DOI QR코드

DOI QR Code

Diagnosis of Spinal Arachnoid Cyst using Magnetic Resonance Imaging in a Dog

개에서 자기공명영상을 이용한 척추부 지주막 낭종의 진단

  • Shin, Chang-ho (Haeundae Animal Medical Center) ;
  • Kim, Young-ki (Haeundae Animal Medical Center) ;
  • Hwang, Tae-sung (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Yoon, Young-min (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Jung, Dong-in (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Yeon, Seong-chan (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Hee-chun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University)
  • 신창호 (해운대 동물의료원) ;
  • 김영기 (해운대 동물의료원) ;
  • 황태성 (경상대학교 동물의학연구소) ;
  • 윤영민 (경상대학교 동물의학연구소) ;
  • 정동인 (경상대학교 동물의학연구소) ;
  • 연성찬 (경상대학교 동물의학연구소) ;
  • 이희천 (경상대학교 동물의학연구소)
  • Accepted : 2015.10.15
  • Published : 2015.10.30

Abstract

A 6-year-old, intact male maltese was presented with hindlimb ataxia of 4 day duration. Physical and neurological examinations revealed a bright, alert, and responsive dog, with no evidence of cranial nerve deficits, conscious proprioceptive deficits. Spinal reflexes of the hind and forelimbs were normal. Patellar, cranial tibial, and withdrawal reflexes were normal. Pain could not be elicited on manipulation of the neck or palpation of the spinal column. Survey radiographs of the vertebral column were unremarkable. Computed tomography (CT) scans in the transverse plane were performed. The results of CT imaging were unremarkable. Magnetic resonance imaging (MRI) in both sagittal and transverse planes was performed. The extent of the lesion was 25 mm in length by 4 mm in thickness. The spinal cord was deviated ventrally and appreared thinner. On T1-weighted and FLAIR images, a discrete hypointense lesion dorsal to the spinal cord was observed at L1-2 which was contiguous with the subarachnoid space. On T2-weighted images, this region was hyperintense, consistent with a fluid-filled structure. The signal intensity of the cysts was equivalent to cerebrospinal fluid (CSF). Surgical treatment involving dorsal laminectomy had successful outcomes.

6살의 중성화한 수컷 말티즈는 운동실조로 인하여 내원하였다. 본 증례는 일반방사선 촬영, 컴퓨터단층촬영, 자기공명영상을 실시하여 낭종의 위치, 크기, 척수와의 관련성 및 동반된 질환을 알 수 있었다. 자기공명영상 결과 T1W과 FLAIR 영상에서는 hypointense한 영역, T2W 영상에서는 hyperintense한 영역이 L1~2 척수의 등쪽으로 나타났다. 이는 CSF와 동일한 신호로 나타났으며, 등쪽에서 척수를 압박하여 배쪽으로 이동시켰다. 낭종의 길이는 25 mm, 두께는 4 mm로 나타났다. 무증상일 경우는 치료가 필요 없으나, 본 증례는 신경학적 이상이 나타나 수술적 치료를 실시하였다.

