Comparative Magnetic Resonance Imaging Findings Between Gliomas and Presumed Cerebrovascular Accidents in Dogs

Abstract

Cerebrovascular accidents, or strokes, and gliomas are common intraaxial brain lesions in dogs. An accurate differentiation of these two lesions is necessary for prognosis and treatment decisions. The magnetic resonance (MR) imaging characteristics of 21 dogs with a presumed cerebrovascular accident and 17 with a glioma were compared. MR imaging findings were reviewed retrospectively by three observers unaware of the final diagnosis. Statistically significant differences between the appearance of gliomas and cerebrovascular accidents were identified based on lesion location, size, mass effect, perilesional edema, and appearance of the apparent diffusion coefficient map. Gliomas were predominantly located in the cerebrum (76%) compared with presumed cerebrovascular accidents that were located mainly in the cerebellum, thalamus, caudate nucleus, midbrain, and brainstem (76%). Gliomas were significantly larger compared with presumed cerebrovascular accidents and more commonly associated with mass effect and perilesional edema. Wedge-shaped lesions were seen only in 19% of presumed cerebrovascular accidents. Between the three observers, 10-47% of the presumed cerebrovascular accidents were misdiagnosed as gliomas, and 0-12% of the gliomas were misdiagnosed as cerebrovascular accidents. Diffusion weighted imaging increased the accuracy of the diagnosis for both lesions. Agreement between observers was moderate (j ¼ 0.48, Po0.01). r

Canine intracranial gliomas: Relationship between magnetic resonance imaging criteria and tumor type and grade

“…When provided with clinical data and MRI, investigators can suspect intracranial glioma with high sensitivity (91%) and specificity (94%) in dogs (Wolff et al, 2012), but other tumors including PNET or lymphoma (Ródenas et al, 2011; Snyder et al, 2006), and lesions such as cerebrovascular accident and inflammatory disease (Cervera et al, 2011; Wolff et al, 2012) must still be retained in the differential diagnosis.…”

“…The magnetic resonance imaging (MRI) features of gliomas and other intra-axial primary brain tumors in dogs have been described (Cervera et al, 2011; Kraft et al, 1990, 1997; Lipsitz et al, 2003; Ródenas et al, 2011; Snyder et al, 2006; Wolff et al, 2012), but only recently have associations between the MRI appearance and the tumor type or the tumor grade been studied (Young et al, 2011). Typical canine intracranial gliomas are intra-axial, T1W- iso- to hypo-intense, T2W- iso- to hyper-intense mass lesions with varying perilesional edema and contrast enhancement (Kraft et al, 1997; Ródenas et al, 2011; Snyder et al, 2006; Young et al, 2011).…”

“…Based primarily on a review of the MRI literature relating to canine gliomas (Cervera et al, 2011; Kraft et al, 1990, 1997; Lipsitz et al, 2003; Polizopoulou et al, 2004; Snyder et al, 2006; Sturges et al, 2008) and a pilot study (Bentley et al, 2010), and secondarily to studies of human gliomas (Dean et al, 1990; Jenkinson et al, 2007; Provenzale et al, 2006), we hypothesized that increasing tumor grade is related to increasing degree of contrast enhancement, the formation of single cysts or multiple ITFs, and T2*-weighted gradient echo (GRE) signal voids. Regarding tumor type, we hypothesized that ventricular distortion is more common with oligodendrogliomas than astrocytomas.…”

Diagnostic accuracy of stereotactic brain biopsy for intracranial neoplasia in dogs: Comparison of biopsy, surgical resection, and necropsy specimens

“…Advances in diagnostic imaging, particularly magnetic resonance imaging (MRI), have revolutionized the management of many intracranial disorders in veterinary medicine predominantly by providing information that complements historical and clinical findings and allows for the generation of a refined list of differential diagnoses. However, all of the currently available imaging modalities are sufficiently unreliable to allow for the definitive diagnosis of most intracranial disorders that are commonly encountered in veterinary neurology practice . Because potential treatments and prognoses can differ substantially among the differential diagnoses generated in an individual patient based on clinical and imaging data; this diagnostic uncertainty can have profound implications on patient management.…”

Spontaneous ischaemic stroke lesions in a dog brain: neuropathological characterisation and comparison to human ischaemic stroke

“…Like humans, dogs with ischaemic stroke display variable neurological signs depending on the topography of the vascular occlusion and the size of the infarct [1, 3–5]. …”