Variations in the morphology of lagomorph confluence sinuum on contrast enhanced CT.

Abstract

Knowledge of lagomorph confluence sinuum anatomy on contrast-enhanced CT may prevent the misdiagnoses of intracranial, extra-axial masses. The purpose of this retrospective, observational, descriptive study was to describe the characteristics of the confluence sinuum in rabbits on contrast-enhanced CT. Images of 24 rabbits who had pre- and postcontrast CT sequences of the skull were reviewed by an American College of Veterinary Radiology-certified veterinary radiologist and third-year radiology resident. Degree of contrast enhancement within the region of the confluence sinuum was graded based on consensus as no (0), mild (1), moderate (2), or marked (3) contrast enhancement. Hounsfield units (HU) of the confluence sinuum was measured in three different regions of interest, averaged for each patient, and divided into each group for comparison using one-way ANOVA analysis. Contrast enhancement was mild in 45.8% (11/24) rabbits, moderate in 33.3% (8/24), marked in 20.8% (5/24), and none in 0.0% (0/24). There were significant differences (P<0.05) between the average HU of the mild and marked group (P-value=0.0001) and moderate and marked groups (P-value=0.0010). Two rabbits with marked contrast enhancement were initially misdiagnosed with an intracranial, extra-axial mass along the parietal lobe based on contrast-enhanced CT. On necropsy, no gross or histopathological abnormalities were identified in the brain for these rabbits. In summary, contrast enhancement was identified in all rabbits (24/24) on contrast-enhanced CT imaging . This normal structure can be variable in size should not be mistaken for a pathological lesion in the absence of mass effect, secondary calvarial lysis, or hyperostosis.