Utility of a flexed neck sagittal magentic resonance imaging sequence for the assessment of cerebellomedullary cistern in dogs

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Abstract

Cerebrospinal fluid (CSF) collection from the cerebellomedullary cistern (CM) of dogs with congenital or acquired cerebellar herniation could lead to serious complications. It is anecdotally more challenging in large brachycephalic breeds possibly due to the increased distance between the skin and CM. The first objective of this study was to assess whether flexed-neck sagittal magnetic resonance imaging (MRI) sequences would assist in the decision-making process of collecting CSF from the CM. The second objective was to examine the dimensions of the CM measured in extended and flexed views, and whether cranial index (CI), skull height and body weight correlated with the distance of the CM from the skin surface. Forty-one dogs of various breeds were included in the study. Measurements were performed on T2-weighted sagittal sequences acquired in extended and flexed-neck positions, and transverse sequences acquired in an extended-neck position. Mild cerebellar herniation was detected in 23/41 (56%) of the flexed-neck views versus none in the extended views. The CM area was significantly larger in flexed-neck views than in extended views (p < 0.05). In 29% of the cases (12/41), the trajectory of the needle intersected the cerebellar vermis. There was a positive correlation between the distance of the CM from the skin and body weight (p < 0.05) and skull height (p < 0.05), but not with the CI (p = 0.23). These findings suggest that a flexed-neck sagittal MRI sequence helps with assessment of the size of the CM and degree of cerebellar herniation, and that skull height and body weight, but not cranial index, affect the distance of the CM from the skin surface.

Original languageEnglish
Pages (from-to)1-7
JournalJournal of Anatomy
Early online date9 Feb 2022
DOIs
Publication statusE-pub ahead of print - 9 Feb 2022

Keywords

  • brachycephaly
  • cerebellar herniation
  • cerebellomedullary cistern
  • cerebrospinal fluid sampling
  • Chiari-like malformation
  • cisterna magna

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