Cervera Vicente, Mai Wilfried, Vite Charles H, Johnson Victoria, Dayrell-Hart Betsy, Seiler Gabriela S
Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104-6010, USA.
Vet Radiol Ultrasound. 2011 Jan-Feb;52(1):33-40.
Cerebrovascular accidents, or strokes, and gliomas are common intraaxial brain lesions in dogs. An accurate differentiation of these two lesions is necessary for prognosis and treatment decisions. The magnetic resonance (MR) imaging characteristics of 21 dogs with a presumed cerebrovascular accident and 17 with a glioma were compared. MR imaging findings were reviewed retrospectively by three observers unaware of the final diagnosis. Statistically significant differences between the appearance of gliomas and cerebrovascular accidents were identified based on lesion location, size, mass effect, perilesional edema, and appearance of the apparent diffusion coefficient map. Gliomas were predominantly located in the cerebrum (76%) compared with presumed cerebrovascular accidents that were located mainly in the cerebellum, thalamus, caudate nucleus, midbrain, and brainstem (76%). Gliomas were significantly larger compared with presumed cerebrovascular accidents and more commonly associated with mass effect and perilesional edema. Wedge-shaped lesions were seen only in 19% of presumed cerebrovascular accidents. Between the three observers, 10-47% of the presumed cerebrovascular accidents were misdiagnosed as gliomas, and 0-12% of the gliomas were misdiagnosed as cerebrovascular accidents. Diffusion weighted imaging increased the accuracy of the diagnosis for both lesions. Agreement between observers was moderate (kappa = 0.48, P < 0.01).
脑血管意外，即中风，以及神经胶质瘤是犬类常见的脑内病变。准确区分这两种病变对于预后和治疗决策至关重要。对21只疑似脑血管意外的犬和17只患有神经胶质瘤的犬的磁共振（MR）成像特征进行了比较。三名不知最终诊断结果的观察者对MR成像结果进行了回顾性分析。根据病变位置、大小、占位效应、病变周围水肿以及表观扩散系数图的表现，确定了神经胶质瘤和脑血管意外表现之间的统计学显著差异。与主要位于小脑、丘脑、尾状核、中脑和脑干的疑似脑血管意外（76%）相比，神经胶质瘤主要位于大脑（76%）。与疑似脑血管意外相比，神经胶质瘤明显更大，更常伴有占位效应和病变周围水肿。楔形病变仅在19%的疑似脑血管意外中出现。在三名观察者中，10% - 47%的疑似脑血管意外被误诊为神经胶质瘤，0% - 12%的神经胶质瘤被误诊为脑血管意外。扩散加权成像提高了两种病变诊断的准确性。观察者之间的一致性为中等（kappa = 0.48，P < 0.01）。
