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3T 短时间磁共振方案诊断非创伤性十字韧带断裂犬后肢膝关节病变的准确性。

Diagnostic accuracy of a short-duration 3 Tesla magnetic resonance protocol for diagnosing stifle joint lesions in dogs with non-traumatic cranial cruciate ligament rupture.

机构信息

Small Animal Hospital, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, D-30559, Hannover, Germany.

出版信息

BMC Vet Res. 2013 Feb 28;9:40. doi: 10.1186/1746-6148-9-40.

Abstract

BACKGROUND

Magnetic resonance (MR) imaging is the preferred diagnostic tool to evaluate internal disorders of many joints in humans; however, the usefulness of MR imaging in the context of osteoarthritis, and joint disease in general, has yet to be characterized in veterinary medicine. The objective of this study was to assess the diagnostic accuracy of short-duration 3 Tesla MR imaging for the evaluation of cranial and caudal cruciate ligament, meniscal and cartilage damage, as well as the degree of osteoarthritis, in dogs affected by non-traumatic, naturally-occurring cranial cruciate ligament rupture (CCLR). Diagnoses made from MR images were compared to those made during surgical exploration. Twenty-one client-owned dogs were included in this study, and one experienced evaluator assessed all images.

RESULTS

All cranial cruciate ligaments were correctly identified as ruptured. With one exception, all caudal cruciate ligaments were correctly identified as intact. High sensitivities and specificities were obtained when diagnosing meniscal rupture. MR images revealed additional subclinical lesions in both the cranial and caudal cruciate ligaments and in the menisci. There was a "clear" statistical (kappa) agreement between the MR and the surgical findings for both cartilage damage and degree of osteoarthritis. However, the large 95% confidence intervals indicated that evaluation of cartilage damage and of degree of osteoarthritis is not clinically satisfactory.

CONCLUSIONS

The presence of cruciate ligament damage and meniscal tears could be accurately assessed using the MR images obtained with our protocol. However, in the case of meniscal evaluation, occasional misdiagnosis did occur. The presence of cartilage damage and the degree of osteoarthritis could not be properly evaluated.

摘要

背景

磁共振(MR)成像已成为评估人类许多关节内部疾病的首选诊断工具;然而,在兽医领域,磁共振成像在骨关节炎及一般关节疾病中的作用尚未得到充分评估。本研究旨在评估 3T 短时间 MR 成像评估非创伤性、自发性前十字韧带断裂(CCLR)犬的颅侧和尾侧十字韧带、半月板和软骨损伤以及骨关节炎程度的诊断准确性。MR 图像的诊断结果与手术探查的结果进行了比较。本研究共纳入 21 只患犬,由一位经验丰富的评估员评估所有图像。

结果

所有前十字韧带均正确识别为断裂。除一例外,所有尾侧十字韧带均正确识别为完整。半月板撕裂的诊断具有较高的敏感性和特异性。MR 图像显示在颅侧和尾侧十字韧带以及半月板中均存在额外的亚临床病变。在软骨损伤和骨关节炎程度方面,MR 和手术结果之间存在“明显”的统计学(kappa)一致性。然而,较大的 95%置信区间表明,软骨损伤和骨关节炎程度的评估并不完全令人满意。

结论

使用我们的方案获得的 MR 图像可以准确评估十字韧带损伤和半月板撕裂的情况。然而,在半月板评估中偶尔会出现误诊。软骨损伤和骨关节炎的程度无法得到适当评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a41/3599255/d551a7ee18b6/1746-6148-9-40-1.jpg

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