MAGNETIC RESONANCE IMAGING OF THE CERVICAL SPINE IN 27 DOGS

The cervical spine of 27 dogs with cervical pain or cervical myelopathy was evaluated using magnetic resonance imaging (MRI). Spin echo T1, T2, and post-contrast T1 weighted imaging sequences were obtained with a 0.5 Tesla magnet in 5 dogs and a 1.5 Tesla magnet in the remaining 22 dogs. MRI provided for visualization of the entire cervical spine including the vertebral bodies, intervertebral discs, vertebral canal, and spinal cord. Disorders noted included intervertebral disc degeneration and/or protrusion (12 dogs), intradural extramedullary mass lesions (3 dogs), intradural and extradural nerve root tumors (3 dogs), hydromyelia/syringomyelia (1 dog), intramedullary ring enhancing lesions (1 dog), extradural synovial cysts (1 dog), and extradural compressive lesions (3 dogs). The MRI findings were consistent with surgical findings in 18 dogs that underwent surgery. Magnetic resonance imaging provided a safe, useful non-invasive method of evaluating the cervical spinal cord.     

TRUNCATION ARTIFACT IN MAGNETIC RESONANCE IMAGES OF THE CANINE SPINAL CORD

The truncation artifact in magnetic resonance (MR) images is a line of abnormal signal intensity that occurs parallel to an interface between tissues of markedly different signal intensity. In order to demonstrate the truncation artifact in sagittal images of the canine spinal cord and the effect of changing spatial resolution, we conducted an experimental in vitro study. A section of fixed canine spinal cord was imaged using a 1.5T magnet. Spatial resolution was increased by increasing the acquisition matrix and reconstruction matrix, producing series of T2‐weighted (T2w) images with the following pixel sizes: A, 1.6 (vertical) × 2.2 mm² (horizontal); B, 1.2 × 1.7 mm²; C, 0.8 × 1.1 mm²; D, 0.4 × 0. 6 mm². Plots of mean pixel value across the cord showed variations in signal intensity compatible with truncation artifact, which appeared as a single, wide central hyperintense zone in low‐resolution images and as multiple narrower zones in high spatial resolution images. Even in images obtained using the highest spatial resolution available for the MR system, the edge of the spinal cord was not accurately defined and the central canal was not visible. The experiment was repeated using an unfixed spinal cord specimen with focal compression applied to mimic a pathologic lesion. Slight hyperintensity was observed within the spinal cord at the site of compression although the cord was normal histologically. Results of this study suggest that caution should be applied when interpreting hyperintensity affecting the spinal cord in T2w sagittal images of clinical patients because of the possibility that the abnormal signal could represent a truncation artifact.     

MAGNETIC RESONANCE IMAGING FEATURES OF CERVICAL STENOTIC MYELOPATHY IN 21 DOGS

The cervical spine of 21 dogs with clinical signs of cervical stenotic myelopathy was evaluated using magnetic resonance (MR) imaging. Spin echo T1, T2 and gradient echo T2 weighted images were obtained with a 1.5 Tesla magnet in 12 dogs and a 1.0 Tesla magnet in 9 dogs. Sagittal or parasagittal T1W and T2W images were helpful in determining the presence of spinal cord compression or degenerative disease of the articular processes. Transverse T1W and T2W images were the most useful for the identification of dorsolateral spinal cord compression secondary to soft tissue and ligament hypertrophy, as well as synovial cysts, associated with the articular processes. The MR imaging findings were consistent with the surgical findings in all 14 dogs that underwent surgery. Magnetic resonance imaging provided a safe, non-invasive method of evaluating the cervical spine in dogs suspected of having cervical stenotic myelopathy. Veterinary     

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.     

