Imaging Diagnosis—infiltrative Lipoma Causing Spinal Cord Compression in a Dog

Morgan, Lee W.; Toal, Robert L.; Siemering, George; Gavin, Patrick R.

doi:10.1111/j.1740-8261.2007.00201.x

Cited by 27 publications

(49 citation statements)

References 3 publications

(7 reference statements)

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“…Moreover, because fat suppression techniques are useful in ascertaining the fatty characteristics of a mass [2,[4][5][6], the mass lesion in the present case was exactly defined by a fat suppression technique. Differential diagnoses for an MR image like that in the present case in which T1-and T2-weighted images showed hyperintense signals include hemorrhage, hematoma, and fatty tissue [1,[3][4][5][6]8]. Of these, a fat suppression image may be useful to distinguish the involvement of adipose tissue amongst other possible etiologies [2,[4][5][6].…”

mentioning

confidence: 96%

“…Differential diagnoses for an MR image like that in the present case in which T1-and T2-weighted images showed hyperintense signals include hemorrhage, hematoma, and fatty tissue [1,[3][4][5][6]8]. Of these, a fat suppression image may be useful to distinguish the involvement of adipose tissue amongst other possible etiologies [2,[4][5][6]. In addition, CT was also a powerful tool in this case in determination of a fatty mass, because the only substance other than adipose tissue that demonstrates negative Hounsfield unit values is air [1,4].…”

mentioning

confidence: 99%

“…To thoroughly examine the fatty tissue, both CT and MR images are useful for distinct reasons. An MR image can clearly indicate the border between the fatty tissue and other soft tissue components [2,5,6]. A CT image, however, is also able to detect fatty infiltration in the muscle area around the spinal cord as negative Hounsfield unit values [4,6].…”

mentioning

confidence: 99%

“…The difference between epidural idiopathic sterile pyogranulomatous inflammation and infiltrative lipomas may be the origin of the fatty tissue. The adipose tissue in infiltrative lipomas originally arises in the muscle and then infiltrates the spinal cavity, but pyogranulomatous inflammation is confined within the spinal canal [1,5]. To thoroughly examine the fatty tissue, both CT and MR images are useful for distinct reasons.…”

mentioning

confidence: 99%

“…Epidural idiopathic sterile pyogranulomatous inflammation and infiltrative lipomas have very similar features on both CT and MR images, and both could be consistent with a fatty mass in the spinal canal. The usefulness of MR imaging for the diagnosis of infiltrative lipomas has been reported [5]. Differences between images of the two diseases have not been compared.…”

mentioning

confidence: 99%

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CT and MRI Imaging Diagnosis of Epidural Idiopathic Sterile Pyogranulomatous Inflammation in a Dog Spinal Canal

Murata

Miura

Iwanaga

et al. 2012

The Journal of Veterinary Medical Science

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ABSTRACT. A 12-year-old neutered male shih tzu developed progressive pelvic limb paraparesis. Computed tomography showed a radiolucent mass lesion in the spinal canal at the left side of the 11th thoracic vertebra. The mass was not enhanced by intravenous contrast medium injection. It was hyperintense on both T1-and T2-weighted magnetic resonance images. The signal intensity of the mass was decreased with a fat suppression technique, indicating a fatty origin. After removal of the mass via T11-T12 hemilaminectomy, chronic panniculitis was confirmed by histopathological examination. This case demonstrates the utility of computed tomography and magnetic resonance imaging for the diagnosis of spinal canal pyogranulomatous inflammation. Epidural idiopathic sterile pyogranulomatous inflammation is inflammation of the panniculus adiposus. It exists as a single mass or multiple masses in the subcutaneous tissue [7]. To our knowledge, only one report has described epidural idiopathic sterile pyogranulomatous inflammation in the spinal canal causing neurological deficits [1]. A mildly radiolucent epidural mass impinged upon the spinal cord on myelographic images [1]. However, computed tomography (CT) and magnetic resonance (MR) imaging has not been previously discussed. Epidural idiopathic sterile pyogranulomatous inflammation and infiltrative lipomas have very similar features on both CT and MR images, and both could be consistent with a fatty mass in the spinal canal. The usefulness of MR imaging for the diagnosis of infiltrative lipomas has been reported [5]. Differences between images of the two diseases have not been compared. Complete removal of epidural idiopathic sterile pyogranulomatous inflammation in the spinal canal leads to a good prognosis; in contrast, it is difficult to totally remove infiltrative lipomas, which results in a high rate of recrudescence. Therefore, it is important to differentiate the two diseases for appropriate treatment strategy planning. We herein describe the utility of CT and MR imaging for diagnosis of pyogranulomatous inflammation in the spinal canal, the treatment strategy, and the prognosis.A 12-year-old neutered male shih tzu was examined for pelvic limb paraparesis that developed over a period of 9 weeks. There was generalized weakness and lethargy. The dog was unable to stand on its pelvic limbs without assistance. The dog showed upper motor neuron signs, and neurological abnormalities included conscious proprioception and superficial pain perception deficits in the pelvic limbs, deep pain perception deficits in the left hind leg (which was more affected than the right), and cutaneous trunci reflex deficits on the left side caudally from around the 11th thoracic (T11) vertebra. Moreover, dysuria was observed. On 4-row helical CT images (Asteion TSX-021B; TOSHIBA®, Otahara, Japan), there was a radiolucent lesion within the spinal canal at T11 that was located ventrally to the spinal cord, lateralized to the left, and had a CT value of −38 HU (Fig. 1). The T11 vertebral bone had ...

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