Mari Lorenzo, Behr Sebastien, Shea Anita, Dominguez Elisabet, Johnson Philippa J, Ekiri Abel, De Risio Luisa
Department of Neurology/Neurosurgery, Centre for Small Animal Studies, Animal Health Trust, Newmarket, Suffolk, UK.
Neurology/Neurosurgery Service, Willows Veterinary Centre and Referral Services, Solihull, UK.
Vet Rec. 2017 Sep 16;181(11):293. doi: 10.1136/vr.104090. Epub 2017 Aug 7.
Dogs with fibrocartilaginous embolic myelopathy (FCEM) or acute non-compressive nucleus pulposus extrusion (ANNPE) are reported to have a fair prognosis; however, persistent motor/autonomic deficits are possible. Specific MRI patterns have been suggested to differentiate these diseases although never been validated with histopathology in large studies. The aim of this retrospective study was to evaluate if these MRI patterns are associated with different clinical outcomes in dogs with peracute non-progressive T3-L3 myelopathy. Two hundred and one dogs were included. Outcome data were obtained via medical records and telephone questionnaires. MRIs were blindly reviewed by three board-certified observers, obtaining substantial to almost perfect interobserver agreement on diagnoses (κ=0.635-0.828). Presumptive ANNPE and FCEM were diagnosed in 157 and 44 dogs , respectively. Ambulatory function was regained in 99 per cent of cases, with persistent motor deficits in 83.6 per cent and 92.5 per cent of dogs with presumptive ANNPE and FCEM, respectively. The presumptive diagnosis was not associated with motor function recovery, recovery times or urinary continence. Faecal incontinence was five times more likely in dogs with presumptive ANNPE (23 per cent) compared with presumptive FCEM (7.5 per cent).Distinguishing between MRI patterns of presumptive ANNPE or FCEM in dogs with peracute non-progressive T3-L3 myelopathy may help predict the risk of developing faecal incontinence.
据报道,患有纤维软骨栓塞性脊髓病(FCEM)或急性非压迫性髓核突出症(ANNPE)的犬预后尚可;然而,仍有可能出现持续性运动/自主神经功能障碍。尽管在大型研究中从未通过组织病理学验证,但已有特定的MRI模式被提出用于区分这些疾病。这项回顾性研究的目的是评估这些MRI模式是否与患有超急性非进行性T3-L3脊髓病的犬的不同临床结果相关。共纳入201只犬。通过病历和电话问卷获取结果数据。由三名获得委员会认证的观察者对MRI进行盲法评估,观察者之间在诊断上达成了实质性至几乎完美的一致性(κ=0.635-0.828)。分别在157只和44只犬中诊断出疑似ANNPE和FCEM。99%的病例恢复了行走功能,疑似ANNPE和FCEM的犬分别有83.6%和92.5%存在持续性运动功能障碍。推定诊断与运动功能恢复、恢复时间或尿失禁无关。疑似ANNPE的犬(23%)出现大便失禁的可能性是疑似FCEM的犬(7.5%)的五倍。区分患有超急性非进行性T3-L3脊髓病的犬的疑似ANNPE或FCEM的MRI模式可能有助于预测发生大便失禁的风险。