IMAGING DIAGNOSIS—CANINE MENINGIOANGIOMATOSIS

Meningioangiomatosis is a rare proliferative disorder of the central nervous system. It occurs sporadically in dogs and is characterized by a leptomeningeal plaque that extends from the subarachnoid space along the perivascular spaces into the adjacent parenchyma. We describe the clinical presentation, magnetic resonance (MR) imaging and neuropathologic characteristics of two additional dogs with meningioangiomatosis, and document involvement of the thoracolumbar spinal cord, a site not previously described for this condition. MR imaging findings were different from those previously described, most likely reflecting the degree of vascularity and collagen deposition. The MR imaging features of meningioangiomatosis are not specific.     

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.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FINDINGS IN A CAT WITH SYSTEMIC REACTIVE ANGIOENDOTHELIOMATOSIS

A 10‐year‐old, castrated male domestic short‐haired cat was presented with an acute history of seizures, lethargy, anorexia, vomiting, and dyspnea. Magnetic resonance imaging of the brain showed multifocal areas of gray matter T2‐weighted hyperintensity. The lesions did not enhance with intravenous contrast. The cat was diagnosed at necropsy with feline systemic reactive angioendotheliomatosis, a rare vascular proliferative disorder for which a treatment has not yet been identified. This report is the first to describe associated magnetic resonance imaging changes for this disease.     

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—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.     

NORMAL CANINE BRAIN MATURATION AT MAGNETIC RESONANCE IMAGING

The normal neonatal canine brain exhibits marked differences from that of the mature brain. With development into adulthood, there is a decrease in relative water content and progressive myelination; these changes are observable with magnetic resonance imaging (MRI) and are characterized by a repeatable and predictable time course. We characterized these developmental changes on common MRI sequences and identified clinically useful milestones of transition. To accomplish this, 17 normal dogs underwent MRI of the brain at various times after birth from 1 to 36 weeks. Sequences acquired were T1‐weighted (T1W), T2‐weighted (T2W), fluid attenuated inversion recovery, short tau inversion recovery, and diffusion weighted imaging sequences. The images were assessed subjectively for gray and white matter relative signal intensity and results correlated with histologic findings. The development of the neonatal canine brain follows a pattern that qualitatively matches that observed in humans, and which can be characterized adequately on T1W and T2W images. At birth, the relative gray matter to white matter signal intensity of the cortex is reversed from that of the adult with an isointense transition at 3–4 weeks on T1W and 4–8 weeks on T2W images. This is followed by the expected mature gray matter to white matter relative intensity that undergoes continued development to a mostly adult appearance by 16 weeks. On the fluid attenuated inversion recovery sequence, the cortical gray and white matter exhibit an additional signal intensity reversal during the juvenile period that is due to the initial high relative water content at the subcortical white matter, with its marked T1 relaxation effect.     

COMPARISON OF NONCONTRAST COMPUTED TOMOGRAPHY AND HIGH‐FIELD MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF GREAT DANES WITH CERVICAL SPONDYLOMYELOPATHY

Computed tomography (CT) provides excellent bony detail, whereas magnetic resonance (MR) imaging is superior in evaluating the neural structures. The purpose of this prospective study was to assess interobserver and intermethod agreement in the evaluation of cervical vertebral column morphology and lesion severity in Great Danes with cervical spondylomyelopathy by use of noncontrast CT and high‐field MR imaging. Fifteen client‐owned affected Great Danes were enrolled. All dogs underwent noncontrast CT under sedation and MR imaging under general anesthesia of the cervical vertebral column. Three observers independently evaluated the images to determine the main site of spinal cord compression, direction and cause of the compression, articular process joint characteristics, and presence of foraminal stenosis. Overall intermethod agreement, intermethod agreement for each observer, overall interobserver agreement, and interobserver agreement between pairs of observers were calculated by use of kappa (κ) statistics. The highest overall intermethod agreements were obtained for the main site of compression and direction of compression with substantial agreements (κ = 0.65 and 0.62, respectively), whereas the lowest was obtained for right‐sided foraminal stenosis (κ = 0.39, fair agreement). For both imaging techniques, the highest and lowest interobserver agreements were recorded for the main site of compression and degree of articular joint proliferation, respectively. While different observers frequently agree on the main site of compression using both imaging techniques, there is considerable variation between modalities and among observers when assessing articular process characteristics and foraminal stenosis. Caution should be exerted when comparing image interpretations from multiple observers.     

