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12只患有多发性骨髓瘤的犬的神经学体征和MRI检查结果

Neurological signs and MRI findings in 12 dogs with multiple myeloma.

作者信息

Wyatt Sophie, De Risio Luisa, Driver Colin, José-López Roberto, Pivetta Mauro, Beltran Elsa

机构信息

Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK.

Department of Neurology and Neurosurgery, Animal Health Trust, Newmarket, UK.

出版信息

Vet Radiol Ultrasound. 2019 Jul;60(4):409-415. doi: 10.1111/vru.12759. Epub 2019 May 6.

Abstract

Vertebral lesions and associated neurological signs occur in dogs with multiple myeloma, however, veterinary literature describing MRI findings is currently lacking. The objective of this multicenter, retrospective, case series study was to describe neurological signs and MRI findings in a group of dogs that presented for spinal pain or other neurological deficits and had multiple myeloma. Electronic records of four veterinary referral hospitals were reviewed. Dogs were included if they had a pathologically confirmed diagnosis of multiple myeloma, had presented for spinal pain or other neurological signs, and had undergone MRI of the vertebral column. The MRI studies were evaluated and the anatomical location of lesion(s), signal intensity, presence of extra-dural material, degree of spinal cord compression, extent of vertebral lesions, and contrast enhancement were recorded. Twelve dogs met inclusion criteria. Most dogs (n = 8) had a chronic progressive history, with varying degrees of proprioceptive ataxia and paresis (n = 11), and spinal pain was a feature in all dogs. The MRI findings were variable but more consistent features included the presence of multiple expansile vertebral lesions without extension beyond the outer cortical limits of affected vertebrae, and associated extradural material causing spinal cord compression. The majority of lesions were hyper- to isointense on T2 (n = 12) and T1-weighted (n = 8) sequences, with variable but homogeneous contrast-enhancement (n = 12). These described MRI characteristics of multiple myeloma may be used to aid early identification and guide subsequent confirmatory diagnostic steps, to ultimately improve therapeutic approach and long-term outcome.

摘要

患有多发性骨髓瘤的犬类会出现椎体病变及相关神经症状,然而,目前缺乏描述MRI检查结果的兽医文献。本多中心、回顾性病例系列研究的目的是描述一组因脊柱疼痛或其他神经功能缺损前来就诊且患有多发性骨髓瘤的犬类的神经症状和MRI检查结果。对四家兽医转诊医院的电子记录进行了回顾。如果犬类经病理确诊为多发性骨髓瘤,因脊柱疼痛或其他神经症状前来就诊,并接受了脊柱MRI检查,则纳入研究。对MRI研究进行评估,并记录病变的解剖位置、信号强度、硬膜外物质的存在情况、脊髓受压程度、椎体病变范围以及对比增强情况。12只犬符合纳入标准。大多数犬(n = 8)有慢性进行性病史,伴有不同程度的本体感觉共济失调和轻瘫(n = 11),所有犬均有脊柱疼痛症状。MRI检查结果各异,但更一致的特征包括存在多个膨胀性椎体病变,且未超出受累椎体的皮质外缘,以及相关硬膜外物质导致脊髓受压。大多数病变在T2加权序列(n = 12)和T1加权序列(n = 8)上呈高信号至等信号,对比增强可变但均匀(n = 12)。这些所描述的多发性骨髓瘤的MRI特征可用于辅助早期识别并指导后续的确诊诊断步骤,最终改善治疗方法和长期预后。

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