Caine Abby, Brash Robert, De Risio Luisa, Van Dijk Jan, Cherubini Giunio Bruto, Dennis Ruth
Department of Imaging, Dick White Referrals, Six Mile Bottom, UK.
Department of Imaging, Animal Health Trust, Newmarket, UK.
J Feline Med Surg. 2019 Dec;21(12):1111-1119. doi: 10.1177/1098612X18819162. Epub 2018 Dec 19.
The aim of this study was to evaluate the MRI findings in cats following traumatic brain injury (TBI), and establish which features identified might correlate with prognosis.
The magnetic resonance images of 30 cats with clinical signs attributed to the brain following TBI were retrospectively reviewed to assess the imaging features seen and their correlation with outcome.
Twenty-one of 30 cats had a good outcome (full recovery or minor ongoing neurological deficits); the other nine either died or had ongoing neurological deficits that significantly affected quality of life. There was evidence of parenchymal injury in only 20/30 cats, including 8/9 that had a poor outcome. The frequency of bilateral or multifocal parenchymal lesions on T2-weighted imaging, and mass effect, particularly caudal transtentorial herniation, was statistically significantly higher in patients with a poorer outcome. Extra-axial haemorrhage was not identified. Concurrent soft tissue injury was noted in all cats, with a poorer prognosis statistically associated with a peripharyngeal pattern of injury and orbital trauma.
The number of cases with MRI-identified brain pathology, the patterns of injuries identified and the specific imaging features that appear to have effects on prognosis differ in this series of cats from those published in similar case series of dogs. Further work is needed to establish if cat-specific guidelines are needed to assess brain MRI following trauma.
本研究旨在评估猫创伤性脑损伤(TBI)后的MRI表现,并确定所发现的哪些特征可能与预后相关。
回顾性分析30只因TBI出现脑部临床症状的猫的磁共振图像,以评估所见的影像学特征及其与预后的相关性。
30只猫中有21只预后良好(完全恢复或仅有轻微的持续性神经功能缺损);另外9只要么死亡,要么有严重影响生活质量的持续性神经功能缺损。仅20/30的猫有实质损伤的证据,其中8/9预后不良。在预后较差的患者中,T2加权成像上双侧或多灶性实质病变以及占位效应,特别是幕下疝的发生率在统计学上显著更高。未发现轴外出血。所有猫均有并发软组织损伤,预后较差在统计学上与咽周损伤模式和眼眶创伤相关。
在这一系列猫中,MRI识别出的脑部病变病例数、损伤模式以及似乎对预后有影响的特定影像学特征与类似犬类病例系列中发表的情况不同。需要进一步开展工作以确定是否需要针对猫的特定指南来评估创伤后的脑部MRI。