MAGNETIC RESONANCE IMAGING OF THE CANINE ABDOMEN: EFFECT OF PULSE SEQUENCE ON DIAGNOSTIC QUALITY

Motion artifact is an important limiting factor for abdominal magnetic resonance imaging (MRI) in veterinary patients. The purpose of this study was to determine the effects of pulse sequence on abdominal MRI diagnostic quality in dogs. Ten normal dogs were each scanned using 16 MRI pulse sequences. Sequences included breath‐holding sequences, respiratory navigation sequences, and traditional spin‐echo sequences. Four observers independently scored diagnostic quality for each sequence based on the appearance of specific organs, overall diagnostic quality, and degree of artifactual interference. Signal‐to‐noise ratio and contrast‐to‐noise ratio were also calculated for each sequence. The sequence with the highest overall mean diagnostic quality score was the dorsal T2 turbo spin echo (TSE) with fat saturation and breath‐holding. The sequence with the lowest mean diagnostic quality score was the dorsal T2 fast spin echo. The sequence with the highest signal‐to‐noise ratio for all evaluated organs was the sagittal T1 spin echo. Signal‐to‐noise and contrast‐to‐noise ratios did not correlate with subjective assessment of overall diagnostic quality for the majority of the sequences evaluated (P < 0.05). The three sequences considered to have the highest diagnostic quality for the cranial abdomen were the dorsal T2 TSE with fat saturation and breath‐hold, transverse T1 turbo fast low‐angle shot gradient echo with breath‐hold, and dorsal T2 half‐Fourier acquisition single shot TSE with respiratory navigation. These sequences had short acquisition times, yielded studies of similar diagnostic quality, provided complementary information, and are therefore recommended for routine canine abdominal MRI protocols.     

COMPUTED TOMOGRAPHIC IMAGING PROTOCOL FOR THE CANINE CERVICAL AND LUMBAR SPINE

Computed tomography (CT) has been applied previously for assessment of canine spinal disease using a multitude of different technical imaging parameters. The purpose of this study was to establish an optimized imaging protocol for the cervical and lumbar canine spine using a single-detector-row helical CT unit. Thin slice thickness (1–2 mm), low pitch (axial scan mode, helical pitch <2), and medium-frequency image reconstruction algorithm significantly improved the visibility of the intervertebral disk and spinal cord. Tube current, helical reconstruction interval, and the use of an additional edge enhancement filter had no significant effect on the visibility of the intervertebral disk and spinal cord. There was also no interaction between the use of an additional edge enhancement filter and image reconstruction algorithm. Use of an additional edge enhancement filter introduced a double ring artifact in the periphery of the spinal canal lumen that did not correspond to the spinal cord or pachymeningeal margin.     

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.     

MAGNETIC RESONANCE IMAGING OF THE CANINE OPTIC NERVE

We describe the magnetic resonance (MR) imaging aspects of normal canine optic nerve, the diameter of the optic nerve as measured on MR images, and optimal MR sequences for the evaluation of the optic nerve using a 0.2 T MR unit. Three millimeter contiguous slides of the normal canine orbital region were acquired in transverse and dorsal oblique planes using a variety of tissue weighting sequences. It was apparent that detailed anatomic assessment of the optic nerve can be performed with low‐field MR imaging, but none of the sequences provided unequivocal superior image quality of the optic nerve. The mean diameter of the optic nerve sheath complex was 3.7 mm and of the optic nerve 1.7 mm. The intraorbital and intracanalicular parts of the optic nerve are consistently visible and differentiation between the optic nerve and optic nerve sheath complex is possible using low‐field MR systems.     

