Magnetic Resonance Imaging in Chelonians
J. Straub and K. Jurina, Dr. med. vet.
Because of limits of physical examination in tortoises,
turtles, and terrapins, further examinations are often
necessary. Radiology and ultrasonography have been
routinely performed in reptile medicine for several
years. The use of these techniques in chelonians is
often compromised. Images with soft tissue contrast
superior to that obtained by these imaging techniques
can be produced by means of magnetic resonance im-
aging (MRI). By using MRI, a number of pathologic
alterations, which cannot be visualized by standard im-
aging techniques, can be diagnosed. Unfortunately,
high costs and long examination times limit the use of
MRI in veterinary medicine.
Copyright 9 2001 by W.B. Saunders Company.
Key words: Imaging techniques, magnetic resonance
imaging, reptiles, chelonians.
physical examination is often limited in tor-
F toises, turtles, and terrapins. Pulse, respira-
tion, and body temperature, three major points
for clinical examination of mammals, are not
detectable or only contain minimal information
in reptiles. Therefore, further examinations are
often necessary. For several years, imaging tech-
niques including radiology and uhrasonography
have been p e r f o r m e d routinely in reptile medi-
cine. Unfortunately, the use of these techniques
in chelonians is limited.
On radiographs, soft tissue detail contrast is
massively compromised within the bony shell
capsule and its scutes. To minimize this prob-
lem, contrast radiography may be p e r f o r m e d
especially for the diagnosis of gastrointestinal
and urogenital tract alterations. Because a min-
imum size of the patient is necessary for the
application of contrast media, this technique is
not useful in very small animals. Additionally,
the use of contrast media in constipated animals
may be a risk.
Ultrasound examination is restricted to a cer-
tain size also. For obtaining images of the respi-
ratory tract, neither contrast radiography n o r
ultrasonography is useful.
Magnetic r e s o n a n c e imaging (MRI) is a rel-
atively new imaging t e c h n i q u e in veterinary
medicine. Until now, little is known about its
application in chelonian medicine. 1-3 By using
Seminars in Avian and Exotic Pet Medicine, Vol 10, No 4 (October), 2001: pp 181-186
the MRI technique, soft tissue contrast can be
p r o d u c e d superior to that obtained by other
imaging techniques. Because inner organs do
not interfere with external structures, they can
be recognized easily. The relative appearance of
physiologic versus pathologic tissue can be mod-
ified by altering specific parameters of the acqui-
sition protocol. MRI also offers the unique abil-
ity to acquire images in any orientation without
repositioning the patient.
Restraining and Positioning
MRI examinations require, d e p e n d i n g on the
n u m b e r of scans performed, a relatively long
period of immobilization. Chelonians are usu-
ally placed in ventral recumbency. For most pa-
tients, chemical immobilization is not necessary.
Calm animals are immobilized by simply closing
the head opening of the shell with medical tape
(Fig 1). Restless ones are restrained by closing all
shell openings. Only very exited patients have to
be sedated or anesthetized because movements
of the head and limbs may produce artifacts on
the images.
MRI Scans
For the examinations of the animals, we use a
p e r m a n e n t superconducting magnet (Gyroscan
T5-NT; Philips, Hamburg, Germany) with a field
strength of 0.5 Tesla. To obtain good signal-to-
noise ratios and sufficient spatial resolutions,
adequate coils (depending on the patient's size)
should be used. We use several regular h u m a n
coils (bird-cage coils or superficial coils) for our
examinations. For standard examination, Ta-
From the Institute for Avian Diseases, Clinic for Birds and
Reptiles, Department of Small Animal Medicine, University of
Leipzig, Leipzi~ Germany.
Address correspondence to J. Straub, University of Leipzig, De-
partment of Small Animal Medicine, Clinic for Birds and Reptiles,
An den Tierkliniken 17, D - 04103 Leipzig, Germany.
Copyright 9 2001 by W.B. Saunders Company.
1055-937X/O1/1004-0006535.00/0
doi:l O.1053/saep. 2001.24676
181
182 Straub and Jurina

Table 1. Comparison of Signal Intensities of

Different Organs/Tissues, Gyroscan T5-NT, Philips
Organ/ Compared
Tissue With Tl-Weighted T2-Weighted
Heart Muscle Isointense Hyperintense
Heart Liver Hypointense Hyperintense
Liver Muscle Hyperintense Hyperintense
Kidney Liver Isointense Hyperintense
Kidney Muscle Hyperintense Hyperintense
NOTE. Results may differ with other MRI devices or differ-
ent TR- and TE-times.

