varying degrees of hyperintensity on T2-weighted images and hypointensity on T1-weighted images. In one dog, contrast enhancement was evident. On reevaluation, partial resolution occurred in all 3 dogs. In a fourth animal with an olfactory meningioma, similar appearing lesions in the temporal cortex and right and left piriform lobes were identified after seizure activity. A surgical biopsy of the temporal cortex and hippocampus was performed and edema, neovascularization, reactive astrocytosis, and acute neuronal necrosis were evident. These histologic findings are similar to those reported in humans with seizures. Recognizing the potential occurrence of reversible abnormalities in MR images is important in developing a diagnostic and therapeutic plan in canine patients with seizures. Repeat imaging after seizure control may help differentiate between seizure-induced changes and primary multifocal parenchymal abnormalities.     

IMAGING DIAGNOSIS—INTRACRANIAL CRYPTOCOCCAL MASS IN A CAT

A 4‐year‐old neutered female domestic shorthair was evaluated for mentation changes and left prosencephalic signs. This imaging report describes the imaging findings for this patient. A diagnosis of a cryptococcal mass was made based on imaging and additional diagnostics. Complete resolution of the mass was demonstrated by follow‐up imaging. This report serves as a reminder that masses associated with cryptococcal infection should be included on the differential list for cats with intracranial masses. In addition, this report provides evidence that large intracranial cryptococcal masses may resolve with long‐term medical therapy.     

IMAGING DIAGNOSIS—HYPEROSTOSIS ASSOCIATED WITH MENINGIOMA IN A DOG

A 5-year-old neutered male Beagle mix dog had a 5-day history of generalized tonic-clonic seizures. Before the seizures, the dog had a 1-2-month history of progressive right hemiparesis. In computed tomography images, a presumed extraaxial mass with hyperostosis and destruction of the skull covering the mass were identified. Surgical excision was performed and the histopathologic diagnosis was meningioma. Hyperostosis is frequently associated with feline meningioma, but this report documents that hyperostosis may also occur secondary to meningioma in the dog.     

MAGNETIC RESONANCE IMAGING FEATURES OF INTRACRANIAL ASTROCYTOMAS AND OLIGODENDROGLIOMAS IN DOGS

Astrocytomas and oligodendrogliomas represent one third of histologically confirmed canine brain tumors. Our purpose was to describe the magnetic resonance (MR) imaging features of histologically confirmed canine intracranial astrocytomas and oligodendrogliomas and to examine for MR features that differentiate these tumor types. Thirty animals with confirmed astrocytoma (14) or oligodendroglioma (16) were studied. All oligodendrogliomas and 12 astrocytomas were located in the cerebrum or thalamus, with the remainder of astrocytomas in the cerebellum or caudal brainstem. Most (27/30) tumors were associated with both gray and white matter. The signal characteristics of both tumor types were hypointense on T1‐weighted images (12 each) and hyperintense on T2‐weighted images (11/14 astrocytomas, 12/16 oligodendrogliomas). For astrocytomas and oligodendrogliomas, respectively, common findings were contrast enhancement (10/13, 11/15), ring‐like contrast enhancement (6/10, 9/11), cystic regions within the mass (7/14, 12/16), and hemorrhage (4/14, 6/16). Oligodendrogliomas were significantly more likely to contact the brain surface (meninges) than astrocytomas (14/16, 7/14, respectively, P=0.046). Contact with the lateral ventricle was the most common finding, occurring in 13/14 astrocytomas and 14/16 oligodendrogliomas. No MR features were identified that reliably distinguished between these two tumor types. Contrast enhancement was more common in high‐grade tumors (III or IV) than low‐grade tumors (II, P=0.008).     

IMAGING CHARACTERISTICS OF INTRATHORACIC HISTIOCYTIC SARCOMA IN DOGS

In this retrospective study, two observers independently reviewed thoracic imaging studies of 39 dogs with confirmed histiocytic sarcoma. The most common findings were intrathoracic lymphadenopathy, identified by the first and second observers in 82.1% and 87.2% of dogs, respectively, and pulmonary masses (74.4% and 82.1%). Right middle lung lobe masses were significantly more common than masses in any other lung lobe (P<0.0013), with the majority having a ventral distribution. Sternal and tracheobronchial lymphadenopathy were significantly more common than cranial mediastinal lymphadenopathy (P‐values of 0.0002 and 0.012, respectively). Interobserver agreement regarding distribution of lymphadenopathy and pulmonary masses was good (κ=0.64 and 0.75, respectively). Other findings included pulmonary nodules, pleural effusion, and abnormal pulmonary patterns. In patients with CT examinations, the majority of masses were mildly to moderately enhancing and heterogeneous, poorly marginated, and bronchocentric. Lymphadenopathy and pulmonary masses are the most common intrathoracic findings in dogs with histiocytic sarcoma, and the strong predilection for the ventral aspect of the right middle lung lube may help to differentiate it from other types of neoplasia.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FEATURES OF A CEREBRAL HEMANGIOBLASTOMA IN A DOG

The magnetic resonance (MR) imaging features of a cerebral hemangioblastoma in a 9‐year‐old dog are described. Imaging revealed a well‐defined contrast‐enhancing lesion of the rostral forebrain that appeared extraparenchymal. Histopathology of the excised mass showed clusters of small blood vessels interspersed with interstitial cells staining positive for neuronal specific enolase, features consistent with a cerebral hemangioblastoma; the mass also appeared intraparenchymal after further immunohistochemistry study. This neoplasm should be considered a rare differential diagnosis for intracranial masses in dogs.     

