Estudo retrospectivo de cistos aracnoides da cisterna quadrigeminal diagnosticados pela ressonância magnética e tomografia computadorizada em 26 cães

Cistos aracnoide são acúmulos de líquido cefalorraquidiano que ocorre dentro da membrana aracnoide devido à divisão ou duplicação desta estrutura. O objetivo desse estudo retrospectivo é relatar a ocorrência dessa condição em 26 cães, assim como descrever os aspectos de imagem pela tomografia computadorizada e ressonância magnética e correlacionar com os sinais clínicos. No estudo observamos a prevalência em machos, em raças de pequeno porte, com predomínio de Pinscher miniatura e Shih Tzu, com idade variando de dois meses a nove anos. Os principais sinais neurológicos observados nestes animais foram crises epiléticas e ataxia cerebelar. Foi possível concluir que em 17 cães o cisto aracnoide quadrigeminal foi considerado um achado incidental, em seis cães essa condição foi considerada a causa determinante dos sinais clínicos, e em três cães alguns sinais estavam associados com o cisto aracnoide, porém esses animais apresentaram sinais clínicos relacionados a outros sítios de lesão intracraniana.

TERMOS DE INDEXAÇÃO:
Cistos aracnoides; cisterna quadrigeminal; ressonância magnética; tomografia computadorizada; caninos; convulsões; ataxia cerebelar; hidrocefalia; encefalopatias; patologia

Autoria

Lidiane S. Alves ^**Corresponding author: lidianealves.vet@gmail.com

Departamento de Reprodução Animal e Radiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Universidade Estadual Paulista (Unesp), Distrito Rubião Junior s/n, Botucatu, SP 18618-970, Brasil.Universidade Estadual PaulistaBrazilBotucatu, SP, Brazil Departamento de Reprodução Animal e Radiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Universidade Estadual Paulista (Unesp), Distrito Rubião Junior s/n, Botucatu, SP 18618-970, Brasil.

Diego Rodriguez

Departamento de Clínica Veterinária, Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Universidade Estadual Paulista (Unesp), Distrito Rubião Junior s/n, Botucatu, SP 18618-970.Universidade Estadual PaulistaBrazilBotucatu, SP, Brazil Departamento de Clínica Veterinária, Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Universidade Estadual Paulista (Unesp), Distrito Rubião Junior s/n, Botucatu, SP 18618-970.

Vânia M.V. Machado

Maria J. Mamprim

Luiz C. Vulcano

Rogério M. Amorim

*Corresponding author: lidianealves.vet@gmail.com

SCIMAGO INSTITUTIONS RANKINGS

Figuras | Tabelas

Figuras (4)
Tabelas (2)

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Fig.1.
(A) Transverse MRI of a 3-year-old female Boston Terrier with 9.6 kg presenting seizures weekly, agitation and behavior abnormal. Note the triangular-like shape of the structure (*) between occipital lobes showing the same signal intensity than CSF on T2-weighted, and (B) FLAIR with no contrast enhancement showed on T1-weighted (C).

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Fig.2.
(A) CT images of a 2-year-old male Pinscher Miniature with 1.4 kg presenting ataxia and circling to the right. Note the cyst-like structure (*) of fluid attenuation between occipital lobes and cerebellum extending from the third ventricle on the sagittal plane. (B) This cyst-like structure (*) can be seen between occipital lobes in a triangular-like shape on transverse, and (C) dorsal planes. This dog had severe hydrocephalus. LV = left ventricle; RV = right ventricle.

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Fig.3.
Mid-sagittal T2-weighted MRI showing the 3 different phenotypes of quadrigeminal arachnoid cyst: (A) in association with the 3rd ventricle, (B) in association with the 4th ventricle, and (C) loculated phenotype to the 3rd and 4th ventricle.

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Fig.4.
(A,B) Measurement of the compression degree of the cerebral and cerebellar parenchyma by mid-sagittal T2-weighted MRI, and (C,D) mid-sagittal CT images. The black line of (A) and (C) represents the expected diameter of the cerebellum and the measured length is set at 100%; the white line represents the actual diameter of the cerebellum. The black line of (B) and (D) is drawn for the expected longitudinal dimension of the forebrain and the measured length is set at 100%; the white line represents the actual longitudinal dimension of the forebrain.

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Table 1
Clinical summary of 26 dogs with quadrigeminal arachnoid cysts

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Table 2.
MRI and CT findings, percentual of forebrain and cerebellar compression and phenotype of quadrigeminal arachnoid cyst in 26 dogs

Fig.1. (A) Transverse MRI of a 3-year-old female Boston Terrier with 9.6 kg presenting seizures weekly, agitation and behavior abnormal. Note the triangular-like shape of the structure (*) between occipital lobes showing the same signal intensity than CSF on T2-weighted, and (B) FLAIR with no contrast enhancement showed on T1-weighted (C).