are possible, d e p e n d i n g on the problem pre-

Figure 1. Restrained tortoise placed in a bird-cage sented.
coil.

weighted (TR = 120 to 500 ms, TE = 4 to 20

ms), T2-weighted (TR = 2,000 to 3,900 ms, TE =
90 to 120 ms), and p r o t o n density-weighted
(TR = 1,200 to 2,500 ms, TE = 12 to 15 ms) spin
echo and turbospin echo sequences of the whole
body in coronar, sagittal, and transverse direc-
tion were performed. Slice thickness was be-
tween 3 and 5 mm. By choosing different scan
techniques and modifying scan parameters, even
thinner slices (to 0.5 m m in plane resolution) or
other sequences (eg, fat saturated sequences)
Physiologic Findings
The heart is visible on coronar, sagittal, and
transverse scans. In comparison to the liver, it is
hypointense in Tl-weighted images and hyperin-
tense in T 2 images (Table 1 and Fig 2). Motion
artifacts caused by heart m o v e m e n t may appear,
but in general they do not disturb the examina-
tion of other organs. If necessary, an ECG-trig-
gered scan can be performed. Vessels are irregu-
larly visible as longitudinal, transverse, or oblique
sections d e p e n d i n g on anatomic structures.

Figure 2. Testudo hermanni, coronar scans. (A) Tl-weighted. (B) T2-weighted. L, liver; H, heart; M, skeletal
muscle; B, urinary bladder; G, gallbladder.
 Magnetic Resonance Imaging in Chelonians
Figure 3. Trachemys scripta elegans, dorsal coronar
scan, T2-weighted (lung field).
T h e trachea with its bifurcation is seen as
longitudinal or oblique sections in c o r o n a r and
sagittal scans. In transverse scans, r o u n d to ovoid
sections are visible. Because of the large a m o u n t
of air that is inside the lungs, no signal except
thin septa is visualized. P u l m o n a r y septa are best
seen in T2- a n d p r o t o n density-weighted scans
Figure 4. Testudo hermanni, transverse scan, T~-
weighted. Lu, lung; I, intestine; L, liver; G, gallblad-
der; H, heart; B, urinary bladder.
183
Figure 5. Testudo hermanni, sagittal scan, T2-weighted.
Lu, lung; M, muscle; S, stomach, dorsal part, filled
with gas; L, liver; I, intestine.
(Fig 3). In transverse scans, the 2 lungs present
nearly symmetrically (Fig 4). C o m p a r a b l e to ra-
diographs, the field of the lung occupies the
dorsal half of the body in laterally sagittal and
middle transverse scans.
T h e stomach is located on the left side of the
body. Small amounts of gas can be seen dorsally
Figure 6. Testudo hermanni, transverse scan, T1-
weighted. K, kidney.
184 Straub and Jurina

Figure 7. Trachemysscripta elegans, T2-weighted. (A) Coronar scan. (B) Transverse scan. E, egg; F, follicle.

as small hypointense areas (Fig 5). Like the ves-
sels, the intestinal tract is irregularly visualized as
longitudinal, transverse, or oblique sections de-
pending on direction and thickness of the slices
(Fig 5). Because of different contents of the
intestine (fluids, gas, and solid material), scans
of different weightings are necessary for obtain-
ing the best contrast and detail recognition. In
most cases, it is difficult to identify specific ana-
tomic sections of the intestine and to compare
images of different animals.
The liver can clearly be identified. The 2
lobes are visible on coronar scans (Fig 2). T1-
weighted scans show a h o m o g e n e o u s liver pa-
renchyma, whereas in T2-weighted images, pa-
renchyma signal is fairly reduced and fluid
within the vessels and gallbladder (right lobe) is
better visualized. Compared with skeletal mus-
cles, liver parenchyma is hyperintense in all
weightings.
The urinary bladder is visible if it is filled with
fluid (Figs 2 and 11). Otherwise, it is almost not
distinguishable from the adjacent gastrointesti-
nal tract. In all weightings, the kidney paren-
chyma is h o m o g e n e o u s to moderately inhomo-
geneous (Fig 6). Signal intensity in comparison

