Imaging: MRI from paraparetic cat

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3 replies
  1. aburballa@gmail.com
    aburballa@gmail.com says:

    intradural extramedulary lesion affecting l4-s1 segments of the spinal cord. T2 mildly hyper intense, T1 hypointens and huge homogeneously contrast enhancement. Seems tone non demarcated lesion in T2-W but well demarcated in T1+C.
    DD: meningioma, lymphoma, nerve sheet tumor less likely but we can not excluded myelitys

  2. saracanal79@hotmail.com
    saracanal79@hotmail.com says:

    L3-L4 intervertebral disc looks degenerated and there is an abnormal T2 and T1 focal hyperintensity of the dorsal paravertebral musculature at the same level. Not sure about the L3-L4 alignment (looks like a little misaligned). Maybe a trauma with an intradural L4-S1 haemorrhage?

  3. neuropetvet
    neuropetvet says:

    All great thoughts! Given the cat’s young age, my top differentials were lymphoma and infectious/inflammatory disease. There had been no known trauma since the cat was adopted as a kitten and he was indoors only. Radiographs showed a presumably chronic, healed L3 vertebral body compression fracture on the left side. The hyperintensity on the MRI above was just along the border of the spinous process and lamina on the same side as the fracture so I assume it’s secondary to the original injury. We did a fluorscopy-guided fine-needle aspirate of the “mass” and got back mixed inflammatory pleocytosis with a predominance of degenerate neutrophils and the presence of bacteria. The owner initially elected not to pursue surgery so we started broad-spectrum antibiotics. The following day (my day off!), the cat was able to walk so the owner elected to go ahead with surgery. My colleague did an extensive hemilaminectomy. Final diagnosis was spinal empyema. No growth on culture of the material. The source of the infection was never determined. The cat continues to do well.

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