Clinical use of a new frameless optical neuronavigation system for brain biopsies: 10 cases (2013-2020).

OBJECTIVES: The aim of the retrospective study was to describe the brain biopsy procedure using a new frameless optical neuronavigation system and to report diagnostic yield and complications associated with the procedure. MATERIALS AND METHODS: The medical records for all dogs with forebrain lesions that underwent brain biopsy with a frameless optical neuronavigation system in a single referral hospital between 2013 and 2020 were retrospectively analysed. Following data were collected: signalment, neurological signs, diagnostic findings, number of brain biopsy samples, sampled region, complications, duration of hospitalisation, whether the samples were diagnostic and histopathological diagnoses. The device consists of a computer workstation with navigation software, an infrared camera, patient tracker and reflective instruments. The biopsy needle was equipped with reflective spheres, so the surgeon could see the position of the needle during sampling the intracranial lesion free handed through a mini-burr hole. RESULTS: Ten dogs were included. Absolute diagnostic yield based on specific histopathological diagnosis was 73.9%. Three dogs had immune-mediated necrotizing encephalitis, two dogs showed a necrotizing leukoencephalitis and two dogs a meningoencephalitis of unknown origin. In two dogs, the brain specimen showed unspecific changes. In one dog, the samples were non-diagnostic. Seven dogs showed no neurological deterioration, one dog mild temporary ataxia and two dogs died within 36 hours post brain biopsy. CLINICAL SIGNIFICANCE: In these 10 dogs, the frameless optical neuronavigation system employed was useful to gain diagnostic brain biopsy samples. Considering the mortality rate observed, further studies are needed to confirm the safety of this procedure and prove its actual clinical effectiveness.

Intra-abdominal blockage of a ventriculoperitoneal shunt by a suspected mesenteric pseudocyst in a dog.

BACKGROUND: There are few reports of abdominal complications following ventriculoperitoneal (VP) shunt placement for the treatment of hydrocephalus in dogs. CASE REPORT: A 3-year-old dog underwent successful VP shunting for the treatment of hydrocephalus, but re-presented 10 months later with progressive central vestibular syndrome. Magnetic resonance imaging of the brain suggested VP catheter obstruction. The dog was euthanased and on postmortem examination the abdominal tip of the VP catheter was ensheathed and blocked by fibrous mesentery, possibly a pseudocyst. CONCLUSIONS: Abdominal complications are common in humans, with pseudocysts reported in up to 4.5% of cases. This diagnosis should be considered for dogs re-presenting following VP shunt surgery.

[Magnetic resonance imaging of the temporomandibular joint in dogs and cats. Effect of different coils on image quality]. / Magnetresonanztomographische Untersuchung des Kiefergelenks von Hund und Katze. Einfluss unterschiedlicher Spulen auf die Bildqualität.

OBJECTIVE: In magnetic resonance imaging (MRI) the image quality is considerably affected by the coil used, particularly when small structures are examined. The purpose of this study was to determine which coil provides the best scanning results for imaging of the temporomandibular joint (TMJ) of dogs and cats. MATERIAL AND METHODS: MRI investigations were performed using a standard human knee coil and an 8-cm-diameter surface coil with a low-field MRI-system (field strength 0.5 T). TMJs of two dogs and two cats were examined. The scan protocol consisted of T1-weighted spin echo (T1W/SE), T2-weighted turbo spin echo (T2W/TSE), a proton density-weighted sequence (PDW) (slice thickness: 3 mm each), and gradient echo sequences (slice thickness: 1-1.5 mm) in the sagittal plane. Three observers independently compared the features "contrast resolution", "bone structure", "spatial resolution", and "signal-to-noise ratio" (SNR) using a 5-point scale. Investigators were blinded with respect to the coils used. RESULTS: Approximately 50% of the images obtained by the use of the surface coil were rated superior in comparison with the knee coil in terms of the features "contrast resolution", "bone structure", and "spatial resolution". In approximately 50% of the MRI-images no differences in the ratings were seen. With respect to the criterion "signal-to-noise ratio" 90% of the images acquired with the surface coil were rated better. In 5% of the images an identical quality was recorded. The surface coil proved to be superior both in dogs and cats. CONCLUSIONS AND CLINICAL RELEVANCE: Display quality of small structures of the TMJ is dependent on the spatial resolution of the MR images. Therefore, a dedicated coil and a small field of view (FOV) should be used. Results reveal that low-field MRI is able to display subtle anatomic structures of the TMJ in dogs and cats. In principle, the results can be transmitted to other MRI-systems. However, to generate valid scan protocols it is necessary to adapt scan parameters and coil selection specifically.

