Small Animal MRISmall Animal MRISmall Animal MRISmall Animal MRI

Advanced Animal ImagingAdvanced Animal Imaging

Ryan Harrell BS, BS, CNMTRyan Harrell BS, BS, CNMT

Advanced Animal ImagingAdvanced Animal Imaging(AAI)(AAI)

Regionally OwnedRegionally Owned

Advanced TechnologyAdvanced Technology Advanced TechnologyAdvanced Technology

Affordable ImagingAffordable Imaging

Expert AnalysisExpert Analysis

Rapid Report Turn Around TimeRapid Report Turn Around Time

LocationLocation Located at the cornerLocated at the corner

of Liberty Mills Rd.of Liberty Mills Rd.and Homestead Rd.and Homestead Rd.

In the lower level ofIn the lower level of In the lower level ofIn the lower level ofIndian CreekIndian CreekVeterinary Hospital.Veterinary Hospital.

Phone:Phone: (260) 434(260) 434--15551555

5902 Homestead Road5902 Homestead RoadFort Wayne, IN 46814Fort Wayne, IN 46814

AAI ServicesAAI Services

Small Animal MRISmall Animal MRI

Small Animal UltrasoundSmall Animal Ultrasound

Feline IFeline I--131 radioiodine therapy.131 radioiodine therapy. Feline IFeline I--131 radioiodine therapy.131 radioiodine therapy.

Canine and Feline Thyroid hyperthyroid andCanine and Feline Thyroid hyperthyroid andhypothyroid diagnostic testing.hypothyroid diagnostic testing.

Floor Plan for MRI and U/SFloor Plan for MRI and U/S

Small Animal MRISmall Animal MRI

Esaote VETEsaote VET--MRMR

ObjectivesObjectives Understand what small animal MRI is and howUnderstand what small animal MRI is and how

it works.it works. Determine neurological MRI uses.Determine neurological MRI uses. Define nonDefine non--neurological MRI uses.neurological MRI uses. Understand when to order a MRI exam.Understand when to order a MRI exam. Understand when to order a MRI exam.Understand when to order a MRI exam. Decide when to use MRI contrast (gadolinium) .Decide when to use MRI contrast (gadolinium) . MRI versus CT.MRI versus CT. MRI case review.MRI case review. Define AAI’s MRI preparation.Define AAI’s MRI preparation. Answers to common questions.Answers to common questions.

What is MRIWhat is MRI

MRI = Magnetic Resonance ImagingMRI = Magnetic Resonance Imaging

Is a noninvasive imaging test used to diagnoseIs a noninvasive imaging test used to diagnosea variety of medical conditions in the brain,a variety of medical conditions in the brain,a variety of medical conditions in the brain,a variety of medical conditions in the brain,head, orbits, neck, hocks, stifle, hips, andhead, orbits, neck, hocks, stifle, hips, andspine.spine.

What is MRIWhat is MRI

MRI is one of the most advancedMRI is one of the most advancedtools available for the investigationtools available for the investigationofof soft tissue injurysoft tissue injury and pathology.and pathology.

It usually is expensive and notIt usually is expensive and notwidely available in veterinarywidely available in veterinarymedicine.medicine.

How does MRI work?How does MRI work?

MRI creates a high quality detailed image ofMRI creates a high quality detailed image ofthe organs, tissues and bones.the organs, tissues and bones.

MRI uses a strong magnet filed and radioMRI uses a strong magnet filed and radiowaves.waves.waves.waves.

How does MRI work?How does MRI work?

The animals body is made up of billions ofThe animals body is made up of billions ofatoms.atoms.

The nucleus of these atoms spins on an axis.The nucleus of these atoms spins on an axis.(Like a top off of its vertical axis)(Like a top off of its vertical axis)(Like a top off of its vertical axis)(Like a top off of its vertical axis)

How does MRI work?How does MRI work?

Imagine millions of nuclei all randomlyImagine millions of nuclei all randomlyspinning in different directions at the samespinning in different directions at the sametime.time.

MRI is focused on hydrogen atoms (waterMRI is focused on hydrogen atoms (watermolecules).molecules).

How does MRI work?How does MRI work?

When the animal is placed in the MRIWhen the animal is placed in the MRIscanner’s magnetic field the water moleculesscanner’s magnetic field the water moleculeswithin their body line up north and southwithin their body line up north and southwith the magnetic field.with the magnetic field.with the magnetic field.with the magnetic field.

How does MRI work?How does MRI work?

Radio frequency waves are then turned onRadio frequency waves are then turned onand off rapidly throughout the exam.and off rapidly throughout the exam.