IMAGING DIAGNOSIS—MRI CHARACTERISTICS OF A FOURTH VENTRICULAR CHOLESTEROL GRANULOMA IN A DOG

A 2‐year‐old male American Bulldog experienced paroxysmal staggering, altered consciousness, and hyperesthesia. Magnetic resonance (MR) imaging enabled recognition of a fourth ventricular mass causing compression of the cerebellum and brainstem and obstructive hydrocephalus. The mass was uniformly T2‐hyperintense and predominantly T1‐hypointense. A fluid line was evident on the fluid‐attenuated inversion recovery images. A thin rim of contrast enhancement was noted. Histopathologic diagnosis was a cholesterol granuloma. We were unable to identify any other reports of a cholesterol granuloma residing in the fourth ventricle of a dog. This case report documents the clinical, diagnostic imaging, and histopathologic findings of a canine intracranial cholesterol granuloma. © 2012 Veterinary Radiology & Ultrasound.     

LOW FIELD MAGNETIC RESONANCE IMAGING CHARACTERISTICS OF CRANIAL VAULT MENINGIOMAS IN 13 DOGS

Meningiomas are common intracranial masses in the dog, and surgical or radiation treatment of meningiomas depends on accurate identification and location. In this review of 13 patients with confirmed meningioma, low field magnetic resonance imaging characteristics of cranial vault meningiomas included increased signal intensity on T2-weighted images, decreased signal intensity on T1-weighted images, and marked contrast enhancement that was usually nonhomogeneous and well-defined. Mass effect and edema were usually present. Cyst formation and meningeal enhancement were also found in some patients. Low field magnetic resonance imaging characteristics of the meningiomas in these patients were similar to those magnetic resonance imaging findings reported in humans and the few reports pertaining to animals.     

IMAGING DIAGNOSIS—SPINAL CORD HEMANGIOMA IN TWO DOGS

Intramedullary masses are a dilemma due to the limited access for a nonsurgical biopsy, thus, accurate imaging characterization is crucial. Magnetic resonance imaging findings of two confirmed canine thoracic intramedullary hemangiomas are described. A capillary hemangioma was of mixed intensity but predominantly T2‐hyperintense and mildly T1‐hyperintense to spinal cord with strong contrast enhancement. A cavernous hemangioma had a target‐like appearance in both T1‐weighted (T1w) and T2‐weighted (T2w) images. In T2w images there was a small isointense center surrounded by a relatively large hyperintense area. In T1w images, there was a large isointense centre with a relatively small hyperintense periphery. Such characteristics should prioritize hemangioma as a consideration in a progressive myelopathy due to an intramedullary mass.     

MAGNETIC RESONANCE IMAGING OF THE CANINE BRAIN AT 3 AND 7 T

Magnetic resonance (MR) imaging of the canine brain is commonly acquired at field strengths ranging from 0.2 to 1.5 T. Our purpose was to compare the MR image quality of the canine brain acquired at 3 vs. 7 T in dogs. Low‐resolution turbo spin echo (TSE) T2‐weighted images (T2W) were obtained in transverse, dorsal, and sagittal planes, and high‐resolution TSE T2W and turbo spin echo proton density‐weighted images were obtained in the transverse and dorsal planes, at both 3 and 7 T. Three experienced reviewers evaluated 32 predetermined brain structures independently and without knowledge of field strength for spatial resolution and contrast. Overall image quality and evidence of artifacts were also evaluated. Contrast of gray and white matter was assessed quantitatively by measuring signal intensity in regions of interest for transverse plane images for the three pulse sequences obtained. Overall, 19 of the 32 neuroanatomic structures had comparable spatial resolution and contrast at both field strengths. The overall image quality for low‐resolution T2W images was comparable at 3 and 7 T. High‐resolution T2W was characterized by superior image quality at 3 vs. 7 T. Magnetic susceptibility and chemical shift artifacts were slightly more noticeable at 7 T. MR imaging at 3 and at 7 T provides high spatial resolution and contrast images of the canine brain. The use of 3 and 7 T MR imaging may assist in the elucidation of the pathogenesis of brain disorders, such as epilepsy.     

MAGNETIC RESONANCE IMAGING FEATURES OF EQUINE NIGROPALLIDAL ENCEPHALOMALACIA

Magnetic resonance imaging (MR) was used to make a diagnosis of equine nigropallidal encephalomalacia in a horse. Equine nigropallidal encephalomalacia is a neurodegenerative disease that has many characteristics with Parkinson-like diseases in humans. Historically, horses were euthanized based on clinical signs and exposure to the toxic weed, yellow star thistle (Centaurea solstitialis). Previously, the disease has only been confirmed on necropsy. MR imaging can provide accurate and sensitive visualization of typical lesions seen in the brain of horses affected with equine nigropallidal encephalomalacia. Lesions were seen on T1-weighted, T2-weighted and proton density images. There was no contrast enhancement following Gd-DTPA administration. Lesions seen on MR were confirmed at necropsy. Using MR to confirm a diagnosis of equine nigropallidal encephalomalacia will prevent unnecessary suffering of horses and expense to owners that would otherwise incur, while further diagnostics are performed.