Veraa Stefanie, Scheffer Carmen J W, Smeets Danielle H M, de Bruin Renske B, Hoogendoorn Arie C, Vernooij Johannes C M, Nielen Mirjam, Back Willem
Diagnostic Imaging, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
Equine Veterinary Clinic "De Watermolen", Haaksbergen, The Netherlands.
Vet Radiol Ultrasound. 2020 Oct 13;62(1):11-9. doi: 10.1111/vru.12913.
Intervertebral disc disease, as well as the associated alteration of the radiographic intervertebral disc space width, has been reported in horses. Disc height index (DHI) has proven to be an accurate and objective parameter in other species but data related to this parameter are lacking in horses. Therefore, the aims of this retrospective longitudinal diagnostic accuracy study were (a) to evaluate the reliability of measurements within and between observers of the equine Disc Width Index (EDWI) as a parameter for radiographic equine cervical intervertebral disc space width, and (b) to evaluate the sequential development of the EDWI over time. For this, EDWI from all intervertebral disc spaces between second cervical (C) to first thoracic (Th) vertebrae were obtained in a group of 39 Dutch Warmblood horses at 1, 5, and 18 months of age, by one European College of Veterinary Diagnostic Imaging (ECVDI) board-certified veterinary radiologist (S.V.) and two veterinary students. Bland-Altmann plots and intraclass Correlation Coefficient revealed a good intra- and interobserver agreement. A linear mixed-effect model did reveal that mean EDWI increases significantly toward the caudal cervical spine, but did not differ significantly for a certain location over time or between sexes. Spearman's rank test did show a significant correlation between the vertebral alignment angle induced by different head-neck positions and a normalized EDWI (ρ = 0.33, P < .0001). Student's t-test revealed that the presence of C6-C7 transposition of the transverse processes did not influence EDWI significantly. It was concluded that EDWI represents a reliable parameter for equine cervical radiographic intervertebral disc space width. Practical implementation of EDWI warrants monitoring in a group of adult horses while maintaining a standardized head-neck position.
马的椎间盘疾病以及与之相关的影像学椎间盘间隙宽度改变已有报道。椎间盘高度指数(DHI)在其他物种中已被证明是一个准确且客观的参数,但马的相关数据尚缺。因此,这项回顾性纵向诊断准确性研究的目的是:(a)评估马椎间盘宽度指数(EDWI)作为马颈椎椎间盘间隙宽度影像学参数时,观察者内部及观察者之间测量的可靠性;(b)评估EDWI随时间的连续变化。为此,在一组39匹荷兰温血马1月龄、5月龄和18月龄时,由一位欧洲兽医诊断影像学院(ECVDI)认证的兽医放射科医生(S.V.)和两名兽医专业学生,获取第二颈椎(C)至第一胸椎(Th)之间所有椎间盘间隙的EDWI。Bland-Altmann图和组内相关系数显示观察者内部及观察者之间具有良好的一致性。线性混合效应模型显示,平均EDWI向颈椎尾端显著增加,但在特定位置随时间或性别之间无显著差异。Spearman秩检验显示,不同头颈位置引起的椎体排列角度与标准化EDWI之间存在显著相关性(ρ = 0.33,P <.0001)。Student t检验显示,C6-C7横突移位的存在对EDWI无显著影响。结论是,EDWI是马颈椎影像学椎间盘间隙宽度的可靠参数。EDWI的实际应用需要在一组成年马中进行监测,同时保持标准化的头颈位置。