Web-Vet Neurology Specialists
Spinal Tumours
In this study the authors show the heterogeneous MRI and histopathological appearance of spinal lymphoma in 27 cats. All of them were evaluated for progressive neurological deficits, commonly acute or subacute, with paraparesis as the most common sign (62.9%), and pain present in 1/3 of the cases. In MRI studies spinal lymphomas were most commonly shown as a lumbar/lumbosacral epidural lesions, circumferential to the spinal cord, hyperintense on T2W images, and isointense on T1W images, with variable degrees of post-contrast enhancement and bone involvement. The majority of the lesions were focal (81.5%) but tended to extend to >1 vertebral body (66.6%). Antemortem diagnosis was achieved in 81.5% of cases via either CSF analysis, FNA or surgical biopsy.
Inaccurate localisation on MRI of a suspected neoplastic process as intramedullary (IM) as opposed to intradural-extramedulllary (IDEM) implies not only an inaccurate assumed histopathologic diagnosis but also inappropriate treatment recommendations and prognoses. This differentiation between IM and IDEM can be challenging as shown in this study which revealed considerable disagreement in designation of a lesion's relationship with the meninges.
The goals of this retrospective study were to describe the clinical, imaging, and histologic characteristics of canine primary spinal cord meningiomas, to evaluate surgical intervention and radiation therapy as treatment options, and to examine any correlation between tumor grade and clinical outcome.
Of 34 dogs with intraspinal mengiomas, most tumors were in the cervical spinal cord but were also found throughout the neuraxis. Location is correlated with histologic grade, with grade I tumors more likely to be in the cervical region than grade II tumors. Myelography generally shows an intradural extramedullary compressive lesion. On magnetic resonance imaging, the masses are strongly and uniformly contrast enhancing and a dural tail often is present. CSF analysis usually shows increased protein concentration with mild to moderate mixed pleocytosis. Surgical resection is an effective means of improving neurologic status, and adjunctive radiation therapy may lead to an improved outcome.
Clinical and magnetic resonance imaging features of lymphoma involving the nervous system in cats
This study of 31 cats aimed to describe the clinical and MRI features of lymphoma affecting the central (CNS) or peripheral (PNS) nervous system or both.
On MRI, lesions affecting the CNS were diagnosed in 18/31 cats, lesions in both CNS and PNS in 12/31, and lesions in the PNS only in 1/31. Intracranial lesions were diagnosed in 22 cats (extra‐axial, 7/22; intra‐axial, 2/22; mixed, 13/22), and spinal lesions were diagnosed in 12 (6/12 involving the conus medullaris and lumbosacral plexuses). Infiltration of adjacent extra‐neural tissue was present in 11/31 cases. Contrast enhancement was seen in all lesions, being marked in 25/30. Meningeal enhancement was present in all but 2 cases
The objectives of this 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.
MRI had excellent sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data. MRI 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. Interrater agreement was very good for correctly diagnosing dogs with intradural lesions and good for diagnosing dogs with neoplasia.
