ULTRASONOGRAPHIC EVALUATION OF BRACHIAL PLEXUS TUMORS IN FIVE DOGS

Five dogs with unilateral thoracic limb lameness, neurologic deficits, muscle atrophy, and pain, or a combination of these signs, were examined using ultrasonograghy. Large, hypoechoic tubular masses that displaced vessels and destroyed the normal architecture were found in each dog. The affected axilla of each patient was then imaged with computed tomography or magnetic resonance to fully assess the extent of the masses. We describe the use of ultrasound in screening patients for brachial plexus tumors.     

MAGNETIC RESONANCE IMAGING AND ULTRASONOGRAPHY IN THE DIAGNOSIS OF A MALIGNANT PERIPHERAL NERVE SHEATH TUMOR IN A DOG

A 9-year-old male neutered mixed breed dog had a two-month history of progressive left thoracic limb lameness. There was electromyographic evidence of denervation potentials in all muscles of this limb. In magnetic resonance images a multilobulated, hyperintense mass was visible caudal to the middiaphysis of the left humerus on T-2 weighted images. The mass, which was isointense with surrounding tissue on T1 weighted images, extended proximally towards the brachial plexus. The mass was also visible as a fusiform structure of mixed echogenicity sonographically, although fine-needle aspiration performed at this time was nondiagnostic. A malignant peripheral nerve sheath tumor was diagnosed histopathologically.     

MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF LYMPHOMA INVOLVING THE BRACHIAL PLEXUS IN A CAT

An 11-year-old, neutered, female Domestic Long Hair cat had a 3-week history of left forelimb lameness. Conscious proprioception and postural reflexes were absent on the left thoracic limb. The cat had slightly reduced placing and hopping responses on the left pelvic limb, absent cutaneous trunci muscle reflex on the left side, and left triceps muscle atrophy. Magnetic resonance imaging revealed a 2 x 2 x 2 cm mass in the region of the left brachial plexus. The cat was treated by left forelimb amputation and hemilaminectomy. Histopathology of the brachial plexus revealed lymphoma.     

MAGNETIC RESONANCE IMAGING OF ACQUIRED TRIGEMINAL NERVE DISORDERS IN SIX DOGS

The medical records and magnetic resonance (MR) images of dogs with an acquired trigeminal nerve disorder were reviewed retrospectively. Trigeminal nerve dysfunction was present in six dogs with histologic confirmation of etiology. A histopathologic diagnosis of neuritis (n=2) or nerve sheath tumor (n=4) was made. Dogs with trigeminal neuritis had diffuse enlargement of the nerve without a mass lesion. These nerves were isointense to brain parenchyma on T1-weighted (T1W) precontrast images and proton-density-weighted (PDW) images and either isointense or hyperintense on T2-weighted (T2W) images. Dogs with a nerve sheath tumor had a solitary or lobulated mass with displacement of adjacent neuropil. Nerve sheath tumors were isointense to the brain parenchyma on T1W, T2W, and PDW images. All trigeminal nerve lesions enhanced following contrast medium administration. Atrophy of the temporalis and masseter muscles, with a characteristic increase in signal intensity on T1W images, were present in all dogs.     

MAGNETIC RESONANCE IMAGING FEATURES OF THE TEMPOROMANDIBULAR JOINT IN NORMAL DOGS

Evaluation of the canine temporomandibular joint (TMJ) is important in the clinical diagnosis of animals presenting with dysphagia, malocclusion and jaw pain. In humans, magnetic resonance imaging (MRI) is the modality of choice for evaluation of the TMJ. The objectives of this study were to establish a technical protocol for performing MRI of the canine TMJ and describe the MRI anatomy and appearance of the normal canine TMJ. Ten dogs (one fresh cadaver and nine healthy live dogs) were imaged. MRIs were compared with cadaveric tissue sections. T1‐weighted (T1‐W) transverse closed‐mouth, T1‐W sagittal closed‐mouth, T1‐W sagittal open‐mouth, and T2‐W sagittal open‐mouth sequences were obtained. The condylar process of the mandible and the mandibular fossa of the temporal bone were hyperintense to muscle and isointense to hypointense to fat on T1‐W images, mildly hyperintense to muscle on T2‐W images, and were frequently heterogeneous. The articular disc was visible in 14/20 (70%) TMJs on T1‐W images and 13/20 (65%) TMJs on T2‐W images. The articular disc was isointense to hyperintense to muscle on T1‐W images and varied from hypointense to hyperintense to muscle on T2‐W images. The lateral collateral ligament was not identified in any joint. MRI allows evaluation of the osseous and certain soft tissue structures of the TMJ in dogs.     

