title: Magnetic resonance imaging characteristics of necrotizing meningoencephalitis in Pug dogs.
abstract: BACKGROUND
  The magnetic resonance imaging (MRI) characteristics of necrotizing meningoencephalitis (NME) are not well documented.
  
  
  OBJECTIVE
  To describe common MRI features of NME, to compare the MRI features to histopathologic findings, and to determine whether or not MRI lesions are predictive of survival time.
  
  
  METHODS
  Eighteen Pugs with NME.
  
  
  METHODS
  Retrospective MRI case study of Pugs identified by a search of medical records at 6 veterinary institutions. Eighteen dogs met inclusion criteria of histopathologically confirmed NME and antemortem MRI exam. MRI lesions were characterized and compared with histopathology with the kappa statistic. Survival times were compared with MRI findings by use of Mann-Whitney U-tests and Spearman's rho.
  
  
  RESULTS
  Twelve of 18 lesions were indistinctly marginated with mild parenchymal contrast enhancement. Prosencephalic (17/18) lesion distribution included the parietal (16/18), temporal (16/18), and occipital (16/18) lobes. There were cerebellar (4/18) and brainstem (3/18) lesions. Asymmetric lesions were present in both gray and white matter in all dogs. Falx cerebri shift was common (11/18), and 6 dogs had brain herniation. Leptomeningeal enhancement was present in 9/18 dogs. A moderate positive association was found between parenchymal contrast enhancement and both necrosis (kappa= 0.45; P= .045) and monocytic inflammation (kappa= 0.48; P= .025). Higher MRI lesion burden was correlated with longer time from disease onset to MRI (P= .045). MRI lesion burden did not correlate to survival time.
  
  
  CONCLUSIONS
  Asymmetric prosencephalic grey and white matter lesions with variable contrast enhancement were consistent MRI changes in Pugs with confirmed NME. While not pathognomonic for NME, these MRI characteristics should increase confidence in a presumptive diagnosis of NME in young Pugs with acute signs of neurologic disease.
authors: Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX 77843, USA. byoung@cvm.tamu.edu
authors: B D
authors: BD
authors: Young
authors: J M
authors: JM
authors: Levine
authors: G T
authors: GT
authors: Fosgate
authors: A
authors: A
authors: de Lahunta
authors: T
authors: T
authors: Flegel
authors: K
authors: K
authors: Matiasek
authors: A
authors: A
authors: Miller
authors: G
authors: G
authors: Silver
authors: N
authors: N
authors: Sharp
authors: K
authors: K
authors: Greer
authors: S J
authors: SJ
authors: Schatzberg
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000235:genetics / Q000473:pathology*; D004285:Dogs; D005260:Female; D020022:Genetic Predisposition to Disease; D008279:Magnetic Resonance Imaging / Q000662:veterinary*; D008297:Male; D008590:Meningoencephalitis / Q000235:genetics / Q000473:pathology / Q000662:veterinary*