Hugo Timothy B, Heading Kathryn L, Labuc Robert H
Melbourne Veterinary Specialist Centre, Glen Waverley, Vic, Australia.
Vet Med (Auckl). 2014 Aug 18;5:75-84. doi: 10.2147/VMRR.S63805. eCollection 2014.
The combination of cerebrospinal fluid (CSF) analysis and magnetic resonance imaging (MRI) are often used to investigate intracranial disease in dogs. The aim of this retrospective study was to determine if the total nucleated cell count (TNCC) or cytology findings in abnormal CSF are associated with the prevalence of MRI abnormalities.
For each case, the TNCC was categorized into one of three groups: A (<25×10/L); B (25-100×10/L); and C (>100×10/L). Cytology findings were categorized by the predominant cell type as lymphocytic, monocytoid, neutrophilic, or eosinopilic. MRI descriptions were classified as either normal or abnormal, and abnormal studies were further evaluated for the presence of specific characteristics (multifocal or diffuse disease versus focal disease, positive T2-weighted hyperintensity, positive FLAIR hyperintensity, contrast enhancement, mass effect, and the presence of poorly or well-defined lesion margins).
Forty-five dogs met the inclusion criteria and MRI abnormalities were found in 29/45 (64%) dogs. TNCCs were not associated with the prevalence of MRI abnormalities or specific characteristics. Cytology categories were significantly associated with the prevalence of MRI abnormalities (0.001). Specifically, monocytoid cytology was 22.8 times more likely to have an abnormal MRI than lymphocytic cytology. CSF cytology was not significantly associated with specific abnormal MRI characteristics.
There are minimal associations between CSF abnormalities and the prevalence of MRI abnormalities. These results support the continued importance of utilizing both tests when investigating intracranial disease. When CSF analysis must be performed initially, this study has demonstrated that an abnormal CSF with a monocytoid cytology supports the value of performing a brain MRI in dogs with evidence of intracranial neurological disease.
脑脊液(CSF)分析和磁共振成像(MRI)相结合常用于犬颅内疾病的研究。这项回顾性研究的目的是确定异常脑脊液中的总核细胞计数(TNCC)或细胞学检查结果是否与MRI异常的发生率相关。
对于每个病例,TNCC被分为三组之一:A组(<25×10⁶/L);B组(25 - 100×10⁶/L);C组(>100×10⁶/L)。细胞学检查结果根据主要细胞类型分为淋巴细胞性、单核细胞样、嗜中性或嗜酸性。MRI描述分为正常或异常,对异常研究进一步评估是否存在特定特征(多灶性或弥漫性疾病与局灶性疾病、T2加权高信号阳性、液体衰减反转恢复序列(FLAIR)高信号阳性、对比增强、占位效应以及病变边界清晰或不清晰)。
45只犬符合纳入标准,其中29/45(64%)只犬发现MRI异常。TNCC与MRI异常的发生率或特定特征无关。细胞学类别与MRI异常的发生率显著相关(P = 0.001)。具体而言,单核细胞样细胞学的犬MRI异常的可能性是淋巴细胞性细胞学犬的22.8倍。脑脊液细胞学与特定的MRI异常特征无显著相关性。
脑脊液异常与MRI异常的发生率之间关联极小。这些结果支持在研究颅内疾病时同时使用这两种检查的持续重要性。当必须首先进行脑脊液分析时,本研究表明,细胞学为单核细胞样的异常脑脊液支持对有颅内神经疾病证据的犬进行脑部MRI检查的价值。