Butler Danielle, Nemanic Sarah, Warnock Jennifer J
Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, 97333.
Vet Radiol Ultrasound. 2018 Jan;59(1):43-53. doi: 10.1111/vru.12558. Epub 2017 Sep 3.
Detection and accurate classification of traumatic tarsal fractures are important for identifying cases requiring surgical intervention. The aim of this prospective, experimental, methods comparison study was to directly compare the accuracy, sensitivity, and specificity of tarsal computed tomography (CT), ten-view and two-view digital radiographs for detecting traumatic fractures of the canine tarsus. The working hypothesis was that tarsal fractures would be detected with higher accuracy, sensitivity, and specificity using CT imaging compared to radiography, and a ten-view would be superior to a two-view radiographic study. Ten cadaver hind limbs of medium to large dogs received a CT scan and ten-view radiographic study before and after induction of fractures with a hydraulic press. All bones included in the radiographic images were assessed for fractures by two observers and gross dissection was used as the gold standard. The two-view radiographic study (dorsoplantar, lateromedial) was created from the ten-view study and reviewed 2 years later. All limbs sustained fractures, the most common locations were the talus and calcaneus (n = 7). The sensitivity of CT was greater than ten-view radiographic study (77% vs. 57%), while the specificity was similar (97% vs. 98%). The sensitivity and specificity of the ten-view and two-view radiograph studies were similar (57% vs. 55%; both 98%). Computed tomography images were reassessed postdissection to determine if failure to identify fractures resulted from observer error. Overall, CT was better than radiography for detecting fractures of the canine tarsus, however there was little improvement with ten-view compared to two-view radiographic studies.
外伤性跗骨骨折的检测和准确分类对于识别需要手术干预的病例很重要。这项前瞻性、实验性、方法比较研究的目的是直接比较跗骨计算机断层扫描（CT）、十视图和双视图数字X线片检测犬跗骨外伤性骨折的准确性、敏感性和特异性。工作假设是，与X线摄影相比，使用CT成像检测跗骨骨折的准确性、敏感性和特异性更高，并且十视图优于双视图X线摄影研究。十只中大型犬的尸体后肢在用水压机诱导骨折前后接受了CT扫描和十视图X线摄影研究。两名观察者对X线片图像中的所有骨骼进行骨折评估，并将大体解剖作为金标准。双视图X线摄影研究（背跖位、内外侧位）由十视图研究生成，并在两年后进行复查。所有肢体均发生骨折，最常见的部位是距骨和跟骨（n = 7）。CT的敏感性高于十视图X线摄影研究（77%对57%），而特异性相似（97%对98%）。十视图和双视图X线摄影研究的敏感性和特异性相似（57%对55%；均为98%）。解剖后重新评估CT图像，以确定未能识别骨折是否是由于观察者误差所致。总体而言，CT在检测犬跗骨骨折方面优于X线摄影，然而与双视图X线摄影研究相比，十视图的改善不大。
