Carballo Oscar, Frederick Steven W, Keys Deborah A, Moore Sarah A, Giles James T
BluePearl Pet Hospital, San Antonio, TX, United States.
BluePearl Science, Tampa, FL, United States.
Front Vet Sci. 2024 Aug 5;11:1436299. doi: 10.3389/fvets.2024.1436299. eCollection 2024.
This study aimed to describe the diagnostic discrimination and reliability of a novel technique for quantifying lumbosacral articular process displacement (LSAPD) on dorsal plane computed tomography (DPCT) imaging in dogs with and without degenerative lumbosacral stenosis (DLSS).
DPCT surveys of the lumbosacral vertebral column were performed with dogs positioned in extension and flexion. LSAPD is defined as the distance between the cranial aspects of the L7 and S1 articular processes. The LSAPD ratio is identified by dividing the LSAPD by the length of the L7 articular process. Intraclass correlation coefficients (ICCs) for intra- and inter-observer reliability were calculated, and logistic regressions were used to test for the association of LSAPD and LSAPD ratio with odds of DLSS. Significance was set at 0.05. Receiver operator characteristic (ROC) curves were calculated to determine diagnostic discrimination and optimal cutoff for LSAPD and LSAPD ratio in the diagnosis of DLSS.
Intra- and inter-observer reliabilities were excellent for most measurements. In the current cohort, excluding covariates, the area under the curve (AUC) (95%CI) for LSAPD and LSAPD ratio measured in a flexed position were both 0.89 (0.82-0.96), suggesting potentially excellent discrimination for using this measurement as a marker for diagnosing DLSS, pending further studies. The cutoffs for flexed LSAPD and LSAPD ratio that maximizes Youden's index were ≥ 1.2 mm and ≥ 9%, respectively. When age and weight were subsequently included as covariates in a multivariable analysis, a significant relationship between LSAPD or LSAPD ratio and odds of diagnosis of DLSS was not demonstrated, suggesting the need for a larger sample size.
The results of this study suggest that measurements of LSAPD and LSAPD ratio on DPCT are feasible and reliable, although their diagnostic discrimination in DLSS should be evaluated further in future prospective studies.
本研究旨在描述一种用于量化犬腰椎关节突位移（LSAPD）的新技术在退行性腰椎管狭窄（DLSS）患犬和非患犬背侧平面计算机断层扫描（DPCT）成像上的诊断鉴别能力和可靠性。
对处于伸展和屈曲位的犬进行腰椎椎体的DPCT扫描。LSAPD定义为L7和S1关节突颅侧缘之间的距离。LSAPD比值通过将LSAPD除以L7关节突的长度得出。计算观察者内和观察者间可靠性的组内相关系数（ICC），并使用逻辑回归检验LSAPD和LSAPD比值与DLSS几率之间的关联。显著性设定为0.05。计算受试者工作特征（ROC）曲线，以确定LSAPD和LSAPD比值在DLSS诊断中的诊断鉴别能力和最佳截断值。
大多数测量的观察者内和观察者间可靠性良好。在当前队列中，排除协变量后，屈曲位测量的LSAPD和LSAPD比值的曲线下面积（AUC）（95%CI）均为0.89（0.82 - 0.96），这表明在进一步研究之前，将该测量用作诊断DLSS的标志物可能具有良好的鉴别能力。使约登指数最大化的屈曲位LSAPD和LSAPD比值的截断值分别≥1.2毫米和≥9%。当年龄和体重随后作为协变量纳入多变量分析时，未证明LSAPD或LSAPD比值与DLSS诊断几率之间存在显著关系，这表明需要更大的样本量。
本研究结果表明，DPCT上的LSAPD和LSAPD比值测量是可行且可靠的，尽管其在DLSS中的诊断鉴别能力应在未来的前瞻性研究中进一步评估。