Fig.2. (A) CT images of a 2-year-old male Pinscher Miniature with 1.4 kg presenting ataxia and circling to the right. Note the cyst-like structure () of fluid attenuation between occipital lobes and cerebellum extending from the third ventricle on the sagittal plane. (B) This cyst-like structure () can be seen between occipital lobes in a triangular-like shape on transverse, and (C) dorsal planes. This dog had severe hydrocephalus. LV = left ventricle; RV = right ventricle.

Fig.3. Mid-sagittal T2-weighted MRI showing the 3 different phenotypes of quadrigeminal arachnoid cyst: (A) in association with the 3rd ventricle, (B) in association with the 4th ventricle, and (C) loculated phenotype to the 3rd and 4th ventricle.

Fig.4. (A,B) Measurement of the compression degree of the cerebral and cerebellar parenchyma by mid-sagittal T2-weighted MRI, and (C,D) mid-sagittal CT images. The black line of (A) and (C) represents the expected diameter of the cerebellum and the measured length is set at 100%; the white line represents the actual diameter of the cerebellum. The black line of (B) and (D) is drawn for the expected longitudinal dimension of the forebrain and the measured length is set at 100%; the white line represents the actual longitudinal dimension of the forebrain.

Table 1 Clinical summary of 26 dogs with quadrigeminal arachnoid cysts

Cão	Signalment	Presenting complaint	Neurolocalization	CSF analysis
1	3 year old, F, Shih Tzu, 8.6kg	Tonic-clonic seizures	Bilateral cerebral cortex	Moderate increase of protein concentration; mild pleocytosis. Cytology did not perform due insufficient sample
2	6 year old, M, ShihTzu, 5.6kg	Tonic-clonic seizures, central blindness	Bilateral occipital cortex	-
3	4 year old, M, Shih Tzu, 5.7kg	Behavioral changes	Brainstem, temporal cortex	-
4	2 year old, M, Shih Tzu, 1.5kg	Neck pain, parataxia, paraparesis, proprioceptive deficit of hindlimbs	Spinal cord C1-C5	-
5	1 year old, F, Pinscher, 1.8kg	Propioceptive ataxia, head tilting, gait disturbance with rigid gait	Cerebellum, spinal cord C1-C5	-
6	6 year old, F, Poodle, 2.3 kg	Cerebellar ataxia, hypermetria, wide stance	Cerebellum, spinal cord C1-C5	Moderate increased of protein concentration; moderate mixed pleocytosis
7	2 year old, F, mixedbreed, 3.4kg	Gait disturbance with compulsive gait, pleurotothonus to left, hemiparesis to right, central blindness to left, tonic- clonic seizures, circling to left, proprioceptive ataxia	Left cerebral cortex (frontal, parietal, occipital)	-
8	3 year old, F, Boston Terrier, 9.6kg	Tonic-clonic seizures	Cerebral cortex	-
9	7 month old, M, mixed breed, 8.8kg	Circling, central blindness, compulsive walking, ventrolateral strabismus	Occipital and frontal cortex	-
10	1.6 year old, M, Schnawzer, 5.3kg	Tonic-clonic seizures, focal seizures	Cerebral cortex (frontal, temporal, occipital)	No increase of protein concentration; no pleocytosis
11	1.6 year old, M, Lhasa Apso, 7.2kg	Tonic-clonic seizures	Cerebral cortex (frontal, temporal, occipital)	-
12	5.3 year old, F, Lhasa Apso, 5.9kg	Hypermetria, intention tremor, cerebellar ataxia, proprioceptive deficit, wide base, tonic-clonic seizures	Pontine-cerebellar	No increase of protein concentration; no pleocytosis
13	5 month old, F, Shih Tzu, 1.8kg	Head pressing, circling, behavioral changes, central blindness	Cerebelar cortex	-
14	3 year old, F, Pinscher, 2.6kg	Tonic-clonic seizures	Cerebral cortex (frontal, temporal occipital)	Mild increase of protein concentration; no pleocytosis
15	1 year old, M, Pinscher, 4.2kg	Behavioral changes, circling to right, compulsive walking, tonic-clonic seizures	Cerebral cortex (frontal, temporal occipital)	Moderate increase of protein concentration; moderate mixed pleocytosis
16	2 year old, F, Lhasa Apso, 7.5kg	Tonic-clonic seizures	Cerebral cortex (frontal, temporal occipital)	No increase of protein concentration; marked mixed pleocytosis
17	3 year old, M, Shi Tzu, 7 kg	Behavioral changes, tonic-clonic seizures, paraparesis, parataxia, parestesis, central blindness	Cerebral cortex (fontal, parietal, occipital)	-
18	2 month old, M, Shih Tzu, 1.2kg	Tetrataxia, proprioceptive deficit, compulsive walking, head tilting, central blindness	Fronto-parietal cortex, central vestibular, system optic nerve or optic chiasm	-
19	2 year old, M, Pinscher, 1.4kg	Tetrataxia, proprioceptive deficit, behavioral changes, circling, central blindness, depression, head tilting, focal seizures	Cerebral cortex, central vestibular system	-
20	7 year old, M, Yorkshire, 5.4kg	Intention tremor, proprioceptive, behavioral changes, hypermetria	Cerebral cortex (frontal, parietal), cerebellum	-
21	7.6 year old, M, Pinscher, 2.2kg	Head tilting	Peripheral vestibular system	-
22	8 month old, F, Brazilian Terrier, 1.4kg	Cerebellar ataxia, tetraparesis, depression	Cerebral cortex (frontal, parietal), cerebellum	-
23	3 year old, M, Lhasa Apso, 5kg	Tonic-clonic seizures, intention tremor, cerebellar ataxia	Cerebral cortex (frontal, temporal, occipital), cerebellum	-
24	8 month old, M, Pinscher, 2.3kg	Tonic-clonic seizures, head pressing, circling	Cerebral cortex	-
25	9 year old, F, Poodle, 9kg	Cerebellar ataxia	Cerebellum	-
26	2 month old, M, Shih Tzu, 0.3kg	Circling, gait disturbance with compulsive gait, peripheral blindness, behavioral changes, proprioceptive deficit, cerebellar ataxia	Cerebral cortex (frontal, temporal, parietal), cerebellum	-

