RESUMEN
Magnetic resonance imaging (MRI) is a common test for dogs with suspected intradural spinal cord lesions, however studies on diagnostic performance for this test are lacking. Objectives of this multi-institutional, retrospective, case-control study were to estimate sensitivity and specificity of MRI for (1) distinguishing between histopathologically confirmed intradural spinal cord disease versus degenerative myelopathy in dogs, (2) categorizing intradural spinal cord diseases as neoplastic, inflammatory, or vascular; and (3) determining tumor type within the etiologic category of neoplasia. Additional aims were to (1) determine whether knowledge of clinical data affects sensitivity and specificity of MRI diagnoses; and (2) report interrater agreement for MRI classification of intradural spinal lesions. Cases were recruited from participating hospital databases over a 7-year period. Three reviewers independently evaluated each MRI study prior to and after provision of clinical information. A total of 87 cases were sampled (17 degenerative myelopathy, 53 neoplasia, nine inflammatory, and eight vascular). Magnetic resonance imaging had excellent (>97.6%) sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data (68.6% vs. 82.4%, P = 0.023). Magnetic resonance imaging had good sensitivity (86.8%) and moderate specificity (64.7-72.5%) for diagnosing neoplasia. Sensitivity was lower for classifying inflammatory lesions but improved with provision of clinical data (48.1% vs. 81.5%, P = 0.015). Magnetic resonance imaging was insensitive for diagnosing vascular lesions (25.0%). Interrater agreement was very good for correctly diagnosing dogs with intradural lesions (ĸ = 0.882-0.833), and good (ĸ = 0.726-0.671) for diagnosing dogs with neoplasia.
Asunto(s)
Enfermedades de los Perros/diagnóstico , Mielitis/veterinaria , Neoplasias de la Médula Espinal/veterinaria , Enfermedades Vasculares de la Médula Espinal/veterinaria , Animales , Estudios de Casos y Controles , Enfermedades de los Perros/diagnóstico por imagen , Perros , Femenino , Imagen por Resonancia Magnética , Masculino , Mielitis/diagnóstico , Mielitis/diagnóstico por imagen , Estudios Retrospectivos , Sensibilidad y Especificidad , Neoplasias de la Médula Espinal/diagnóstico , Neoplasias de la Médula Espinal/diagnóstico por imagen , Enfermedades Vasculares de la Médula Espinal/diagnóstico , Enfermedades Vasculares de la Médula Espinal/diagnóstico por imagenRESUMEN
Two surgically treated haematomyelia cases were documented. One dog and one cat were presented for acute progressive paraplegia following a fall from height incident. Neurological examinations suggested a L4-S3 myelopathy in both cases. Radiography and magnetic resonance imaging in both cases revealed no fracture or subluxation of the spine, but well-defined intramedullary mass lesions in lower lumbar regions compatible with haemorrhage and haematoma formation. Exploratory surgeries were performed over the lesions. Dark-red friable masses were removed via myelotomy. Histopathological examinations revealed organizing haematomas at the acute to subacute stage. Postoperatively, both cases improved and regained ambulation. The dog walked normally but remained urinary and faecal incontinent 9 months after the surgery. The cat was continent and ambulatory with a paraparetic gait 5 months after the surgery. In both cases, the outcomes and the patients' quality of life were considered satisfactory by the owners.
Asunto(s)
Enfermedades de los Perros , Enfermedades de la Médula Espinal , Enfermedades Vasculares de la Médula Espinal , Perros , Animales , Calidad de Vida , Enfermedades de la Médula Espinal/etiología , Enfermedades de la Médula Espinal/cirugía , Enfermedades de la Médula Espinal/veterinaria , Imagen por Resonancia Magnética/veterinaria , Enfermedades Vasculares de la Médula Espinal/complicaciones , Enfermedades Vasculares de la Médula Espinal/veterinaria , Resultado del Tratamiento , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/etiologíaRESUMEN
A 30-month-old Maine Coon presented with progressive proprioceptive ataxia, paraparesis, thoracolumbar pain, and decreased appetite. An extradural mass was detected within the left side of the 13th thoracic vertebral canal that compressed the spinal cord on magnetic resonance (MR) and was considered to be mineralized on computed tomography (CT) images. The resected mass was diagnosed as a vertebral vascular hamartoma. Clinical signs improved, but recurrence was diagnosed by MR and CT imaging at 7 months after surgery. Repeated excisional surgery yielded the same diagnosis and the clinical signs abated. Fifteen months after the second surgery, there was apparent vertebral deformation, but there was no further change on CT images by 29 months.
Asunto(s)
Enfermedades de los Gatos/cirugía , Hamartoma/veterinaria , Enfermedades Vasculares de la Médula Espinal/veterinaria , Animales , Enfermedades de los Gatos/diagnóstico por imagen , Gatos , Hamartoma/diagnóstico por imagen , Hamartoma/cirugía , Masculino , Recurrencia , Enfermedades Vasculares de la Médula Espinal/diagnóstico por imagen , Enfermedades Vasculares de la Médula Espinal/cirugía , Vértebras Torácicas , Tomografía Computarizada por Rayos X/veterinariaRESUMEN
We conducted combined electrophysiological examinations including F-wave, motor nerve conduction velocity (MNCV), spinal cord-evoked potential (SCEP), and needle electromyography (EMG) in two cats involved in traffic accidents that consequently developed hind limb paralysis caused by lumbar hematomyelia. F-wave could no longer be elicited within 3 days after the accident, and the MNCV and compound muscle action potential (CMAP) amplitude decreased in a time-dependent manner, with CMAP no longer being evoked after 7 or 8 days. EMG showed abnormalities such as fibrillation and positive sharp waves after 6 to 8 days. These results suggest that such combined electrophysiological examinations may provide objective, quantitative data for motor nerve dysfunction in cats with lumbar hematomyelia.
Asunto(s)
Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/patología , Electrofisiología/métodos , Región Lumbosacra/patología , Neuronas Motoras/patología , Enfermedades Vasculares de la Médula Espinal/veterinaria , Accidentes de Tránsito , Animales , Gatos , Electromiografía/veterinaria , Potenciales Evocados/fisiología , Conducción Nerviosa/fisiología , Enfermedades Vasculares de la Médula Espinal/diagnóstico , Enfermedades Vasculares de la Médula Espinal/patología , Factores de TiempoRESUMEN
A 2-year-old male (Hungarian Vizsla) was evaluated for progressive discomfort of possible spinal origin. A minimum data base, thoracolumbar magnetic resonance (MR) imaging examination and electrophysiologic investigation were all normal. Cerebellomedullary and lumbar cerebrospinal fluid (CSF) was collected. The fluid was unremarkable except for elevated total protein. Shortly, thereafter, the dog had progressive neurologic deterioration referable to a caudal lumbar spinal cord lesion. In a repeated MR examination there was a well-circumscribed intramedullary lesion at the site where lumbar CSF was collected. The signal characteristics of the lesion were compatible with subacute hemorrhage, which was confirmed to be hematomyelia at the time of successful decompressive surgery.