Gilmour Lindsey J, Jeffery Nick D, Miles Kristina, Riedesel Elizabeth
Veterinary Clinical Sciences Department, College of Veterinary Medicine, Iowa State University, 1600 South 16th Street, Ames, IA, 50011.
Veterinary Large Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, 4475 TAMU, College Station, TX, 77845-4475.
Vet Radiol Ultrasound. 2017 Mar;58(2):197-205. doi: 10.1111/vru.12463. Epub 2016 Dec 15.
Progressive myelomalacia is an uncommon type of ischemic, hemorrhagic spinal cord infarction. Diagnosis can be difficult, but prompt recognition is important. We hypothesized that cerebrospinal fluid signal attenuation on magnetic resonance (MR) images would be more extensive in dogs that developed progressive myelomalacia vs. control dogs. A retrospective analytic cohort study was designed. Dogs were included if they presented for acute paraplegia and loss of deep pain perception and had undergone MR imaging using both sagittal single-shot turbo spin echo (SSTSE) and standard sagittal T2-weighted fast spin echo (T2W) pulse sequences. Dogs were divided into progressive myelomalacia and control groups for comparisons. All MR examinations were evaluated by three reviewers blinded to patient outcome. Length of cerebrospinal fluid attenuation was recorded as a ratio to the length of the L2 vertebral body in SSTSE and T2W sequences (CSF:L2 and CSF:L2 , respectively). Length of intramedullary spinal cord hyperintensity was recorded as a ratio to the length of the L2 vertebral body in T2W sequences. A total of 21 dogs were included (five in the progressive myelomalacia group and 16 in the control group). The mean CSF:L2 attenuation value was significantly higher in dogs that developed progressive myelomalacia (CSF:L2 = 10.7) compared to controls (CSF:L2 = 5.4; P = 0.015). A cut off ratio of attenuation >7.4 provided optimal differentiation between groups in this study. Findings supported the conclusion that dogs with CSF:L2 ≤ 7.4 are unlikely to develop progressive myelomalacia while dogs with CSF:L2 > 7.4 are indeterminate for progressive myelomalacia.
进行性脊髓软化是一种罕见的缺血性、出血性脊髓梗死类型。诊断可能困难,但及时识别很重要。我们假设,与对照犬相比,发生进行性脊髓软化的犬在磁共振(MR)图像上脑脊液信号衰减会更广泛。设计了一项回顾性分析队列研究。纳入因急性截瘫和深部痛觉丧失就诊且使用矢状面单次激发快速自旋回波(SSTSE)和标准矢状面T2加权快速自旋回波(T2W)脉冲序列进行过MR成像的犬。将犬分为进行性脊髓软化组和对照组进行比较。所有MR检查由三位对患者结局不知情的阅片者进行评估。在SSTSE和T2W序列中,脑脊液衰减长度记录为与L2椎体长度的比值(分别为CSF:L2和CSF:L2 )。在T2W序列中,脊髓髓内高信号长度记录为与L2椎体长度的比值。共纳入21只犬(进行性脊髓软化组5只,对照组16只)。发生进行性脊髓软化的犬的平均CSF:L2衰减值(CSF:L2 = 10.7)显著高于对照组(CSF:L2 = 5.4;P = 0.015)。在本研究中,衰减比值>7.4可提供组间的最佳区分。研究结果支持以下结论:CSF:L2≤7.4的犬不太可能发生进行性脊髓软化,而CSF:L2>7.4的犬发生进行性脊髓软化的情况不确定。