Clinician's View: Neurology
For neurologists at WSU, who use MRI in more than 75% of their patient cases, the machine is an invaluable tool.
Why is an MRI important for neurology?
"MRI is very good at looking at soft tissue structures," says WSU neurologist Stephanie Thomovsky. "Because the central nervous system—brain and spinal cord—are soft tissue, MRI is the ideal way to image them."
MRI uses multiple sequences. After viewing each sequence our neurologists can be more certain the origin of different lesions seen on the MRI scans.
"For example, if we see a mass, the different sequences can differentiate between that mass being cancer, a fatty mass or a cystic structure," says Thomovsky.
"By knowing what we are dealing with, we are able to offer pet owners the best options for treating diseases," says Dr. Annie Chen, WSU neurologist. "For diseases that require surgery, the MRI is also essential for surgical planning."
Dr. Stephanie Thomovsky, WSU veterinary neurologist
Without an MRI machine, how would it affect diagnoses?
"It would be more difficult to image the central nervous system," says Thomovsky. "We would rely, as we did years ago, solely on CT scan; which is best used for bone imaging and myelography where we inject a dye into the central nervous system and then take x-rays."
Clients make the trip to WSU specifically to receive MRI when their animals have neurological disease or injury. Veterinarians refer patients to WSU because they know MRI is the best way to image the nervous system.
"Without the MRI, we may not be able to make clear diagnosis and surgical planning may be difficult for certain diseases," says Dr. Chen. "We would definitely be a lot more hesitant in treating certain diseases. And we might make inaccurate diagnosis, which may lead to inappropriate therapy for a patient."
How does MRI improve diagnosis and treatment?
WSU veterinary neurologists Drs. Annie Chen and Stephanie Thomovsky
"The MRI allows us the best opportunity to make a complete diagnosis," says Dr. Thomovsky. "In the case of surgical disease, it tells us where the lesion is and from the MRI we decide how and at what sites to do surgery."
It also is an invaluable research tool. Dr. Chen is currently evaluating the safety and effectiveness of an MRI-guided brain biopsy device.
"If we are able to prove that this biopsy system is effective and safe, we can then routinely offer this to clients to help us make more accurate diagnoses," says Dr. Chen. "Without the MRI, projects like that could never happen and we would not be able to advance veterinary medicine."
How might an MRI change your initial thinking about a patient’s condition?
"Ever since an MRI has been available at WSU, we have started to diagnose diseases we never thought happened to animals," says Dr. Chen. "For example, ten years ago, we always taught students that dogs and cats never stroked. Now with the MRI available, we realize that dogs and cats do stroke and that it is not that uncommon as we used to think."
"Sometimes in an examination we think a cancer is the most likely cause of a dog or cat's limb weakness or paralysis," says Dr. Thomovsky. "Then imaging shows a disease that can be surgically curable, such as intervertebral disc disease."
"Ultimately as neurologists, we all want to provide the best diagnostics and treatments for our patients," says Dr. Chen. "We can't do this without the MRI."