Tivers M S, Mahoney P N, Baines E A, Corr S A
Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
J Small Anim Pract. 2009 Jul;50(7):324-32. doi: 10.1111/j.1748-5827.2009.00780.x.
To assess the usefulness of computed tomography arthrography of the stifle in diagnosing meniscal tears in dogs with cranial cruciate ligament insufficiency.
A prospective clinical study was performed. Dogs were included if they had evidence of cranial cruciate ligament insufficiency or persistent or recurrent lameness following surgery for cranial cruciate ligament insufficiency. Dogs were sedated for a computed tomography scan of the affected stifle, orientated in the dorsal plane. A survey computed tomography scan was followed by a computed tomography arthrogram. A stifle arthrotomy was performed, and the surgical findings were recorded. The computed tomography scans were reviewed by three blinded reviewers, and the results were compared to the surgical findings.
Twenty-one computed tomography arthrograms from 20 dogs were included. At surgery, damage to the medial meniscus was identified in 14 stifles. Initial interpretation of computed tomography arthrography images was 57 to 64 per cent sensitive and 71 to 100 per cent specific for diagnosing medial meniscal injuries. Interpretation of the images on retrospective analysis was 71 per cent sensitive and 100 per cent specific, with an accuracy of 0.857.
The accuracy of stifle computed tomography arthrography for the diagnosis of tears to the medial meniscus was found to be good. It is a minimally invasive and repeatable technique, which does not require general anaesthesia or specialist training to obtain the images. The ability to reliably diagnose meniscal injury without the need for surgery may be advantageous, particularly in dogs which had previously had surgery for cranial cruciate ligament insufficiency.
评估膝关节计算机断层扫描关节造影术在诊断颅交叉韧带功能不全犬的半月板撕裂中的作用。
进行了一项前瞻性临床研究。如果犬有颅交叉韧带功能不全的证据或在颅交叉韧带功能不全手术后持续或反复出现跛行，则纳入研究。对犬进行镇静后，对患侧膝关节进行计算机断层扫描，扫描方向为背侧平面。先进行一次计算机断层扫描平扫，然后进行计算机断层扫描关节造影。进行膝关节切开术，并记录手术结果。三位不知情的评估者对计算机断层扫描图像进行评估，并将结果与手术结果进行比较。
纳入了来自20只犬的21份计算机断层扫描关节造影图像。手术中，在14个膝关节中发现内侧半月板损伤。计算机断层扫描关节造影图像的初步解读对诊断内侧半月板损伤的敏感性为57%至64%，特异性为71%至100%。回顾性分析图像的解读敏感性为71%，特异性为100%，准确率为0.857。
发现膝关节计算机断层扫描关节造影术诊断内侧半月板撕裂的准确性良好。这是一种微创且可重复的技术，获取图像无需全身麻醉或专业培训。无需手术就能可靠诊断半月板损伤的能力可能具有优势，特别是对于先前已接受颅交叉韧带功能不全手术的犬。
