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头部创伤犬的计算机断层扫描结果及基于计算机断层扫描的新型预后评分系统的开发

Computed tomographic findings in dogs with head trauma and development of a novel prognostic computed tomography-based scoring system.

作者信息

Chai Orit, Peery Dana, Bdolah-Abram Tali, Moscovich Efrat, Kelmer Efrat, Klainbart Sigal, Milgram Joshua, Shamir Merav H

出版信息

Am J Vet Res. 2017 Sep;78(9):1085-1090. doi: 10.2460/ajvr.78.9.1085.

Abstract

OBJECTIVE To characterize CT findings and outcomes in dogs with head trauma and design a prognostic scale. ANIMALS 27 dogs admitted to the Koret School Veterinary Teaching Hospital within 72 hours after traumatic head injury that underwent CT imaging of the head. PROCEDURES Data were extracted from medical records regarding dog signalment, history, physical and neurologic examination findings, and modified Glasgow coma scale scores. All CT images were retrospectively evaluated by a radiologist unaware of dog status. Short-term (10 days after trauma) and long-term (≥ 6 months after trauma) outcomes were determined, and CT findings and other variables were analyzed for associations with outcome. A prognostic CT-based scale was developed on the basis of the results. RESULTS Cranial vault fractures, parenchymal abnormalities, or both were identified via CT in 24 of 27 (89%) dogs. Three (11%) dogs had only facial bone fractures. Intracranial hemorrhage was identified in 16 (59%) dogs, cranial vault fractures in 15 (56%), midline shift in 14 (52%), lateral ventricle asymmetry in 12 (44%), and hydrocephalus in 7 (26%). Hemorrhage and ventricular asymmetry were significantly and negatively associated with short- and long-term survival, respectively. The developed 7-point prognostic scale included points for hemorrhage, midline shift or lateral ventricle asymmetry, cranial vault fracture, and depressed fracture (1 point each) and infratentorial lesion (3 points). CONCLUSIONS AND CLINICAL RELEVANCE The findings reported here may assist in determining prognoses for other dogs with head trauma. The developed scale may be useful for outcome assessment of dogs with head trauma; however, it must be validated before clinical application.

摘要

目的 描述头部创伤犬的CT表现及预后情况,并设计一个预后评分系统。动物 27只犬在头部创伤后72小时内被收治于科雷特兽医学院兽医教学医院,并接受了头部CT成像检查。方法 从病历中提取有关犬的品种、病史、体格检查和神经学检查结果以及改良格拉斯哥昏迷量表评分的数据。所有CT图像均由一名不了解犬病情的放射科医生进行回顾性评估。确定短期(创伤后10天)和长期(创伤后≥6个月)预后,并分析CT表现及其他变量与预后的相关性。根据结果制定了一个基于CT的预后评分系统。结果 27只犬中有24只(89%)通过CT发现有颅骨骨折、实质异常或两者皆有。3只(11%)犬仅有面部骨折。16只(59%)犬发现颅内出血,15只(56%)有颅骨骨折,14只(52%)有中线移位,12只(44%)有侧脑室不对称,7只(26%)有脑积水。出血和脑室不对称分别与短期和长期生存显著负相关。制定的7分预后评分系统包括出血、中线移位或侧脑室不对称、颅骨骨折、凹陷性骨折(各1分)和幕下病变(3分)。结论及临床意义 此处报告的结果可能有助于确定其他头部创伤犬的预后。制定的评分系统可能有助于评估头部创伤犬的预后;然而,在临床应用前必须进行验证。

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