Provencher M, Habing A, Moore S A, Cook L, Phillips G, da Costa R C
Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH.
College of Veterinary Medicine and the Center for Biostatistics, The Ohio State University, Columbus, OH.
J Vet Intern Med. 2016 Jul;30(4):1121-8. doi: 10.1111/jvim.13981. Epub 2016 May 30.
The dynamic component of disc-associated cervical spondylomyelopathy (DA-CSM) currently is evaluated using traction magnetic resonance imaging (MRI), which does not assess changes in flexion and extension of the cervical vertebral column. In humans with cervical spondylotic myelopathy, kinematic MRI is used to identify dynamic compressions.
HYPOTHESIS/OBJECTIVES: To evaluate the feasibility and utility of kMRI in Doberman Pinschers with DA-CSM using a novel positioning device. We hypothesized that kMRI would identify compressive lesions not observed with neutral positioning and change the dimensions of the spinal cord and cervical vertebral canal.
Nine client-owned Doberman Pinschers with DA-CSM.
Prospective study. After standard MR imaging of the cervical spine confirmed DA-CSM, dogs were placed on a positioning device to allow imaging in flexion and extension. Morphologic and morphometric assessments were compared between neutral, flexion, and extension images.
Flexion was associated with improvement or resolution of spinal cord compression in 4/9 patients, whereas extension caused worsening of compressions in 6/9 patients. Extension identified 6 new compressive lesions and was significantly associated with dorsal and ventral compression at C5-C6 (P = .021) and C6-C7 (P = .031). A significant decrease in spinal cord height occurred at C6-C7 from neutral to extension (P = .003) and in vertebral canal height at C5-C6 and C6-C7 from neutral to extension (P = .011 and .017, respectively).
Our results suggest that kMRI is feasible and provides additional information beyond what is observed with neutral imaging, primarily when using extension views, in dogs with DA-CSM.
目前采用牵引磁共振成像(MRI)评估椎间盘源性颈椎病(DA-CSM)的动态成分,该方法无法评估颈椎屈伸时的变化。在患有颈椎病性脊髓病的人类中,运动MRI用于识别动态压迫。
假设/目的:使用一种新型定位装置评估运动MRI在患有DA-CSM的杜宾犬中的可行性和实用性。我们假设运动MRI能够识别中立位成像未观察到的压迫性病变,并改变脊髓和颈椎管的尺寸。
9只患有DA-CSM的客户拥有的杜宾犬。
前瞻性研究。在颈椎的标准MRI成像证实DA-CSM后,将犬放置在定位装置上以进行屈伸位成像。比较中立位、屈曲位和伸展位图像的形态学和形态测量学评估。
4/9的患者在屈曲时脊髓压迫得到改善或缓解,而6/9的患者在伸展时压迫加重。伸展位发现了6个新的压迫性病变,并且与C5-C6(P = .021)和C6-C7(P = .031)水平的背侧和腹侧压迫显著相关。从中立位到伸展位,C6-C7水平的脊髓高度显著降低(P = .003),C5-C6和C6-C7水平的椎管高度也从中立位到伸展位显著降低(分别为P = .011和.017)。
我们的结果表明,运动MRI是可行的,并且在患有DA-CSM的犬中,除了中立位成像观察到的信息外,还能提供额外信息,主要是在使用伸展位视图时。