LOW FIELD MAGNETIC RESONANCE IMAGING OF THE CANINE CENTRAL NERVOUS SYSTEM

Magnetic resonance (MR) imaging is a relatively new method of medical imaging. MR studies on the normal canine central nervous system were performed using a low field MR scanner. The regions of interest were the head, neck, and lumbar region. The MR findings in two patients with brain atrophy and cervical neck disc protrusion were also evaluated. Based on our findings it appears that low-field scanners will be satisfactory for use in veterinary diagnostic imaging.     

MAGNETIC RESONANCE IMAGING OF THE CAUDAL LUMBAR AND LUMBOSACRAL SPINE IN 13 DOGS (1990–1993)

The caudal lumbar and lumbosacral spine of 13 dogs with pain or neurologic deficits were evaluated using magnetic resonance imaging (MRI). Spin echo T1, proton density, and T2 weighted and gradient echo T2* imaging sequences were utilized. MRI permitted direct, multiplanar, tomographic visualization of the spine facilitating evaluation of all components of degenerative caudal lumbar and lumbosacral stenosis. Abnormalities detected included intervertebral disc degeneration, intervertebral disc protrusion involving both the vertebral canal and intervertebral foramina, articular process osteophytosis, articular process fracture, nerve root impingement by spondylosis deformans, and the presence of low signal material within the vertebral canal of 2 dogs with recurrent pain following previous spinal surgery. In all 7 dogs treated surgically, MRI findings were consistent with surgical findings.     

ACCURACY OF MAGNETIC RESONANCE IMAGING FOR ESTIMATING INTRAMEDULLARY OSTEOSARCOMA EXTENT IN PRE-OPERATIVE PLANNING OF CANINE LIMB-SALVAGE PROCEDURES

The objective of this work was to compare the accuracy of radiographs and magnetic resonance imaging (MRI) for estimating appendicular osteosarcoma margins. The accuracy of computed tomography (CT) and bone scintigraphy was also assessed when these studies were available. Eight dogs with appendicular osteosarcoma underwent radiographic and MRI of affected limbs. In addition, bone scintigraphy was performed in six dogs and CT examination was performed in five dogs. Two observers jointly measured tumor length on all imaging studies. Correlative gross and histologic evaluation of all affected limbs was performed to determine tumor extent as measured from the nearest articular surface. Results from imaging studies were compared to gross and microscopic morphometry findings to determine the accuracy of each modality for determining tumor boundaries. MRI images were accurate with a mean overestimation of actual tumor length of 3 +/- 13%. T1-weighted non-contrast images were superior in identifying intramedullary tumor margins in most instances whereas contrast-enhanced images provided supplemental information in two dogs. Lateromedial and craniocaudal radiographs overestimated tumor length by 17 +/- 28% and 4 +/- 26%, respectively. Scintigraphy and CT overestimated tumor margins by 14 +/- 28% and 27 +/- 36%, respectively. MRI appears to be an accurate diagnostic imaging modality in determining intramedullary osteosarcoma boundaries. MRI should be considered as part of a pre-operative assessment of appendicular osteosarcoma, particularly when a limb-sparing procedure is contemplated.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING FINDINGS OF PRIMARY CEREBRAL HEMANGIOMA

Intracranial hemangioma is a rare intraaxial hemorrhagic neoplasm with imaging characteristics similar to other intracranial hemorrhagic lesions. We describe two canine cerebral hemangiomas that appeared as poorly circumscribed intraaxial compressive lesions that were predominantly hypointense on T2 sequences and heterogeneously contrast enhancing. Both lesions had perilesional edema and were hypointense on T2^*‐gradient recalled echo sequences, consistent with hemorrhage. In one tumor a short partial peripheral rim was present, which was suggestive of hemosiderin deposition. Cerebral hemangioma should be included as a differential for hemorrhagic intracranial lesions.