Beckmann Katrin, Steffen Frank, Ohlerth Stefanie, Kircher Patrick R, Carrera Inés
Section of Neurology, Department of Small Animals, Vetsuisse Faculty, University of Zurich, 8057, Zurich, Switzerland.
Clinic of Diagnostic Imaging, Department of Small Animals, Vetsuisse Faculty, University of Zurich, 8057, Zurich, Switzerland.
Vet Radiol Ultrasound. 2016 Jan;57(1):41-8. doi: 10.1111/vru.12303. Epub 2015 Oct 15.
Central European tick-borne encephalomyelitis can be challenging to diagnose in dogs because the virus may not be detected in blood and cerebrospinal fluid (CSF) after the first viremic stage of the disease. The purpose of this retrospective case series study was to describe 3 Tesla magnetic resonance imaging (3T MRI) findings in a sample of dogs with a confirmed diagnosis of tick-borne encephalomyelitis. Dogs were included if they had neurological signs consistent with tick-borne encephalomyelitis, history of a stay in endemic areas for tick-borne encephalomyelitis virus, 3T MRI of the brain and/or spinal cord, cerebrospinal fluid changes compatible with viral infection and positive antibody titers in cerebrospinal fluid or pathologic confirmation of tick-borne encephalomyelitis. Twelve dogs met inclusion criteria. Ten out of 12 patients had 3T MRI lesions at the time of presentation. One patient had persistent lesions in follow-up MRI. The 3T MRI findings included bilateral and symmetrical gray matter distributed lesions involving the thalamus, hippocampus, brain stem, basal nuclei, and ventral horn on the spinal cord. All lesions were hyperintense in T2-weighted sequences compared to white matter, iso- to hypointense in T1-weighted, nonenhancing, and had minimal or no mass effect or perilesional edema. Six patients survived while the remaining six dogs were euthanized. Necropsy revealed neuronophagia and gliosis of the gray matter of the affected regions seen in 3T MRI, in addition to the cerebellum. Findings from the current study indicated that tick-borne encephalomyelitis should be included in the differential diagnosis list for dogs with the above described 3T MRI characteristics.
中欧蜱传脑脊髓炎在犬类中可能难以诊断,因为在疾病的第一个病毒血症阶段之后,血液和脑脊液(CSF)中可能检测不到该病毒。本回顾性病例系列研究的目的是描述一组确诊为蜱传脑脊髓炎的犬类样本的3特斯拉磁共振成像(3T MRI)结果。如果犬类有与蜱传脑脊髓炎一致的神经症状、有在蜱传脑脊髓炎病毒流行地区停留的病史、进行了脑和/或脊髓的3T MRI检查、脑脊液变化与病毒感染相符且脑脊液抗体滴度呈阳性或经病理证实为蜱传脑脊髓炎,则将其纳入研究。12只犬符合纳入标准。12例患者中有10例在就诊时存在3T MRI病变。1例患者在随访MRI中存在持续性病变。3T MRI结果包括双侧对称分布的灰质病变,累及丘脑、海马、脑干、基底核和脊髓腹角。与白质相比,所有病变在T2加权序列中呈高信号,在T1加权序列中呈等信号至低信号,无强化,且占位效应或病灶周围水肿最小或无。6例患者存活,其余6只犬实施安乐死。尸检显示,除小脑外,在3T MRI中可见的受影响区域灰质存在噬神经元现象和胶质细胞增生。本研究结果表明,对于具有上述3T MRI特征的犬类,蜱传脑脊髓炎应列入鉴别诊断清单。