Advanced imaging of the nervous system in the horse

Neuroimaging underwent a dramatic revolution during the past few decades due to the development of new technologies that produce exquisite images of patient morphology and function, new technologies that store and distribute information more efficiently, and research that has improved understanding of pathogenesis and effective clinical use of new imaging methods. Advanced equine neuroimaging is a specialized field with unique challenges associated with patient size, availability of equipment, using equipment designed for humans, small sample size for various diseases, and issues associated with recovering a horse with neurologic problems from general anesthesia. Despite these challenges, modern imaging techniques provide much useful information in horses with neurologic disease that are important for making a diagnosis, planning treatment, monitoring patient response, or providing prognostic information to guide owner choices regarding decisions about patient care. In particular, CT and MRI have been beneficial in diagnosing several equine neurologic diseases including congenital malformations (eg, hydrocephalus), equine protozoal myeloencephalitis, strangles (Streptococcus equi ssp. equi) abscesses, nigropallidal encephalomalacia, pituitary macroadenomas, cholesterinic granulomas, THO, CSM, trauma, and various neoplasms. Optimizing equine neuroimaging starts with selecting an appropriate examination, understanding the prior probability of disease and the capabilities of the different imaging technologies, understanding normal anatomy and pathogenesis, and having a systematic approach to review the images. Advanced equine neuroimaging will continue to evolve as more of the challenges are overcome and new research is produced on the effective use of imaging methods and understanding of specific diseases.