This paper was presented at the Annual Convention of the American College of Veterinary Radiology in San Antonio, TX in September 2008 by the primary author. Four of these animals were described separately in another manuscript. None of these images were used in that manuscript. The data were analyzed and the manuscript was primarily written at Texas A&M University. Cases were gathered, imaged, and histopathology performed at Texas A&M University, Cornell University, the University of Leipzig, The Animal Health Trust, Massachusetts Veterinary Referral Hospital, the University of Georgia, Red Bank Animal Hospital, and Canada West Veterinary Specialists and Critical Care Hospital.
Magnetic Resonance Imaging Characteristics of Necrotizing Meningoencephalitis in Pug Dogs
Version of Record online: 13 APR 2009
Copyright © 2009 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 23, Issue 3, pages 527–535, May/June 2009
How to Cite
Young, B. D., Levine, J. M., Fosgate, G. T., De Lahunta, A., Flegel, T., Matiasek, K., Miller, A., Silver, G., Sharp, N., Greer, K. and Schatzberg, S. J. (2009), Magnetic Resonance Imaging Characteristics of Necrotizing Meningoencephalitis in Pug Dogs. Journal of Veterinary Internal Medicine, 23: 527–535. doi: 10.1111/j.1939-1676.2009.0306.x
- Issue online: 19 MAY 2009
- Version of Record online: 13 APR 2009
- Submitted July 22, 2008; Revised November 21, 2008; Accepted January 20, 2009.
Background: The magnetic resonance imaging (MRI) characteristics of necrotizing meningoencephalitis (NME) are not well documented.
Objectives: To describe common MRI features of NME, to compare the MRI features to histopathologic findings, and to determine whether or not MRI lesions are predictive of survival time.
Animals: Eighteen Pugs with NME.
Methods: Retrospective MRI case study of Pugs identified by a search of medical records at 6 veterinary institutions. Eighteen dogs met inclusion criteria of histopathologically confirmed NME and antemortem MRI exam. MRI lesions were characterized and compared with histopathology with the kappa statistic. Survival times were compared with MRI findings by use of Mann-Whitney U-tests and Spearman's ρ.
Results: Twelve of 18 lesions were indistinctly marginated with mild parenchymal contrast enhancement. Prosencephalic (17/18) lesion distribution included the parietal (16/18), temporal (16/18), and occipital (16/18) lobes. There were cerebellar (4/18) and brainstem (3/18) lesions. Asymmetric lesions were present in both gray and white matter in all dogs. Falx cerebri shift was common (11/18), and 6 dogs had brain herniation. Leptomeningeal enhancement was present in 9/18 dogs. A moderate positive association was found between parenchymal contrast enhancement and both necrosis (κ= 0.45; P= .045) and monocytic inflammation (κ= 0.48; P= .025). Higher MRI lesion burden was correlated with longer time from disease onset to MRI (P= .045). MRI lesion burden did not correlate to survival time.
Conclusions and Clinical Importance: Asymmetric prosencephalic grey and white matter lesions with variable contrast enhancement were consistent MRI changes in Pugs with confirmed NME. While not pathognomonic for NME, these MRI characteristics should increase confidence in a presumptive diagnosis of NME in young Pugs with acute signs of neurologic disease.