Do you use STIR and T1-W post contrast for lymphoma patients?

VRU 2016

Brian Allett, Silke Hecht

Background
Lymphoma is a common neoplasm in dogs, capable of affecting the central nervous system, including the spine. Despite its prevalence, MRI-based investigations of spinal lymphoma in dogs are scarce. This study retrospectively evaluates MRI findings in dogs with confirmed spinal lymphoma, aiming to document characteristic imaging features for diagnostic guidance.

Methods
The study analyzed MRI scans and clinical records of six dogs diagnosed with spinal lymphoma between 2005 and 2015. MRI findings, including lesion number, location, signal characteristics on T1-weighted (T1-W), T2-weighted (T2-W), and short tau inversion recovery (STIR) sequences, and contrast enhancement patterns, were reviewed. Diagnoses were confirmed by cytology or histopathology of spinal or associated tissues.

Results
MRI Features:
-Multifocal disease was present in 4/6 dogs, with vertebral and paraspinal involvement noted in 5/6 dogs.
-Lesions typically appeared as T2-W isointense to hyperintense, T1-W hypointense to isointense, and STIR hyperintense, with moderate to strong contrast enhancement.
-Vertebral changes were confined to the medullary cavity, sparing the cortical bone.
-Spinal cord compression was observed in 4/6 dogs, ranging from moderate to severe.


Anatomical Involvement: All dogs had lesions involving multiple spinal compartments, including the vertebral canal, vertebrae, and paraspinal soft tissues.


Additional Findings: Associated abnormalities included lymphadenopathy, hepatomegaly, splenomegaly, and splenic nodules in several cases.


Limitations
The small sample size and retrospective design limit generalizability. In some cases, spinal lesions were not directly sampled, relying on extrapolation from diagnoses of systemic lymphoma. Lack of necropsy and CT imaging reduced confidence in confirming cortical bone involvement.

Conclusions
MRI features of spinal lymphoma in dogs often involve multifocal lesions with involvement of vertebrae, vertebral canal, and paraspinal tissues. STIR sequences were particularly effective in detecting abnormalities. These findings support the inclusion of lymphoma in differential diagnoses for dogs with similar MRI presentations.

FIG. 1. Sagittal (A) and transverse (B, C) T2-W images of the thoracolumbar spine in a 7-year-old castrated male Boston terrier (patient 1). (A) There are multifocal patchy variably hyperintense lesions associated with vertebral bodies of the thoracolumbar spine (arrows), which remained hyperintense on STIR images (not shown). (B, C) Additional findings include enlarged mesenteric lymph nodes (asterisk), splenomegaly, and a nodule associated with the head of the spleen (arrowhead)

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