When this occurs the hydrogen moleculesWhen this occurs the hydrogen molecules When this occurs the hydrogen moleculesWhen this occurs the hydrogen moleculesflip back to their original alignment givingflip back to their original alignment givingoff a small signaloff a small signal

How does MRI work?How does MRI work?

These small signals are picked up by a coilThese small signals are picked up by a coiland sent to a computer.and sent to a computer.

The computer is able to reconstruct detailedThe computer is able to reconstruct detailedimages of the animal from these signals.images of the animal from these signals.images of the animal from these signals.images of the animal from these signals.

How does MRI work?How does MRI work?

Different tissues in the body give off uniqueDifferent tissues in the body give off uniquesignals.signals.

BoneBone

Soft TissueSoft TissueFatFat LigamentsLigaments TendonsTendons

MuscleMuscle Synovial TissueSynovial Tissue NervesNerves

Blood VesselsBlood Vessels

Animal Cranial NervesAnimal Cranial Nerves

CNICNI = Olfactory= Olfactory

CNIICNII = Optic= Optic

CNIII,CNIII, CNIV,CNIV, CNVICNVI = Eye= Eyeposition, Pupil Response,position, Pupil Response,Sympathetics,Sympathetics,

CNVCNV = Corneal Reflex= Corneal Reflex CNVCNV = Corneal Reflex= Corneal Reflex

CNVIICNVII = Facial= Facial

CNVIIICNVIII = Auditory= Auditory

CNIX, CNX, CNXICNIX, CNX, CNXI ==Swallowing, Gag Reflux, EyeSwallowing, Gag Reflux, EyePressure, Heart Rate,Pressure, Heart Rate,Laryngeal and TrapeziusLaryngeal and TrapeziusMuscles.Muscles.

CNXIICNXII = Tongue Movement= Tongue Movement

Animal Cranial NervesAnimal Cranial Nerves CNICNI = Olfactory= Olfactory

CNIICNII = Optic= Optic

CNIII,CNIII, CNIV,CNIV, CNVICNVI = Eye= Eyeposition, Pupil Response,position, Pupil Response,Sympathetics,Sympathetics,

CNVCNV = Corneal Reflex= Corneal Reflex

CNVIICNVII = Facial= Facial CNVIICNVII = Facial= Facial

CNVIIICNVIII = Auditory= Auditory

CNIX, CNX, CNXICNIX, CNX, CNXI ==Swallowing, Gag Reflux, EyeSwallowing, Gag Reflux, EyePressure, Heart Rate,Pressure, Heart Rate,Laryngeal and TrapeziusLaryngeal and TrapeziusMuscles.Muscles.

CNXIICNXII = Tongue Movement= Tongue Movement

Neurological MRINeurological MRI NeurologicalNeurological

Problems dealing withProblems dealing withthe nervous system.the nervous system.

Peripheral NervousPeripheral NervousSystemSystem

Central NervousCentral NervousSystemSystem

BrainBrain

Brain StemBrain Stem

SpineSpineSystemSystem

Sensory FibersSensory Fibers

Motor NeuronsMotor Neurons

SpineSpine

Neurological MRINeurological MRI

Autonomic NervousAutonomic NervousSystemSystem

Nerves involved inNerves involved inorgan movement.organ movement.

The animal has noThe animal has no The animal has noThe animal has novoluntary control overvoluntary control overthe autonomic system.the autonomic system.

Reasons to order aReasons to order aNeurological MRINeurological MRI

Seizures / ConvulsionsSeizures / Convulsions

Head TiltHead Tilt

Loss of BalanceLoss of Balance

Abnormal Behaviors (Stuck in corners, staring into space)Abnormal Behaviors (Stuck in corners, staring into space)

Inability to WalkInability to Walk

Weakness in the legs/limbsWeakness in the legs/limbs

Walking in circlesWalking in circles

DeafnessDeafness

BlindnessBlindness

Abnormal Nasal Drainage or SwellingAbnormal Nasal Drainage or Swelling

Neurological PainNeurological Pain

Other Neurological SignsOther Neurological Signs

Reasons to order aReasons to order aNeurological MRINeurological MRI

Blindness can be neurological orBlindness can be neurological oropthalmological.opthalmological.

Lameness can be neurological or orthopedic.Lameness can be neurological or orthopedic.

Seizures can be due to brain disorders, toxins,Seizures can be due to brain disorders, toxins,or liver disease.or liver disease.

Seizures / ConvulsionsSeizures / Convulsions

SeizuresSeizures (Epilepsy)(Epilepsy) are common and there areare common and there aremany causes.many causes.

