Magnetic resonance imaging of focal splenic and hepatic lesions in the dog

Clifford CA, Pretorius ES, Weisse C, et al.

J Vet Intern Med 2004;18:330-338.

Focal hepatic and splenic lesions in the dog are common, and approximately half of such lesions are malignant. Both incidentally discovered lesions and lesions in patients with known malignancies represent diagnostic dilemmas. Ultrasound often fails to characterize such lesions adequately. This uncertainty may result in unnecessary splenectomies and liver biopsies for benign lesions or noncurative surgery for advanced-stage malignancies. In humans, ultrasound largely has been supplanted by computed tomography and magnetic resonance imaging (MRI) for the characterization of focal hepatic and splenic lesions. The inherently high soft tissue contrast of MRI allows the differentiation of benign from malignant hepatic and splenic lesions in the human patients. In this prospective study, 35 focal lesions of either the spleen (n = 8) or the liver (n = 27) were characterized by MRI in 23 dogs. Lesions were presumptively classified as malignant or benign on the basis of MRI findings. Imaging results then were correlated with histopathologic (29) or cytologic (6) evaluation of the lesions. The overall accuracy in differentiating malignant from benign lesions was 94% (33 of 35 lesions). The overall sensitivity and specificity were 100% (95% CI, 78-100%) and 90% (95% CI, 68-99%), respectively. MRI classified malignant hepatic lesions as hepatocellular carcinoma (HCC) in all confirmed cases and correctly predicted the histologic grade of 5 HCC lesions. These results suggest that MRI is a useful modality for abdominal imaging in veterinary patients, and MRI accurately differentiated benign from malignant focal hepatic and splenic lesions in this sample of patients.