[Computed tomography imaging of the temporomandibular joint in dogs and cats. Effects of different scan parameters on image quality]. / Computertomographische Darstellung des Kiefergelenks von Hund und Katze. Beeinflussung der Bildqualität durch unterschiedliche Aufnahmeparameter.

OBJECTIVE: Temporomandibular joints (TMJs) of dogs and cats were examined with multislice computed tomography (MSCT) using different technical scan parameters in order to investigate their impact on image quality. Another aspect was to analyze whether size differences of the TMJ affect the display of small joint structures. MATERIAL AND METHODS: The TMJs of two dogs and two cats were examined using MSCT. Scan parameters were varied including tube current, scan matrix, resolution mode, slice thickness, and reconstruction increment. Three observers being blinded with respect to the used scan parameters independently assessed the image quality in terms of "contrast resolution", "bone structure", "spatial resolution", "evaluation of the joint space", and "artefacts" according to a 4-point scale. RESULTS: The criteria "spatial resolution" and "evaluation of the joint space" emphasize the influence of the size of the TMJ. The image quality of the TMJ of the dogs was evaluated superior (by 0.5 to 1.5 points higher graded) compared to the smaller ones of the cats. In terms of "spatial resolution" and "bone structure" the images of an ultra high resolution technique achieved a higher evaluation level (scoring one point superior) compared to the images created by a high resolution protocol. The tube current did not significantly influence the image quality in any of the pictures. CONCLUSIONS AND CLINICAL RELEVANCE: The display quality of small structures of the TMJ is dependent on the spatial resolution of the CT images. Therefore, a thin slice collimation, a small field of view, and a high resolution reconstruction matrix should be used. Under those aspects subtle alterations of bone structure of the TMJ can be reliably detected. The soft tissue structures of the TMJ can not be visualized with MSCT in small animals. In principle, the results can be applied to any other MSCT-scanner. However, adjustments of the technical parameters may be still necessary.

Neurological, imaging and pathological features of a meningeal inflammatory pseudotumour in a Maltese terrier.

A five-year eight-month-old Maltese terrier was presented with a 3-week history of progressive paraparesis and pelvic limb ataxia. Neurological examination was consistent with a lesion involving the T3-L3 spinal cord segments. Myelogram and magnetic resonance imaging revealed a spherical, intradural-extramedullary mass lesion at T13/L1. A dorsal laminectomy, durotomy and debulking of the mass were performed. Histopathologic examination revealed a highly cellular tissue, most likely of mesenchymal origin, infiltrated by many lymphocytes, macrophages and neutrophils. The pathological diagnosis of an inflammatory pseudotumour was made. Postsurgical analgesia was achieved with opioids and 2 mg/kg carprofen twice daily for 5 days. When the histopathological diagnosis was made, a tapering course of 1 mg/kg prednisolone twice daily was prescribed, with dose reduction by approximately 50% every 4 to 6 weeks over a 4-month period. Magnetic resonance imaging was repeated at 22, 32 and 85 weeks postsurgery; no signs of regrowth could be detected and the patient recovered with residual mild paraparesis. Inflammatory pseudotumour has not been documented previously at this site in dogs and, although rare, should be considered in the differential diagnosis of a focal mass lesion affecting the spinal cord. Surgical debulking and immunomodulatory therapy can be curative.