Most commonly occur between age 1Most commonly occur between age 1--5 years old.5 years old.

Seizure is composed of 3 parts:Seizure is composed of 3 parts: Seizure is composed of 3 parts:Seizure is composed of 3 parts: PreictalPreictal

IctusIctus

PostictalPostictal

Seizure recurring without recovery betweenSeizure recurring without recovery betweenepisodes is calledepisodes is called status epilepticusstatus epilepticus and is aand is aserious medical emergency.serious medical emergency.

Seizures / Convulsions SignsSeizures / Convulsions Signs

Sudden / Violent ShakingSudden / Violent Shaking

PaddlingPaddling

Dilation of PupilsDilation of Pupils

Unresponsive StaringUnresponsive Staring

Loss of ConsciousnessLoss of Consciousness Loss of ConsciousnessLoss of Consciousness

Salivation / DroolingSalivation / Drooling

StiffnessStiffness

TwitchingTwitching

Involuntary Urination /Involuntary Urination /Defecation.Defecation.

Common Causes of SeizuresCommon Causes of Seizures CongenitalCongenital

HydrocephalusHydrocephalus LissencephalyLissencephaly

InflammatoryInflammatory InfectiousInfectious

BacterialBacterial RickettsialRickettsial

Rocky Mountain Spotted FeverRocky Mountain Spotted Fever EhrlichiosisEhrlichiosis EhrlichiosisEhrlichiosis

ViralViral DistemperDistemper Feline Infectious Peritonitis (FIP)Feline Infectious Peritonitis (FIP) Feline Immunodeficiency virus (FIV)Feline Immunodeficiency virus (FIV) Feline Leukemia Virus (FeLV)Feline Leukemia Virus (FeLV)

FungalFungal CryptococcosisCryptococcosis

ProtozoalProtozoal NeoseporosisNeoseporosis ToxoplasmosisToxoplasmosis

ParasiticParasitic

Common Causes of SeizuresCommon Causes of Seizures InflammatoryInflammatory

ImmuneImmune--MediatedMediated MeningocephalitisMeningocephalitis BreedBreed--Specific EncephalitisSpecific Encephalitis

Small Dog EncephalitisSmall Dog Encephalitis Pug Dog Encephalitis (PDE)Pug Dog Encephalitis (PDE)

NeoplasticNeoplastic GliomaGlioma GliomaGlioma MeningiomaMeningioma Metastatic NeoplasiasMetastatic Neoplasias

ToxicToxic StrychnineStrychnine MetaldehydeMetaldehyde OrganophosphateOrganophosphate Heavy MetalsHeavy Metals

TraumaticTraumatic Head InjuryHead Injury

EncephalitisEncephalitis

Common Causes of SeizuresCommon Causes of Seizures InflammatoryInflammatory

MetabolicMetabolic

Storage DiseasesStorage Diseases

Thiamine DeficiencyThiamine Deficiency

HypocalcemiaHypocalcemia HypocalcemiaHypocalcemia

HypoglycemiaHypoglycemia

HepatoencephalopathyHepatoencephalopathy Portosystemic ShuntPortosystemic Shunt

Hepatic MicrovascularHepatic MicrovascularDysplasiaDysplasia

Liver Failure / HepatitisLiver Failure / Hepatitis

Types of SeizuresTypes of Seizures

Partial / Focal SeizuresPartial / Focal Seizures

SimpleSimple

Complex / PyschomotorComplex / Pyschomotor

Generalized SeizuresGeneralized Seizures Generalized SeizuresGeneralized Seizures

AbsenceAbsence

TonicTonic--clonic / Grand Malclonic / Grand Mal

Secondary TonicSecondary Tonic--clonic Seizuresclonic Seizures

Both Partial and Generalized SeizuresBoth Partial and Generalized Seizures

When to Order the MRI ExamWhen to Order the MRI ExamRecommended PracticeRecommended Practice

Blood workBlood work to screen forto screen formetabolic or infectiousmetabolic or infectiouscauses.causes.

WaitWait and if happens moreand if happens moreoften order a MRI.often order a MRI.

Common PracticeCommon Practice

Blood workBlood work to screen forto screen formetabolic or infectiousmetabolic or infectiouscauses.causes.

WaitWait..

MedicateMedicate if seizures occurif seizures occur often order a MRI.often order a MRI.

MRIMRI to search for brainto search for brainstructural abnormalities.structural abnormalities.

Analysis of cerebrospinalAnalysis of cerebrospinalfluid (CFS)fluid (CFS) for signs offor signs ofinfection.infection.