Table 2. MRI and CT findings, percentual of forebrain and cerebellar compression and phenotype of quadrigeminal arachnoid cyst in 26 dogs

Cão	Diagnostic imaging	Other findings	Forebrain compression*	Cerebellar compression*	Phenotype
	modality		(%)	(%)
1	MRI	Neoplasia (choroid plexus tumor of the lateral cerebellar pontine angle with moderate obstructive hydrocephalus)	18.9	0	3rd ventricle
2	MRI	Inflammatory/infectious (meningoencephalitis)	24.2	45.2	3rd and 4th ventricle
3	MRI	No abnormalities	20.2	18.6	4th ventricle
4	MRI	Congenital/anomalous (hydrocephalus, atlanto-occipital malformation, branchial cysts)	0	32.3	4th ventricle
5	MRI	Congenital/anomalous (moderate obstructive hydrocephalus, syringohydromyelia)	0	20.2	3rd and 4th ventricle
6	MRI	Inflammatory/infectious (hydrocephalus ex vacuo)	0	15.7	4th ventricle
7	MRI	Inflammatory/infectious (interstitial edema focal in left hemicerebrum with hydrocephalus ex vacuo to the left)	0	27.6	4th ventricle
8	MRI	Inflammatory (cortical edema with moderate ventriculomegaly)	0	20.6	3rd ventricle
9	MRI	Congenital/anomalous (severe obstructive hydrocephalus with syringohydromyelia, diverticle of 4th ventricle, compression of pons)	-	-	3rd ventricle
10	MRI	Anomalous (moderate ventriculomegaly)	12.8	0	3rd ventricle
11	MRI	Congenital/anomalous (asymmetrical hydrocephalus to the left)	0	53.3	4th ventricle
12	MRI	Anomalous (moderate ventriculomegaly)	8.5	0	3rd ventricle
13	MRI	Congenital/anomalous (severe hydrocephalus)	0	40.9	4th ventricle
14	MRI	Anomalous (moderate ventriculomegaly)	0	12.7	4th ventricle
15	MRI	Inflammatory (cortical edema and moderate hydrocephalus)	0	0	4th ventricle
16	MRI	No abnormalities	0	0	3rd and 4th ventricle
17	MRI	Congenital/anomalous (agenesis of corpus callosum, partial lissencephaly)	19.0	0	3rd ventricle
18	CT	Congenital/anomalous (severe hydrocephaly)	0	55.7	4th ventricle
19	CT	Congenital/anomalous (severe hydrocephalus)	15.8	42.2	3rd and 4th ventricle
20	CT	Anomalous (moderate asymmetrical ventriculomegaly)	14.2	0	3rd ventricle
21	CT	Anomalous (moderate asymmetrical ventriculomegaly)	16.9	36	4th ventricle
22	CT	Congenital/anomalous (severe hydrocephalus)	0	0	3rd and 4th ventricle
23	CT	No abnormalities	-	-	4th ventricle
24	CT	Anomalous (hydrocephalus)	-	-	3rd ventricle
25	CT	Degenerative (cerebellar atrophy)	-	-	3rd ventricle
26	CT	Congenital/anomalous (severe hydrocephalus)	-	-	3rd and 4th ventricle

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Estudo retrospectivo de cistos aracnoides da cisterna quadrigeminal diagnosticados pela ressonância magnética e tomografia computadorizada em 26 cães

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[1] *Corresponding author: lidianealves.vet@gmail.com