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颅脑创伤后犬早期 CT 检查对短期预后预测的价值有限。

Early CT in dogs following traumatic brain injury has limited value in predicting short-term prognosis.

机构信息

Department of Veterinary Clinical Science and Services, Royal Veterinary College, University of London, Hatfield, UK.

出版信息

Vet Radiol Ultrasound. 2021 Mar;62(2):181-189. doi: 10.1111/vru.12933. Epub 2020 Nov 26.

Abstract

Traumatic brain injury is associated with a high risk of mortality in veterinary patients, however publications describing valid prognostic indicators are currently lacking. The objective of this retrospective observational study was to determine whether early CT findings are associated with short-term prognosis following traumatic brain injury (TBI) in dogs. An electronic database was searched for dogs with TBI that underwent CT within 72 h of injury; 40 dogs met the inclusion criteria. CT findings were graded based on a Modified Advanced Imaging System (MAIS) from grade I (normal brain parenchyma) to VI (bilateral lesions affecting the brainstem with or without any foregoing lesions of lesser grades). Other imaging features recorded included presence of midline shift, intracranial hemorrhage, brain herniation, skull fractures, and percentage of total brain parenchyma affected. Outcome measures included survival to discharge and occurrence of immediate onset posttraumatic seizures. Thirty dogs (75%) survived to discharge. Seven dogs (17.5%) suffered posttraumatic seizures. There was no association between survival to discharge and posttraumatic seizures. No imaging features evaluated were associated with the study outcome measures. Therefore, the current study failed to identify any early CT imaging features with prognostic significance in canine TBI patients. Limitations associated with CT may preclude its use for prognostication; however, modifications to the current MAIS and evaluation in a larger study population may yield more useful results. Despite this, CT is a valuable tool in the detection of structural abnormalities following TBI in dogs that warrants further investigation.

摘要

创伤性脑损伤与兽医患者的高死亡率相关,但目前缺乏描述有效预后指标的出版物。本回顾性观察研究的目的是确定犬创伤性脑损伤(TBI)后早期 CT 发现是否与短期预后相关。电子数据库中搜索了在受伤后 72 小时内接受 CT 的创伤性脑损伤犬;符合纳入标准的有 40 只狗。根据改良高级成像系统(MAIS)将 CT 发现分级为 I 级(正常脑实质)至 VI 级(双侧影响脑干的病变,无论是否有较轻程度的病变)。记录的其他影像学特征包括中线移位、颅内出血、脑疝、颅骨骨折和受影响的总脑实质百分比。预后评估指标包括存活至出院和是否发生即刻外伤性癫痫发作。30 只狗(75%)存活至出院。7 只狗(17.5%)发生外伤性癫痫发作。存活至出院与外伤性癫痫发作之间无关联。评估的影像学特征与研究预后评估指标均无关联。因此,目前的研究未能确定犬创伤性脑损伤患者具有预后意义的任何早期 CT 影像学特征。CT 可能存在与预后相关的局限性;然而,对当前 MAIS 的修改和在更大的研究人群中的评估可能会产生更有用的结果。尽管如此,CT 是一种在狗 TBI 后检测结构异常的有价值工具,值得进一步研究。

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