Inflammatory diseases

Question 1

What is the defining MRI feature of steroid-responsive meningitis-arteritis (SRMA) in dogs?

Answer 1

Meningeal contrast enhancement
Paravertebral soft tissues, including:
* Synovium of the articular facets
* Paravertebral muscles

This feature reflects inflammatory infiltration of the meninges due to immune-mediated vasculitis.

Question 2

What advanced imaging sequence can enhance the detection of inflammation in SRMA?

Answer 2

• T1W post-contrast
• Fat suppression sequences.

Particularly effective on high-field MRI units.

Question 3

What type of neural structure compression can occur in SRMA?

Answer 3

Focal compression due to hemorrhagic processes

Example includes a well-defined intradural–extramedullary mass in a Golden Retriever.

Question 4

What were the MRI characteristics of the reported mass in a Golden Retriever with SRMA?

Answer 4

Heterogeneously hyperintense on T2-W
Mild hyperintensity on T1-weighted images and uneven peripheral contrast enhancement

Consistent with an early hyperacute hemorrhagic process.

Question 5

What does CSF analysis in SRMA typically reveal?

Answer 5

Inflammatory.
Mixed pleocytosis with a prominence of neutrophils alongside lymphocytes

A hallmark is marked neutrophilic pleocytosis.

Question 6

What is the typical total nucleated cell count in CSF for SRMA?

Answer 6

Can exceed 100 cells/μL

Neutrophils usually comprise over 75% of the cell population.

Question 7

How do CSF alterations relate to MRI findings in SRMA?

Answer 7

CSF alterations correlate with the extent of meningeal enhancement seen on MRI

This underscores the relationship between imaging severity and inflammatory activity.

Question 8

What role does MRI play in diagnosing SRMA?

Answer 8

Primarily to exclude other differential diagnoses, such as neoplastic or infectious processes

Findings provide a strong presumptive basis for diagnosis.

Question 9

What can unilateral or multifocal parenchymal hyperintensities on T2-weighted sequences indicate in SRMA?

Answer 9

Potential impact of inflammatory vasculitis on neural tissue integrity

May be associated with neurological deficits like paresis.

Question 10

What constitutes a reliable diagnostic profile for SRMA in canine patients?

Answer 10

Combination of:
* Diffuse or focal meningeal enhancement on MRI
* Significant neutrophilic pleocytosis
* Elevated protein levels in the CSF

This profile is critical for diagnosis.

Question 11

What type of disease is Steroid‐Responsive Meningitis‐Arteritis (SRMA)?

Answer 11

An immune‐mediated inflammatory disease

Question 12

What are common clinical signs of SRMA?

Answer 12

• Neck pain
• Fever
• Reluctance to move

Question 13

Name some traditionally predisposed breeds for SRMA.

Answer 13

• Bernese Mountain Dogs
• Boxers
• Beagles
• German Shorthaired Pointers
• Wirehaired Pointers
• Weimaraners

Question 14

Which breeds have been more recently included in the list of predisposed breeds for SRMA?

Answer 14

• Golden Retrievers
• Wirehaired Pointing Griffons

Question 15

What is the range of relapse incidence reported for SRMA?

Answer 15

20% to as high as 60%

Question 16

What biomarker has been correlated with an increased likelihood of multiple relapses in SRMA?

Answer 16

Higher serum C-reactive protein (CRP) levels

Question 17

What is the typical duration for tapering corticosteroids in SRMA treatment?

Answer 17

6 to 10 months

Question 18

What are some immunomodulators used in SRMA treatment?

Answer 18

• Azathioprine
• Cyclosporine
• Mycophenolate

Question 19

What should regular monitoring in SRMA management include?

Answer 19

• Repeated clinical evaluations
• Laboratory assessments, particularly serum CRP levels