Snaps F R, Balligand M H, Saunders J H, Park R D, Dondelinger R F
Department of Medical Imaging, Faculty of Veterinary Medicine, University of Liège, Sart-Tilman, Belgium.
Am J Vet Res. 1997 Dec;58(12):1367-70.
To describe the magnetic resonance imaging (MRI) appearance of medial coronoid process and humeral condyle lesions in dysplastic cubital joints and to compare survey radiography and MRI for evaluation of fragmented medial coronoid process (FMCP) and lesions of the medial aspect of the humeral condyle (MAHC).
18 dogs with elbow dysplasia.
Radiography of 22 cubital joints was performed. The 22 joints then underwent MRI. The scans were evaluated with regard to the shape and signal of the coronoid process; articular cartilage change, subchondral bone disruption of the MAHC. Surgical findings were used as the standard to calculate accuracy, sensitivity, specificity, and positive- and negative-predictive values for specific diagnosis of FMCP (free fragment) and lesions of the MAHC.
At surgery, 31.8% of the joints had FMCP (free), 36.4% had nondisplaced unmineralized coronoid process, and 27.2% had nondisplaced mineralized coronoid process. Eleven joints had lesions of the MAHC, and wear lesions were observed in 41% of the joints. On radiography, FMCP (free) was visualized in 9% of the joints and lesions of the MAHC were observed in 23%. MRI had the highest accuracy (95.5%), sensitivity (100%), and negative-predictive value (100%) for detection of FMCP (free), and had accuracy (91%), sensitivity (87.5%), specificity (92.5%), and positive (87.5%)- and negative (92.5%)-predictive values for detection of nondisplaced unmineralized coronoid process.
Compared with radiography, MRI was useful for detection of nondisplaced unmineralized coronoid process; images consistently correlated with surgical findings. The technique is accurate and especially useful when radiographic findings are inconclusive.
描述发育异常的肘关节内侧冠状突和肱骨髁病变的磁共振成像(MRI)表现,并比较X线平片和MRI对碎裂内侧冠状突(FMCP)和肱骨髁内侧病变(MAHC)的评估。
18只患有肘关节发育异常的犬。
对22个肘关节进行X线摄影。然后对这22个关节进行MRI检查。评估扫描结果,包括冠状突的形状和信号;关节软骨变化、MAHC的软骨下骨破坏情况。以手术结果作为标准,计算FMCP(游离碎片)和MAHC病变特异性诊断的准确性、敏感性、特异性以及阳性和阴性预测值。
手术时,31.8%的关节有游离的FMCP,36.4%有未移位的未矿化冠状突,27.2%有未移位的矿化冠状突。11个关节有MAHC病变,41%的关节观察到磨损性病变。X线平片上,9%的关节可见游离的FMCP,23%的关节观察到MAHC病变。MRI检测游离FMCP的准确性(95.5%)、敏感性(100%)和阴性预测值(100%)最高,检测未移位未矿化冠状突的准确性(91%)、敏感性(87.5%)、特异性(92.5%)以及阳性(87.5%)和阴性(92.5%)预测值。
与X线平片相比,MRI有助于检测未移位的未矿化冠状突;图像与手术结果始终相关。该技术准确,在X线平片结果不明确时尤其有用。