MedicateMedicate depending ondepending onthe MRI results.the MRI results.

MedicateMedicate if seizures occurif seizures occurmore frequently.more frequently.

Balance DisordersBalance Disorders

Four main functions in the animal vestibular systemFour main functions in the animal vestibular systemneed to function for proper balance.need to function for proper balance.

Sensors in theSensors in the inner earinner ear monitor head position and time.monitor head position and time.

Converting the information about the position of theConverting the information about the position of thehead into electrical signals in the inner ear viahead into electrical signals in the inner ear viahead into electrical signals in the inner ear viahead into electrical signals in the inner ear viavestibulocochlear nervevestibulocochlear nerve to the lower brain.to the lower brain.

The balance control center is theThe balance control center is the brainstembrainstem workingworkingsignals with the cerebellum to keep an animal upright.signals with the cerebellum to keep an animal upright.

The vestibular nuclei relay signals from the brain steamThe vestibular nuclei relay signals from the brain steamto theto the cerebellumcerebellum which uses constant feed back on bodywhich uses constant feed back on bodyposition to coordinate movement.position to coordinate movement.

Balance Disorders SignsBalance Disorders Signs

Lack of BalanceLack of Balance

Head TiltHead Tilt

CirclingCircling

NauseaNausea

Falling / RollingFalling / RollingHorner’s SyndromeHorner’s Syndrome

Falling / RollingFalling / Rolling

NystagmusNystagmus

TremorsTremors

AtaxialAtaxial

Horner’s SyndromeHorner’s Syndrome

HypermetriaHypermetria

Head TiltHead Tilt

Horner’s SyndromeHorner’s Syndrome

AtaxiaAtaxia

Common Causes ofCommon Causes ofBalance DisordersBalance Disorders

Peripheral Vestibular DiseasePeripheral Vestibular Disease (Inner Ear &(Inner Ear &Vestibulocochlear Nerve)Vestibulocochlear Nerve)

InflammatoryInflammatory Infection (otitis media / interna)Infection (otitis media / interna) ImmuneImmune--mediated (polyps)mediated (polyps)

Neoplastic (inner / middle ear)Neoplastic (inner / middle ear) Neoplastic (inner / middle ear)Neoplastic (inner / middle ear) MelanomaMelanoma Squamous cell carcinomaSquamous cell carcinoma AdenocarcinomaAdenocarcinoma

TraumaticTraumatic Head InjuryHead Injury Eardrum RuptureEardrum Rupture

ToxicToxic MedicationsMedications

IdiopathicIdiopathic Geriatric Vestibular SyndromGeriatric Vestibular Syndrom

Central Vestibular DiseaseCentral Vestibular Disease (Brainstem &(Brainstem &Cerebellum)Cerebellum) Degenerative / MetabolicDegenerative / Metabolic

Cerebellar Abiotrophy (Breed Specific)Cerebellar Abiotrophy (Breed Specific)

CongenitalCongenital

Cerebellar HypoplasiaCerebellar Hypoplasia

HydrocephalusHydrocephalus

Common Causes ofCommon Causes ofBalance DisordersBalance Disorders

HydrocephalusHydrocephalus

InflammatoryInflammatory

ImmuneImmune--MediatedMediated

CerebellitisCerebellitis

White Dog SyndromeWhite Dog Syndrome

NeoplasticNeoplastic

MedulloblastomaMedulloblastoma

TruamaticTruamatic

Head InjuryHead Injury

ToxicToxic

MetronidazoleMetronidazole

VascularVascular

Central Nervous SystemCentral Nervous System

When to Order the MRI ExamWhen to Order the MRI Exam

Common PracticeCommon Practice

Physical ExamPhysical Exam

CBC / Labs / CSFCBC / Labs / CSFFluid.Fluid.

Recommended PracticeRecommended Practice

Physical ExamPhysical Exam

Neurological ExamNeurological Exam

CBC / Labs / CSFCBC / Labs / CSFFluid.Fluid.

MedicateMedicate and Observeand Observe CBC / Labs / CSFCBC / Labs / CSF

FluidFluid

OrderOrder MRIMRI

MedicateMedicate and Observeand Observe

Abnormal BehaviorAbnormal Behavior

Abnormal behavior can be caused by severalAbnormal behavior can be caused by severaldifferent factors.different factors.

Using a neurological physical examinationUsing a neurological physical examinationcan help identify if it is a neurologicalcan help identify if it is a neurologicalcan help identify if it is a neurologicalcan help identify if it is a neurologicaldisorder or a defiant animal behavior.disorder or a defiant animal behavior.