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Presentation transcript:

Case of the month October 2006 Yorkshire Terrier, m, 7y

BDLD-syndrome “big dog little dog” syndrome History Dog was referred to the Neurology division of the Vetsuisse Faculty Berne because of Bitten and shaken by a big, big dog two days ago; now tetraparetic Neurological localisation was deep cervical.

FSE T2 sagittal

STIR (fat suppression) dorsal

plainContrast enhanced

FSE T2 traFE T2* tra Level of C1 dorsal right dorsal right

Findings ?

Whereas the sagittal T2 shows an unremarkable deep cervical spinal cord, the STIR reveals foci of high signal intensity in the muscles surrounding C1 (yellow arrows). This is confirmed by contrast uptake of these regions in T1 (red arrow).

Findings In the transverse T2 there is increased signal intensity in the right halve of the spinal cord (yellow arrows). This is not demonstrated by the T2*- weighted Gradient Echo, but the impression fracture (red arrow) of the dorsal arch is delineated more clearly than in the classical T2.

The STIR is a fat suppressing sequence which is very sensitive for any kind of fluid. It showed – together with the T2 – no abnormalities in the suspected region, but revealed changes at the level of C1. These were confirmed by contrast uptake in the T1-weighted sequence. Therefore the region of interest was changed and the T2 weighting showed high signal intensity in the right halve of the spinal cord consistent with contusion. The impression fracture of the vertebral arch was best seen with the T2*-weighted gradient echo. The choice of the correct sequence is essential in MRI for finding the right diagnosis. Comment