Samii Valerie F, Dyce Jonathan, Pozzi Antonio, Drost Wm Tod, Mattoon John S, Green Eric M, Kowaleski Michael P, Lehman Amy M
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA.
Vet Radiol Ultrasound. 2009 Mar-Apr;50(2):144-50. doi: 10.1111/j.1740-8261.2009.01507.x.
The purpose of this study was to evaluate the utility of single-detector computed tomographic arthrography (CT arthrography) for the diagnosis of cranial and caudal cruciate ligament and meniscal lesions in the dog stifle. Four normal and 25 abnormal stifle joints, determined to have lesions related to intra-articular ligamentous insufficiency based on clinical history, orthopedic examination, and survey orthogonal radiographs, were imaged using a previously developed CT arthrography protocol. Surgery was performed immediately following the CT procedure. Three board-certified radiologists inexperienced at interpreting CT stifle arthrograms reviewed all CT studies independently, and then as a group, without knowledge of surgical or necropsy findings. Sensitivity, specificity, positive predictive value, and negative predictive value for determination of cranial and caudal cruciate and meniscal tears were calculated for each individual reviewer and based on group consensus. All reviewers identified the normal canine stifle joints imaged correctly. Reviewers did well in discriminating normal from torn cranial cruciate ligaments, with sensitivities of 96-100% and specificities of 75-100%. No reviewer correctly identified the solitary caudal cruciate ligament tear and specificity ranged from 89.3% to 100%. Reviewers were less adept at discriminating normal from torn meniscal fibrocartilage, with sensitivities of 13.3-73.3% and specificities of 57.1-100%. Interpretive accuracy improved slightly when consensus scores were compared with surgical findings. Single-detector CT arthrography may be useful for identifying pathology of the canine cruciate ligaments but is of limited value for assessing the menisci.
本研究的目的是评估单探测器计算机断层扫描关节造影（CT关节造影）在诊断犬膝关节颅侧和尾侧交叉韧带及半月板损伤中的应用价值。根据临床病史、骨科检查和正交X线平片，确定4个正常膝关节和25个异常膝关节存在与关节内韧带功能不全相关的损伤，并使用先前制定的CT关节造影方案进行成像。CT检查后立即进行手术。三位不擅长解读CT膝关节造影的认证放射科医生独立审查了所有CT研究，然后在不了解手术或尸检结果的情况下进行集体审查。计算了每位审阅者以及基于小组共识确定颅侧和尾侧交叉韧带及半月板撕裂的敏感性、特异性、阳性预测值和阴性预测值。所有审阅者均正确识别了成像的正常犬膝关节。审阅者在区分正常与撕裂的颅侧交叉韧带方面表现良好，敏感性为96% - 100%，特异性为75% - 100%。没有审阅者正确识别出单独的尾侧交叉韧带撕裂，特异性范围为89.3%至100%。审阅者在区分正常与撕裂的半月板纤维软骨方面不太擅长，敏感性为13.3% - 73.3%，特异性为57.1% - 100%。将共识评分与手术结果进行比较时，解释准确性略有提高。单探测器CT关节造影可能有助于识别犬交叉韧带的病变，但在评估半月板方面价值有限。