Keywords

References

  1. Agnoli AL, Schonmayr R, Laun A. Intraspinal arachnoid cysts. Acta neurochirurgica 1982; 61: 291-302. https://doi.org/10.1007/BF01743873
  2. Bagley RS, Silver GM, Seguin B, Lincoln JD, Britt LG. Scoliosis and associated cystic spinal cord lesion in a dog. J Am Vet Med Assoc 1997; 211: 573-575.
  3. Bently JF, Simpson ST, Hathcock JT. Spinal arachnoid cyst in a dog. J Am Anim Hosp Assoc 1991; 27: 549-551.
  4. Cambridge AJ, Bagley RS, Britt LG, Silser GM. Radiographic diagnosis: Arachnoid cyst in a dog. Vet Radiol Ultrasound 1997; 38: 434-436. https://doi.org/10.1111/j.1740-8261.1997.tb00867.x
  5. Catala M, Poirier J. Arachnoid cysts: histologic, embryologic and physiopathologic review. Rev Neurol 1998; 154: 489-501.
  6. Catala M, Poirier J. Intracranial and intraspinal epithelial cysts: a simplified classification. Rev Neurol 2000; 156: 447-449.
  7. Dietmann JL, Filippi de la Palavesa MM, Kastler B, Warter JM, Buchheit F. Thoracic intradural arachnoid cyst: possible pitfalls with myelo-CT and MR. Neuroradiology 1991; 33: 90-91. https://doi.org/10.1007/BF00593348
  8. Dyce J, Herrtage ME, Houlton JEF, Palmer AC. Canine spinal arachnoid cysts. J Small Anim Pract 1991; 32: 433-437. https://doi.org/10.1111/j.1748-5827.1991.tb00980.x
  9. Frykman OF. Spinal arachnoid cyst in four dogs: Diagnosis, surgical treatment and follow-up results. J Small Anim Pract 1999; 40: 544-549. https://doi.org/10.1111/j.1748-5827.1999.tb03017.x
  10. Gage ED, Hoerlein BF, Bartels JE. Spinal cord compression resulting from a leptomeningeal cyst in the dog. J Am Vet Med Assoc 1968; 152: 1664-1670.
  11. Galloway AM, Curtis NC, Sommerlad SF, Watt PR. Correlative imaging findings in seven dogs and one cat with spinal arachnoid cysts. Vet Radiol Ultrasound 1999; 40: 445-452. https://doi.org/10.1111/j.1740-8261.1999.tb00373.x
  12. Gimeno A, Vinken PF, Bruyn GW, eds. Congenital malformations of the spine and spinal cord. In: Handbook of Clinical Neurology, Vol 32. Amsterdam: Elsevier Science Publishing Company. 1978: 393-448.
  13. Gnirs K, Ruel Y, Blot S, Begon D, Rault D, Delisle F, Boulouha L, Colle MA, Carozzo C, Moissonnier P. Spinal subarachnoid cyst in 13 dogs. Vet Radiol Ultrasound. 2003; 44: 402-408. https://doi.org/10.1111/j.1740-8261.2003.tb00476.x
  14. Hardie RJ, Linn KA, Rendano VT. Spinal meningeal cyst in a dog: A case report and literature review. J Am Anim Hosp Assoc 1996; 32: 477-480. https://doi.org/10.5326/15473317-32-6-477
  15. Hashizume CT. Cervical spinal arachnoid cyst in a dog. Can Vet J 2000; 41: 225-227.
  16. Kendall BE, Valentine AR, Keis B. Spinal arachnoid cysts: clinical and radiological correlations with prognosis. Neuroradiology 1982; 22: 225-234. https://doi.org/10.1007/BF00342069
  17. Kriss TC, Kriss VM. Symptomatic spinal intradural arachnoid cyst development after lumbar myelography: Case report and review of the literature. Spine 1997; 22: 568-572. https://doi.org/10.1097/00007632-199703010-00023
  18. Lake PA, Minckler J, Scanlan RL. Spinal epidural cyst: theories of pathogenesis. J Neurosurg 1974; 40: 774-778. https://doi.org/10.3171/jns.1974.40.6.0774
  19. McKee WM, Renwick PW. Marsupialisation of an arachnoid cyst in a dog. J Sm Anim Pract 1994;35: 108-111. https://doi.org/10.1111/j.1748-5827.1994.tb02550.x
  20. Nabors MW, Pait TG, Byrd EB, Karim NO, Davis DO, Kobrine AI, Rizzoli HV. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg 1988; 68: 366-377. https://doi.org/10.3171/jns.1988.68.3.0366
  21. Ness MG. Spinal arachnoid cysts in two Shih Tzu littermates. Vet Rec 1998; 142: 515-516. https://doi.org/10.1136/vr.142.19.515
  22. Nishiura I, Koyama T. Idiopathic cervical arachnoid cyst. Neurochirurgia 1989; 32: 25-29.
  23. Parker AJ, Adams WM, Zackery JF. Spinal arachnoid cysts in the dog. J Am Anim Hosp Assoc 1983; 19: 1001-1008.
  24. Parker AJ, Smith CW. Meningeal cyst in a dog. J AM Anim Hosp Assoc 1974; 10: 595-597.
  25. Rylander H, Lipsitz D, Berry WL, Sturges BK, Vernau KM, Dickinson PJ, Anor SA, Higgins RJ, LeCouteur RA. Retrospective analysis of spinal arachnoid cysts in 14 dogs. J Vet Intern Med 2002; 16: 690-696. https://doi.org/10.1111/j.1939-1676.2002.tb02409.x
  26. Santamarta D. Aguas J. Ferrer E. The natural history of arachnoid cysts: endoscopic and cine-mode MRI evidence of a slit-valve mechanism. Minim Invasive Neurosurg 1995; 38: 133-137. https://doi.org/10.1055/s-2008-1053473
  27. Schwartz JF, O'Brien MS, Hoffman JC. Hereditary spinal arachnoid cysts, distichiasis, and lymphedema. Annals of Neurology 1980; 7: 340-343. https://doi.org/10.1002/ana.410070410
  28. Shamir MH. Shahar R. Aizenberg I. Subarachnoid cvst in a cat. J Am Anim Hosp Assoc 1997; 33: 123-125. https://doi.org/10.5326/15473317-33-2-123
  29. Silbergleit R, Brunberg JA, Patel SC, Mehta BA, Aravapalli SR. Imaging of spinal intradural arachnoid cysts: MRI, myelography and CT. Neuroradiology Neuroradiology. 1998; 40: 664-668.
  30. Sklar E, Quencer RM, Green BA, Montdlvo BM, Donovan Post MJ. Acquired spinal subarachnoid cysts: Evaluation with MR, CT myelography, and intraoperative sonography. American Journal of Roentgenology. 1989; 153: 1057-1064. https://doi.org/10.2214/ajr.153.5.1057
  31. Vernau KM, Kortz GD, Koblik PD, LeCouteur RA, Bailey CS, Pedroia V. Magnetic resonance imaging and computed tomography characteristics of intracranial intra-arachnoid cysts in 6 dogs. Vet Radiol Ultrasound. 1997; 38: 171-176. https://doi.org/10.1111/j.1740-8261.1997.tb00835.x