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. 2018 Nov 28;5:280. doi: 10.3389/fvets.2018.00280

Figure 4.

Figure 4

Use of CT myelography to investigate arachnoid adhesions in in a 10 year old female Pug dog presented with signs of a thoracic myelopathy and that had previous surgical management for spinal arachnoid diverticulum and vertebral instability. Six months previous this dog had previously been managed surgically for a spinal arachnoid diverticulum (red arrow) with associated spinal cord edema/presyrinx (yellow arrow) at the level of T9/T10. She had been presented originally with a 2 year progressive history of myelopathy and the arachnoid diverticulum was considered associated with vertebral instability. Surgical management included marsupialization of the arachnoid diverticulum and spinal stabilization with Interface Pins (IMEX Veterinary Inc, Long View Texas) and Simplex-tobramycin bone cement (Howmedica, Limerick, Ireland). After an initial improvement the dog deteriorated and the metal implant precluded repeat MRI. CT myelography was performed from a lumbar injection. There is a reduced flow of contrast cranially (green arrow) and block to flow of the contrast material on the left side (blue arrow) and transverse images suggest adhesions between the spinal cord tissue and laminectomy site confirmed at surgery (pink arrow). (A) T2-weighted mid-sagittal MRI of the spinal cord from T6 to L1. There is a focal area of spinal cord edema (presyrinx) at the level of T9/T10 (red arrow). (B) Transverse 3D-CISS image at the level of T9/T10. There is a focal dilatation of the subarachnoid space at T9/T10 (yellow arrow). (C) Dorsal 3D-CISS image at the level of T7 to T13 demonstrating spinal cord edema (presyrinx) at the level of T9/T10 (red arrow) and suspected arachnoid diverticulum cranial to it (yellow arrow). (D) Midsagittal computed tomographic myelography from T6 to L2; there is reduced flow of iodinated contrast material cranial to T9 (green arrow). (E) transverse computed tomographic myelopathy at the level of T9. There is an adhesion between the spinal cord and laminectomy site (pink arrow). (F) Dorsal computed tomographic myelography from T6 to L2; there is a block of iodinated contrast material cranial to T9 (blue arrow) (Siemens Magnetom Symphony, A Tim System, 1.5 T, Erlangen, Germany; Toshiba Aquilion Prime 160 slice, Otawara, Japan). Image acknowledgment Dr Anna Tauro and Dr Colin Driver, Fitzpatrick Referrals.