Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Clinical Feasibility of CT Brain Perfusion in a Dog with Sellar Region Tumor

  • Minji Kim (Institute of Animal Medicine, Department of Veterinary Medical Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Gunha Hwang (Institute of Animal Medicine, Department of Veterinary Medical Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Jeongmin Ryu (Institute of Animal Medicine, Department of Veterinary Medical Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Jiwon Yoon (Institute of Animal Medicine, Department of Veterinary Medical Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Moon Yeong Choi (Yangsan S animal cancer center) ;
  • Joong-Hyun Song (College of Veterinary Medicine, Chungnam National University) ;
  • Tae Sung Hwang (Institute of Animal Medicine, Department of Veterinary Medical Imaging, College of Veterinary Medicine, Gyeongsang National University) ;
  • Hee Chun Lee (Institute of Animal Medicine, Department of Veterinary Medical Imaging, College of Veterinary Medicine, Gyeongsang National University)
  • Received : 2024.03.15
  • Accepted : 2024.05.12
  • Published : 2024.06.30
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Abstract

A 10-year-old spayed female Poodle was referred for blindness. On ophthalmic examination, loss of bilateral ocular pupil light reflex, visual loss, and right retinal detachment were confirmed at a local hospital. Magnetic resonance imaging (MRI) of the brain was performed to identify the optic nerve, optic chiasm, and brain disease. A sessile mass centered on the region of the optic chiasm was identified. The mass had iso- to hypointense on fluid-attenuated inversion recovery and T2-weighted images and mildly hypointense on T1-weighted images compared to the gray matter, with strong contrast enhancement. Peripheral edema was also identified. Computed tomography (CT) brain perfusion was performed to obtain additional hemodynamic information about the patient using a multislice CT. CT perfusion showed that the cerebral blood volume in the left temporal lobe region (13.4 ± 1.6 mL/100 g) was decreased relative to the contralateral region (19.9 ± 0.3 mL/100 g). The patient showed decreased appetite and consciousness one week after the CT scan with clinical symptoms worsened. The patient had seizure, tetraparesis, and loss of consciousness. It was euthanized one month later at the request of the owner. This report suggests that CT brain perfusion can provide additional hemodynamic information such as insufficient brain perfusion in sellar region tumor which can help assess potential complications and prognosis and plan treatment.

Keywords

Acknowledgement

This study was supported by a grant from the Cooperative Research Program for Agriculture Science and Technology Development (Project No. RS-2023-00231792), RDA, Republic of Korea.

References

  1. Bone B, Fogarasi A, Schulz R, Gyimesi C, Kalmar Z, Kovacs N, et al. Secondarily generalized seizures in temporal lobe epilepsy. Epilepsia 2012; 53: 817-824.
  2. Freda PU, Post KD. Differential diagnosis of sellar masses. Endocrinol Metab Clin North Am 1999; 28: 81-117, vi.
  3. Garosi L, McConnell JF, Platt SR, Barone G, Baron JC, de Lahunta A, et al. Clinical and topographic magnetic resonance characteristics of suspected brain infarction in 40 dogs. J Vet Intern Med 2006; 20: 311-321.
  4. Hyde BR, Martin LG, Chen AV, Guess SC, Carrera-Justiz S, Bruyette D, et al. Clinical characteristics and outcome in 15 dogs treated with transsphenoidal hypophysectomy for nonfunctional sellar masses. Vet Surg 2023; 52: 69-80.
  5. Kent MS, Bommarito D, Feldman E, Theon AP. Survival, neurologic response, and prognostic factors in dogs with pituitary masses treated with radiation therapy and untreated dogs. J Vet Intern Med 2007; 21: 1027-1033.
  6. Knash M, Tsang A, Hameed B, Saini M, Jeerakathil T, Beaulieu C, et al. Low cerebral blood volume is predictive of diffusion restriction only in hyperacute stroke. Stroke 2010; 41: 2795-2800.
  7. Koenig M, Kraus M, Theek C, Klotz E, Gehlen W, Heuser L. Quantitative assessment of the ischemic brain by means of perfusion-related parameters derived from perfusion CT. Stroke 2001; 32: 431-437.
  8. Konstas AA, Goldmakher GV, Lee TY, Lev MH. Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 1: theoretic basis. AJNR Am J Neuroradiol 2009; 30: 662-668.
  9. McConnell JF. Ischemic brain disease and vascular anomalies. In: Mai W, editor. Diagnostic MRI in dogs and cats. Boca Raton: CRC Press. 2018: 254-259.
  10. Rey-Dios R, Payner TD, Cohen-Gadol AA. Pituitary macroadenoma causing symptomatic internal carotid artery compression: surgical treatment through transsphenoidal tumor resection. J Clin Neurosci 2014; 21: 541-546.
  11. Sanders K, Galac S, Meij BP. Pituitary tumour types in dogs and cats. Vet J 2021; 270: 105623.
  12. Vaninetti NM, Clarke DB, Zwicker DA, Yip CE, Tugwell B, Doucette S, et al. A comparative, population-based analysis of pituitary incidentalomas vs clinically manifesting sellar masses. Endocr Connect 2018; 7: 768-776.