Figure 8. Testudo graeca. (A) Radiograph, craniocaudal view (parts of the carapace are projected into the lung
field). (B) Transverse scan, T2-weighted (asymmetrical hyperintense area within the lung field).
 Magnetic Resonance Imaging in Chelonians 185

to the liver is similar in Tl-weighted and in-

creased in T2-weighted scans.
Follicles and eggs are excellently displayed in
MRI scans (Fig 7). The size, number, and structure
can be determined. Depending on the stage of
maturity, most of them are visualized as homoge-
neous round structures (hypointense to signal-free
in T2-weighted scans, higher intensity in Ti scans)
or divided into layers of different intensities that
are best seen in Tz-weighted images. Some follicles
are inhomogeneous. According to results of ultra-
sonographic examinations, 4~ it might be sus-
pected that these follicles are atretic.

Pathologic Findings
A n u m b e r o f pathologic alterations, which
c a n n o t be visualized by standard imaging tech-
niques, can be diagnosed by using MRI. Figure 10. Kinixys sp., coronar scan, T2-weighted. I,
intestine filled with radiolucent material.
P u l m o n a r y alterations are best seen on T2-
a n d p r o t o n density-weighted c o r o n a r and trans-
verse scans. Mild to m o d e r a t e inflammatory re- Some tortoises are presented to the veterinar-
action of the lung, which is not detectable on ian with anorexia a n d / o r respiratory distress
radiographs, can be f o u n d in MRI scans f r o m without any sign of specific respiratory disease.
chelonians with respiratory disease (Fig 8). Pul- In these cases, a decreased size of the lung field
m o n a r y bleeding can also be visualized (Fig 9). and an e n l a r g e m e n t of the ventral organ shadow
Blood detection is of different qualities in MRI is often visible on craniocaudal and laterolateral
d e p e n d e n t u p o n the stage of blood degradation, radiographs. T h e cause of the compression of
which is caused by different p a r a m a g n e t i c prop- the lung can only be diagnosed if it is caused by
erdes of h e m o g l o b i n and its metabolites. Fresh
blood is not or rarely detectable, whereas older
bleedings are easily identifiable as hyperintense
signals in TI-, T2-, and p r o t o n density-weighted
scans. In comparison, other fluids would show
different signal intensities in different weight-
ings.

~i84~

Figure 9. Trachemysscripta elegans, transverse scan, T~-

weighted. B, blood; F, fluid within the urinary blad- Figure 11. Testudo horsfieldii, coronar scan, T2-
der. weighted. B, urinary bladder, massively filled.
186 Straub and Jurina
Fig 12. Trachemys scgpta elegans, coronar scans. (A) T~-weighted. L, liver; G, gallbladder; S, stomach. (B) Fat
saturation technique.
a c o n s t i p a t i o n with r a d i o d e n s e m a t e r i a l such as
stones or sand. By m e a n s of MRI, it is possible to
d i a g n o s e a c o n s t i p a t i o n c a u s e d by r a d i o l u c e n t
m a t e r i a l (eg, w o o d shavings) (Fig 10). F u r t h e r -
m o r e , d i s t i n g u i s h i n g b e t w e e n a n e n l a r g e m e n t of
the i n t e s t i n a l tract a n d o t h e r o r g a n s is possible
(Fig 11). I n s o m e cases, even the cause o f a n
e n l a r g e m e n t o f a n o r g a n c a n be d i a g n o s e d . He-
patic lipidosis, for e x a m p l e , c a n b e d i a g n o s e d by
fat s a t u r a t i o n t e c h n i q u e s (Fig 12).
MRI is a relatively u n h a z a r d o u s diagnostic im-
aging t e c h n i q u e because it does n o t use ionizing
radiation or any o t h e r critical means. I n most
cases, a sedation or anesthesia is n o t necessary.
T h e most i m p o r t a n t disadvantages, o n the
o t h e r h a n d , are high costs a n d l o n g e x a m i n a t i o n
times ( d e p e n d i n g o n the e q u i p m e n t a n d n u m b e r
of sequences). Despite these disadvantages a n d
because of the increasing n u m b e r of e x a m i n a t i o n
facilities, it will b e c o m e a very useful additional
i m a g i n g modality in reptiles, especially chelonians.
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