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.     

MALIGNANT PERIPHERAL NERVE SHEATH TUMOR IN A CAT

A report of a cat with a cranial tumor of nerve sheath origin is presented. The cranial mass, with a cyst-like character on presentation to the referring veterinarian suggested a benign lesion, but the clinical course was rapid and indicative of central nervous system involvement. The tumor was poorly differentiated by histologic examination, but immunohistochemistry was consistent with Schwann cell origin. Features of peripheral nerve sheath tumors in cats and other species are briefly discussed.     

MAGNETIC RESONANCE ARTHROGRAPHY OF THE CANINE STIFLE JOINT TECHNIQUE AND APPLICATIONS IN ELEVEN MILITARY DOGS

The stifle joints of eleven military working dogs were evaluated using conventional magnetic resonance (MR) imaging and MR arthrography. A protocol optimizing MR imaging of the canine stifle joint is discussed, as well as potential uses for administration of intra-articular gadolinium. The technique for performing MR arthrography is described, and post-contrast image findings are reviewed. MR arthrography was performed by using an intra-articular injection of diluted gadolinium. Consistently good quality images were obtained, and no complications were clinically detected following MR arthrography. Cranial cruciate ligament abnormalities were seen in six dogs, meniscal abnormalities were visualized in nine menisci, and synovitis and medial ligament strain were seen in eight dogs. Surgical and post-mortem confirmation of these findings is discussed in seven dogs. Although MR arthrography adds an invasive procedure to conventional MR imaging, it can provide useful information on pathologic changes in the canine stifle joint.     

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.     

MAGNETIC RESONANCE IMAGING FEATURES OF MULTILOBULAR OSTEOCHONDROSARCOMA IN 3 DOGS

Three dogs with multilobular osteochondrosarcoma of the skull were evaluated using magnetic resonance (MR) imaging. Spin echo T1, T2, proton weighted and post contrast T1W images were obtained with a 1.5 Tesla magnet. The MR imaging findings were similar in all three dogs with mixed signal intensities in the T1W, T2W and proton weighted images and fairly large areas of contrast enhancement in the post contrast T1W images. The extent of brain and soft tissue involvement were well delineated and provided useful information concerning surgical planning. MR imaging provided a useful method of evaluating dogs with skull tumors.     

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.     

MAGNETIC RESONANCE IMAGING OF THE INTRATEMPORAL FACIAL NERVE IN IDIOPATHIC FACIAL PARALYSIS IN THE DOG

The most common cause of peripheral facial nerve paralysis in dogs, in the absence of otitis media, is thought to be idiopathic. Gadolinium-enhanced (Gd) magnetic resonance (MR) imaging has been used to study peripheral facial weakness in humans with a wide variety of disorders, including Bell's palsy, the clinical equivalent of idiopathic facial nerve paralysis in dogs. Gd-MR imaging may be useful to demonstrate abnormal enhancement of the intratemporal facial nerve. The aim of this study was to define the role of the Gd-MR imaging in dogs with idiopathic facial nerve paralysis, with regard to pattern of enhancement, and to search for prognostic information. Six dogs with peripheral facial nerve paralysis, followed between 2003 and 2005, were studied. Physical and neurologic examinations, as well as clinical tests, were performed, including routine hematology, serum biochemistry, thyroid screening, cerebrospinal fluid analysis, and MR imaging. The time interval between the onset of the clinical signs, the progress of the disease, and the final recovery was noted in each dog. The following four intratemporal segments of the facial nerve were analyzed: internal acoustic meatus, labyrinthine segment/geniculate ganglion, tympanic segment, and mastoid segment. Along its length, contrast enhancement was found in four dogs. In this group, contrast enhancement of the facial nerve was found in all segments of two dogs, in three segments of one dog, and in one segment of the other dog. In the four dogs with enhancement, one recovered completely in 8 weeks and three have not recovered completely. The two dogs without evidence of enhancement recovered completely in an average time of 4 weeks.     

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).     

