Parry A T, Harris A, Upjohn M M, Chandler K, Lamb C R
Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK.
J Small Anim Pract. 2010 Jun;51(6):312-7. doi: 10.1111/j.1748-5827.2010.00936.x. Epub 2010 May 10.
A retrospective cross-sectional study was done to look for differences in outcome in canine spinal patients that had myelography compared to those that had magnetic resonance imaging.
Medical records of dogs with spinal conditions in the period January 2004 to December 2007 were reviewed. Data on patient age, gender, breed, size, neurolocalisation, rate of onset, imaging modality, time taken to image, type of treatment, neurological grade at admission and discharge, length and cost of hospitalisation and status at discharge were collected. Only dogs with neurological grade 3 to 6 with signs referable to the thoracolumbar spine were included.
Of 107 dogs that met the inclusion criteria, 66 (62%) had myelography and 41 (38%) had magnetic resonance imaging. Using multivariable analyses, non-chondrodystrophoid breed, increasing age and higher neurological grade at admission were found to be associated negatively with survival. Neurological grade 5 at admission was found to be associated positively with likelihood of neurological improvement. Male gender, higher neurological grade at admission and medical treatment were associated negatively with length of hospitalisation. magnetic resonance imaging, surgical treatment and period of hospitalisation were associated positively with total cost of hospitalisation.
No significant association was found between type of imaging and any patient outcome variables except cost of hospitalisation, which was higher for dogs having magnetic resonance imaging. Although magnetic resonance imaging may be considered advantageous compared to myelography because it is non-invasive and provides superior anatomical detail for surgical guidance, no beneficial effect on outcome of dogs with non-ambulatory thoracolumbar spinal disease was found.
开展一项回顾性横断面研究,以探寻接受脊髓造影的犬类脊柱疾病患者与接受磁共振成像的患者在预后方面的差异。
回顾了2004年1月至2007年12月期间患有脊柱疾病犬只的病历。收集了有关患者年龄、性别、品种、体型、神经定位、发病速度、成像方式、成像所需时间、治疗类型、入院和出院时的神经学分级、住院时间和费用以及出院时状况的数据。仅纳入神经学分级为3至6级且有胸腰椎相关体征的犬只。
在符合纳入标准的107只犬中,66只(62%)接受了脊髓造影,41只(38%)接受了磁共振成像。通过多变量分析发现,非软骨发育不良品种、年龄增长和入院时较高的神经学分级与生存率呈负相关。发现入院时神经学分级为5级与神经功能改善的可能性呈正相关。雄性、入院时较高的神经学分级和药物治疗与住院时间呈负相关。磁共振成像、手术治疗和住院时间与住院总费用呈正相关。
除住院费用外,未发现成像类型与任何患者预后变量之间存在显著关联,接受磁共振成像的犬只住院费用更高。尽管与脊髓造影相比,磁共振成像可能被认为具有优势,因为它是非侵入性的,并且为手术指导提供了更优的解剖细节,但未发现对非行走性胸腰椎脊髓疾病犬只的预后有有益影响。