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磁共振磁化传递和弥散张量成像在椎间盘突出症犬中的应用。

Magnetization transfer and diffusion tensor imaging in dogs with intervertebral disk herniation.

机构信息

Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.

Summit Veterinary Referral Center, Tacoma, Washington, USA.

出版信息

J Vet Intern Med. 2020 Nov;34(6):2536-2544. doi: 10.1111/jvim.15899. Epub 2020 Oct 2.

Abstract

BACKGROUND

Quantitative magnetic resonance imaging (QMRI) techniques of magnetization transfer ratio (MTR) and diffusion tensor imaging (DTI) provide microstructural information about the spinal cord.

OBJECTIVE

Compare neurologic grades using the modified Frankel scale with MTR and DTI measurements in dogs with thoracolumbar intervertebral disk herniation (IVDH).

ANIMALS

Fifty-one dogs with thoracolumbar IVDH.

METHODS

Prospective cohort study. Quantitative MRI measurements of the spinal cord were obtained at the region of compression. A linear regression generalized estimating equations model was used to compare QMRI measurements between different neurological grades after adjusting for age, weight, duration of clinical signs, and lesion location.

RESULTS

Grade 5 (.79  ×  10 mm /s [median], .43-.91 [range]) and axial (1.47 × 10 mm /s, .58-1.8) diffusivity were lower compared to grades 2 (1.003, .68-1.36; P = .02 and 1.81 × 10 mm /s, 1.36-2.12; P < .001, respectively) and 3 (1.07 × 10 mm /s, .77-1.5; P = .04 and 1.92 × 10 mm /s, 1.83-2.37;P < .001, respectively). Compared to dogs with acute myelopathy, chronic myelopathy was associated with higher mean (1.02 × 10 mm /s, .77-1.36 vs. .83 × 10 mm /s, .64-1.5; P = .03) and radial diffusivity (.75 × 10 mm /s, .38-1.04 vs. .44 × 10 mm /s, .22-1.01; P = .008) and lower MTR (46.76, 31.8-56.43 vs. 54.4, 45.2-62.27; P = .004) and fractional anisotropy (.58, .4-0.75 vs. .7, .46-.85; P = .02). Fractional anisotropy was lower in dogs with a T2-weighted intramedullary hyperintensity compared to those without (.7, .45-.85 vs. .54, .4-.8; P = .01).

CONCLUSION AND CLINICAL RELEVANCE

Mean diffusivity and AD could serve as surrogates of severity of spinal cord injury and are complementary to the clinical exam in dogs with thoracolumbar IVDH.

摘要

背景

磁化传递比(MTR)和弥散张量成像(DTI)的定量磁共振成像(QMRI)技术可提供脊髓的微观结构信息。

目的

比较犬胸腰椎椎间盘突出症(IVDH)中使用改良 Frankel 量表和 MTR 和 DTI 测量值的神经学分级。

动物

51 只患有胸腰椎 IVDH 的狗。

方法

前瞻性队列研究。在受压区域获得脊髓的定量 MRI 测量值。使用线性回归广义估计方程模型,在调整年龄、体重、临床症状持续时间和病变位置后,比较不同神经学分级之间的 QMRI 测量值。

结果

与 2 级(1.003,0.68-1.36;P=0.02 和 1.81×10mm/s,1.36-2.12;P<.001,分别)和 3 级(1.07×10mm/s,0.77-1.5;P=0.04 和 1.92×10mm/s,1.83-2.37;P<.001,分别)相比,5 级(0.79×10mm/s,0.43-0.91;范围)和轴向(1.47×10mm/s,0.58-1.8)扩散率较低。与急性脊髓病相比,慢性脊髓病与更高的平均(1.02×10mm/s,0.77-1.36 与 0.83×10mm/s,0.64-1.5;P=0.03)和径向扩散率(0.75×10mm/s,0.38-1.04 与 0.44×10mm/s,0.22-1.01;P=0.008)和更低的 MTR(46.76,31.8-56.43 与 54.4,45.2-62.27;P=0.004)和分数各向异性(0.58,0.4-0.75 与 0.7,0.46-0.85;P=0.02)有关。与没有 T2 加权脊髓内高信号的狗相比,有 T2 加权脊髓内高信号的狗的分数各向异性较低(0.7,0.45-0.85 与 0.54,0.4-0.8;P=0.01)。

结论和临床相关性

平均弥散率和 AD 可作为脊髓损伤严重程度的替代指标,并在犬胸腰椎 IVDH 中与临床检查互补。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ee/7694818/ee028665ce17/JVIM-34-2536-g001.jpg

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