Wang-Leandro A, Siedenburg J S, Hobert M K, Dziallas P, Rohn K, Stein V M, Tipold A
Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.
Centre of Systems Neuroscience, Hannover, Germany.
J Vet Intern Med. 2017 May;31(3):842-848. doi: 10.1111/jvim.14715. Epub 2017 Apr 25.
Prognostic tools to predict early postoperative motor function recovery (MFR) after thoracolumbar intervertebral disk herniation (IVDH) in paraplegic dogs represent an opportunity to timely implement novel therapies that could shorten recovery times and diminish permanent neurological dysfunctions.
Fractional anisotropy (FA) values obtained using diffusion tensor imaging have a higher prognostic value than a lesion extension ratio in T2-weighted images (T2W-LER) and clinical assessment of deep pain perception (DPP) for MFR.
Thirty-five paraplegic dogs with diagnosis of acute or subacute thoracolumbar IVDH.
Prospective, descriptive observational study. At admission, absence or presence of DPP, T2W-LER, and FA values was evaluated. MFR was assessed within 4 weeks after decompressive surgery. Values of T2W-LER and FA of dogs with and without MFR were compared using t-tests. All 3 methods were evaluated for their sensitivity and specificity as a prognostic factor.
No differences were found between groups regarding T2W-LER. FA values differed statistically when measured caudally of lesion epicenter being higher in dogs without MFR compared to dogs with MFR (P = .023). Logistic regression analysis revealed significance in FA values measured caudally of the lesion epicenter (P = .033, area under the curve = 0.72). Using a cutoff value of FA = 0.660, the technique had a sensitivity of 80% and a specificity of 55%. Evaluation of DPP had a sensitivity of 73.3% and specificity of 75% (P = .007).
Evaluation of DPP showed a similar sensitivity and a better specificity predicting early MFR than quantitative magnetic resonance imaging.
预测截瘫犬胸腰椎椎间盘突出症（IVDH）术后早期运动功能恢复（MFR）的预后工具，为及时实施新疗法提供了契机，这些新疗法可缩短恢复时间并减少永久性神经功能障碍。
使用扩散张量成像获得的分数各向异性（FA）值，在预测MFR方面比T2加权图像中的病变延伸率（T2W-LER）和深部痛觉（DPP）的临床评估具有更高的预后价值。
35只诊断为急性或亚急性胸腰椎IVDH的截瘫犬。
前瞻性、描述性观察研究。入院时，评估DPP的有无、T2W-LER和FA值。在减压手术后4周内评估MFR。使用t检验比较有和没有MFR的犬的T2W-LER和FA值。评估所有3种方法作为预后因素的敏感性和特异性。
两组在T2W-LER方面未发现差异。在病变中心尾侧测量时，FA值有统计学差异，无MFR的犬比有MFR的犬更高（P = 0.023）。逻辑回归分析显示，在病变中心尾侧测量的FA值具有显著性（P = 0.033，曲线下面积 = 0.72）。使用FA = 0.660的临界值，该技术的敏感性为80%，特异性为55%。DPP评估的敏感性为73.3%，特异性为75%（P = 0.007）。
与定量磁共振成像相比，DPP评估在预测早期MFR方面显示出相似的敏感性和更好的特异性。
