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开发一种用于成年犬髋关节超声引导注射的技术。

DEVELOPING A TECHNIQUE FOR ULTRASOUND-GUIDED INJECTION OF THE ADULT CANINE HIP.

作者信息

Bergamino Chiara, Etienne Anne-Laure, Busoni Valeria

机构信息

University College Dublin, Diagnostic Imaging, Dublin, Ireland.

Faculty of Veterinary Medicine, Diagnostic Imaging Section, Boulevard de Colonster, 20, Bâtiment B41, Liège, Liège, Belgium, 4000.

出版信息

Vet Radiol Ultrasound. 2015 Jul-Aug;56(4):456-61. doi: 10.1111/vru.12242. Epub 2015 Jan 24.

Abstract

An accurate method for guiding injections into the canine hip would facilitate diagnostic localization of lameness and targeted treatments. Ultrasound-guided hip injections are commonly used in humans and large animals. Aims of this prospective study were to describe ultrasound (US) anatomy of the adult canine hip and determine the feasibility and accuracy of intra-articular placement of injectate using US-guidance. Seven adult dogs were used to describe US anatomy, five dog cadavers were used to assess the feasibility of the injection technique and 11 dog cadavers were used to assess accuracy of injections. For the accuracy test, 22 joints were injected with iodinated contrast medium by three operators with different experience. With dogs in lateral recumbency, the hyperechoic femoral head surface was identified by following the femoral neck from the greater trochanter or the acetabular rim was localized by following caudally the ilium from the iliac wing. An anechoic gap between the femoral head and acetabular surface represented the joint. The capsule was visible as a triangular echoic structure and the femoral head articular cartilage appeared as an anechoic band. The needle was inserted axial to the greater trochanter and directed in a dorsolateral-ventromedial direction toward the joint space and then pushed through the capsule. Based on postinjection radiography, accuracy was 81.8% at first attempt and 100% at second attempt. This study indicated that US-guided injection is a feasible and accurate technique for injecting the adult canine hip. Future studies in live dogs are needed to assess safety and efficacy.

摘要

一种准确引导犬髋关节注射的方法将有助于跛行的诊断定位和靶向治疗。超声引导下的髋关节注射在人类和大型动物中普遍使用。这项前瞻性研究的目的是描述成年犬髋关节的超声(US)解剖结构,并确定在超声引导下关节内注射药物的可行性和准确性。使用7只成年犬描述超声解剖结构,5只犬尸体评估注射技术的可行性,11只犬尸体评估注射的准确性。在准确性测试中,由三名经验不同的操作人员向22个关节注射碘化造影剂。犬侧卧时,从大转子处沿股骨颈追踪可识别高回声的股骨头表面,或从髂骨翼沿髂骨向尾侧追踪可定位髋臼边缘。股骨头与髋臼表面之间的无回声间隙代表关节。关节囊可见为三角形回声结构,股骨头关节软骨表现为无回声带。将针轴向插入大转子,并朝背外侧-腹内侧方向指向关节间隙,然后穿过关节囊。根据注射后的X线摄影,首次尝试的准确率为81.8%,第二次尝试的准确率为100%。这项研究表明,超声引导注射是一种可行且准确的成年犬髋关节注射技术。需要在活体犬上进行进一步研究以评估安全性和有效性。

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