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A Dorsal Intramedullary T2-Weighted Hypointense Signal Suggests Haemorrhagic Necrotic Material Indicating
Ursula Teubenbacher1, Diana Henke2, Anna Oevermann3
1Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
Background:
Ascending-descending myelomalacia (ADMM) is a progressive softening of the spinal cord observed in dogs after spinal cord injury (SCI). On histopathology, areas of hemorrhagic necrotic material are found in the central canal and dorsal funiculi.
Hypothesis/Objectives:
We investigated if hemorrhagic necrotic material dorsal to the central canal can be identified on magnetic resonance imaging (MRI). We hypothesized that signal changes are seen in dogs with ADMM, but not in those without ADMM.
Animals:
Twenty-six dogs with pathologically confirmed ADMM, focal myelomalacia (FM) and 10 control dogs.
Methods:
Retrospective case-control study comparing intramedullary signal dorsal to the central canal in dogs with ADMM, FM, and control dogs.
Results:
A hypointense signal dorsal to the central canal on transverse T2-weighted fast spin echo and gradient echo images was observed. If present in both T2-d T2*-weighted sequences, it was significantly associated with ADMM (p = 0.004; specificity, 81%; sensitivity, 100%). If the T2-weighted hypointense focus was identified at a distance ≥ 3 vertebral bodies from the initial site of spinal cord injury, it was strongly associated with ADMM (p = 0.01) with a specificity of 100% and sensitivity of 78%.
Conclusion And Clinical Importance:
A dorsal intramedullary T2-weighted hypointense focus likely represents hemorrhagic necrotic material in the dorsal funiculi. If present at a distance of ≥ 3 vertebral bodies away from the initial site of SCI, it might aid in the diagnosis of ADMM in dogs by MRI.
Insights
A specific MRI finding, a T2-weighted hypointense focus dorsal to the central canal, can help diagnose ascending-descending myelomalacia (ADMM) in dogs. This finding, especially when located at least three vertebral bodies from the initial spinal cord injury, aids in ADMM diagnosis.
Area of Science:
- Veterinary Neurology
- Diagnostic Imaging
- Canine Pathology
Background:
- Ascending-descending myelomalacia (ADMM) is a progressive spinal cord softening in dogs post-spinal cord injury (SCI).
- Histopathology reveals hemorrhagic necrotic material within the central canal and dorsal funiculi in ADMM cases.
Purpose of the Study:
- To determine if MRI can identify hemorrhagic necrotic material dorsal to the central canal in dogs with ADMM.
- To test the hypothesis that signal changes are present in dogs with ADMM but not in controls.
Main Methods:
- A retrospective case-control study involving 26 dogs with confirmed ADMM, focal myelomalacia (FM), and 10 control dogs.
- Comparison of intramedullary signals dorsal to the central canal on MRI between groups.
Main Results:
- A hypointense signal dorsal to the central canal was observed on transverse T2-weighted and gradient echo images.
- This signal, when present on both T2 and T2* sequences, showed high sensitivity (100%) and specificity (81%) for ADMM.
- The presence of this hypointense focus ≥3 vertebral bodies from the initial SCI site was strongly associated with ADMM (100% specificity, 78% sensitivity).
Conclusions:
- A dorsal intramedullary T2-weighted hypointense focus likely represents hemorrhagic necrotic material.
- This MRI finding, particularly when distant from the initial injury site, may assist in diagnosing ADMM in dogs.
