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CANINE MENINGEAL DISEASE: ASSOCIATIONS BETWEEN MAGNETIC RESONANCE IMAGING SIGNS AND HISTOLOGIC FINDINGS
Author(s) -
Keenihan E.K.,
Summers B.A.,
David F.H.,
Lamb C.R.
Publication year - 2013
Publication title -
veterinary radiology and ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.541
H-Index - 60
eISSN - 1740-8261
pISSN - 1058-8183
DOI - 10.1111/vru.12055
Subject(s) - medicine , fluid attenuated inversion recovery , meninges , leptomeninges , subtraction , magnetic resonance imaging , radiology , nuclear medicine , pathology , central nervous system , arithmetic , mathematics
In order to compare the accuracy of MR sequences for diagnosis of meningeal disease, MR images of the brain, and histopathologic specimens including the meninges of 60 dogs were reviewed retrospectively by independent observers in a cross‐sectional study. MR images included T 1‐weighted pre‐ and postgadolinium images, subtraction images, T 2‐weighted images, and T 2‐weighted fluid‐attenuated inversion‐recovery ( FLAIR ) images. Pathologic changes affected the pachymeninges in 16 dogs, leptomeninges in 35 dogs, and brain in 38 dogs. The meninges were normal in 12 dogs. Meninges were classified histopathologically as normal (grade 0), slightly or inconsistently affected (grade 1), or markedly affected (grade 2). When applying relaxed pathologic criteria (grades 0 and 1 considered normal), the results of ROC analysis (area under curve, AUC ) were: T 1‐weighted postcontrast images 0.74; subtraction images 0.7; T 2‐weighted images 0.68; FLAIR images 0.56. The difference in AUC between T 1‐weighted postgadolinium images and FLAIR images was significant ( P = 0.04). AUC for FLAIR images was not significantly different from 0.5. When applying strict pathologic criteria (only grade 0 considered normal), none of the MR sequences had AUC significantly different from 0.5. On the basis of T 1‐weighted postgadolinium images and subtraction images, correct anatomic classification of lesions occurred more often for pachymeningeal than leptomeningeal lesions ( P < 0.001). Overall, MR imaging had low sensitivity for diagnosis of meningeal pathology in dogs, particularly for changes affecting the leptomeninges. Subtraction images had similar accuracy to T 1‐weighted postgadolinium images for meningeal lesions in dogs. T 2‐weighted FLAIR images appear to have limited diagnostic utility for meningeal lesions.