Magnetic Resonance Imaging for the Differentiation of Neoplastic, Inflammatory, and Cerebrovascular Brain Disease in Dogs

Journal of Veterinary Internal Medicine

C.A. Wolff³  S.P. Holmes⁴  B.D. Young⁶  A.V. Chen⁵  M. Kent¹  S.R. Platt¹  M.Y. Savage¹  S.J. Schatzberg¹  G.T. Fosgate² 

[1] Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA;Department of Production Animal Studies, University of Pretoria, Onderstepoort, South Africa;Department of Small Animal Clinical Sciences;Department of Anatomy and Radiology;Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA;Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX

关键词: Canine;    Infarction;    Meningoencephalitis;    Tumor;   

DOI  :  10.1111/j.1939-1676.2012.00899.x

来源: Wiley

【 摘 要 】

Abstract

Background

The reliability and validity of magnetic resonance imaging (MRI) for detecting neoplastic, inflammatory, and cerebrovascular brain lesions in dogs are unknown.

Objectives

To estimate sensitivity, specificity, and inter-rater agreement of MRI for classifying histologically confirmed neoplastic, inflammatory, and cerebrovascular brain disease in dogs.

Animals

One hundred and twenty-one client-owned dogs diagnosed with brain disease (n = 77) or idiopathic epilepsy (n = 44).

Methods

Retrospective, multi-institutional case series; 3 investigators analyzed MR images for the presence of a brain lesion with and without knowledge of case clinical data. Investigators recorded most likely etiologic category (neoplastic, inflammatory, cerebrovascular) and most likely specific disease for all brain lesions. Sensitivity, specificity, and inter-rater agreement were calculated to estimate diagnostic performance.

Results

MRI was 94.4% sensitive (95% confidence interval [CI] = 88.7, 97.4) and 95.5% specific (95% CI = 89.9, 98.1) for detecting a brain lesion with similarly high performance for classifying neoplastic and inflammatory disease, but was only 38.9% sensitive for classifying cerebrovascular disease (95% CI = 16.1, 67.0). In general, high specificity but not sensitivity was retained for MR diagnosis of specific brain diseases. Inter-rater agreement was very good for overall detection of structural brain lesions (κ = 0.895, 95% CI = 0.792, 0.998, P < .001) and neoplastic lesions, but was only fair for cerebrovascular lesions (κ = 0.299, 95% CI = 0, 0.761, P = .21).

Conclusions and Clinical Importance

MRI is sensitive and specific for identifying brain lesions and classifying disease as inflammatory or neoplastic in dogs. Cerebrovascular disease in general and specific inflammatory, neoplastic, and cerebrovascular brain diseases were frequently misclassified.

【 授权许可】

Unknown   
Copyright © 2012 by the American College of Veterinary Internal Medicine