COMPARISON OF SPIN ECHO, GRADIENT ECHO AND FAT SATURATION MAGNETIC RESONANCE IMAGING SEQUENCES FOR IMAGING THE CANINE ELBOW

Two comparison studies were performed. In the first conventional spin-echo (T1- and T2-weighted) sequences and a three-dimensional (3-D Fourier transform [3DFT]) echo gradient fast-imaging sequence were compared for imaging the canine normal elbow joint. In all three sequences, there was an isointense signal of the articular cartilage and a hyposignal of the subchondral bone, as compared with the muscles. The medial coronoid process of the ulna was clearly seen on the dorsal plane images, it appeared with a homogenous low-intensity signal. Its articulation with the radius was clearly outlined. In a second study, the 3DFT echo gradient fast-imaging sequence was compared to a fat saturation sequence on normal shoulder and elbow joints. Elbows were imaged with and without injection of saline, in an attmept to show the opposing cartilaginous articular surfaces. This distinction was possible in the shoulder joint but not in the elbow because of insufficient spatial resolution. On the three MRI sequences compared, gradient echo fast imaging with steady-state precession (GE FISP) sequence was found to be the most suitable for imaging the canine elbow joint.     

ULTRASONOGRAPHIC ANATOMY OF THE BRACHIAL PLEXUS AND MAJOR NERVES OF THE CANINE THORACIC LIMB

A technique for ultrasonography of the brachial plexus and major nerves of the canine thoracic limb is described based on examination of five canine cadavers and three healthy dogs. The ventral branches of the spinal nerves that contribute to the brachial plexus are identifiable at their exit from the intervertebral foramina. These nerves may be followed distally, cranial to the first rib, until they form the brachial plexus. The musculocutaneous, ulnar, and median nerves are identified on the medial aspect of mid‐humerus and followed proximally to the axillary region and distally to the elbow. The radial nerve, formed by multiple nerve components, is seen on the mediocaudal aspect of the humerus. Nerves appear as hypoechoic tubular structures with an internal echotexture of discontinuous hyperechoic bands, surrounded by a thin rim of highly echogenic tissue. Improved understanding of the ultrasonographic anatomy of the brachial plexus and its main branches supports clinical use of this modality.     

MAGNETIC RESONANCE IMAGING OF NORMAL CANINE CARPAL LIGAMENTS

Magnetic resonance imaging was conducted on previously frozen left carpi from six normal dogs using a 1.5 Tesla magnet in combination with a transmit/receive wrist coil. Three-millimeter thick T1-weighted spin-echo images and 1-mm thick T2*-weighted gradient-recalled 3-D images were obtained in dorsal and sagittal planes. Carpi were embedded, sectioned, and stained. Anatomic structures on the histologic sections were correlated with the MR images. All of the carpal ligaments plus the radioulnar articular disc and the palmar fibrocartilage were identified on MR images. The accessorio-quartile ligament, which had not been well described previously in dogs, was also identified. It originated on the accessory carpal bone and inserted on the fourth carpal bone. The T2*-weighted gradient echo imaging technique provided better images than T1-weighted technique, largely because thinner slices were possible (1 mm vs. 3 mm), resulting in less volume averaging of thin ligaments with surrounding structures. Although MRI is currently the imaging modality of choice to identify ligamentous injury in humans, further studies are needed to determine if abnormalities can be detected in canine carpal ligaments using MRI.     

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.     

RADIOGRAPHIC AND MAGNETIC RESONANCE IMAGING OF THE STIFLE JOINT IN EXPERIMENTAL OSTEOARTHRITIS OF DOGS

Radiography and magnetic resonance imaging were used to evaluate osteoarthritis at 2, 6, and 12 weeks following transection of the cranial cruciate ligament of the stifle (femorotibial) joint of 6 dogs. A quantitative radiographic scoring system was used to assess the progression of hard and soft tissue changes of osteoarthritis. Mediolateral (flexed joint) and oblique (extended joint) radiographic projections enabled identification of small osteophytes on the femoral trochlear ridges, which were detected at an earlier stage of development than was previously reported. Magnetic resonance imaging was useful in detecting changes in cartilage thickness, osteophytosis and intraarticular loose bodies. Radiography and magnetic resonance imaging were complementary in the assessment of pathologic changes of osteoarthritis.     

MAGNETIC RESONANCE IMAGING OF BRAIN INFARCTION IN SEVEN DOGS

Magnetic resonance imaging was performed in seven dogs with histopathologically-confirmed brain infarcts. The infarcts were non-hemorrhagic in four dogs and hemorrhagic in three dogs. Six dogs had single infarcts involving the cerebrum and one dog had multiple infarcts involving the cerebrum and brain stem. Non-hemorrhagic infarcts were typically wedge-shaped, hypointense on T1-weighted images, hyperintense on T2-weighted images, and did not enhance with gadolinium-DTPA. Hemorrhagic infarcts had mixed intensity on T1- and T2-weighted images, with variable patterns of enhancement.     

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.