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犬推定和确诊的进行性脊髓软化症相关的磁共振成像特征及临床体征:12例病例(1997 - 2008年)

Magnetic resonance imaging features and clinical signs associated with presumptive and confirmed progressive myelomalacia in dogs: 12 cases (1997-2008).

作者信息

Okada Midori, Kitagawa Masato, Ito Daisuke, Itou Takuya, Kanayama Kiichi, Sakai Takeo

机构信息

Veterinary Research Center, Nihon University, Fujisawa, Kanagawa 252-0880, Japan.

出版信息

J Am Vet Med Assoc. 2010 Nov 15;237(10):1160-5. doi: 10.2460/javma.237.10.1160.

DOI:10.2460/javma.237.10.1160
PMID:21073387
Abstract

OBJECTIVE

To characterize clinical signs and findings from magnetic resonance imaging (MRI) and CSF analysis for dogs with progressive myelomalacia (PM) diagnosed on the basis of clinical and histologic features.

DESIGN

Retrospective case series.

ANIMALS

5 dogs with confirmed PM and 7 with presumptive PM evaluated from 1997 through 2008.

PROCEDURES

Medical records of study dogs were reviewed, and clinical signs and MRI and CSF findings were evaluated. A clinical diagnosis of PM was made on the basis of detection of disk-associated spinal cord compression via MRI and progression of clinical signs from initial paraparesis or paraplegia to thoracic limb lower motor neuron paresis to tetraplegia associated with cranial migration of the extent of cutaneous trunci reflex extinction and analgesia, terminating in death due to respiratory paralysis.

RESULTS

All dogs were paraplegic and had signs of lower motor neuron lesions. As revealed by MRI of the vertebral column, the length of abnormal signal intensity was more than 6-fold, compared with the body length of L2. In some dogs, these abnormal MRI findings were observed before PM was clinically diagnosed. The CSF examination revealed hemorrhagic xanthochromia.

CONCLUSIONS AND CLINICAL RELEVANCE

A hyperintense region of the spinal cord > 6 times the length of L2 on T2-weighted imaging might be a characteristic MRI finding of PM. In some dogs, such MRI findings were observed before PM was clinically diagnosed. Progressive myelomalacia may thus be diagnosable at the early stage through MRI and CSF examination before signs of PM develop.

摘要

目的

根据临床和组织学特征,对诊断为进行性脊髓软化症(PM)的犬的临床体征以及磁共振成像(MRI)和脑脊液分析结果进行特征描述。

设计

回顾性病例系列研究。

动物

1997年至2008年期间评估的5只确诊为PM的犬和7只疑似PM的犬。

方法

查阅研究犬的病历,并评估临床体征以及MRI和脑脊液检查结果。基于通过MRI检测到与椎间盘相关的脊髓压迫,以及临床体征从最初的轻瘫或截瘫发展为胸肢下运动神经元轻瘫,再到四肢瘫,并伴有皮节反射消失范围和痛觉缺失的头端迁移,最终因呼吸麻痹死亡,从而做出PM的临床诊断。

结果

所有犬均为截瘫,并有下运动神经元损伤的体征。脊柱MRI显示,异常信号强度的长度与L2椎体长度相比超过6倍。在一些犬中,这些异常的MRI表现出现在PM临床诊断之前。脑脊液检查显示出血性黄变症。

结论及临床意义

在T2加权成像上,脊髓高强度区域大于L2椎体长度的6倍可能是PM的特征性MRI表现。在一些犬中,这种MRI表现出现在PM临床诊断之前。因此,在PM体征出现之前,通过MRI和脑脊液检查可能在早期诊断出进行性脊髓软化症。

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