7例犬椎间盘疝出疾病的磁共振影像诊断

为明确不同类型的椎间盘疝出疾病的磁共振影像(MRI)特点,本文对7例犬椎间盘疝出病例的诊治过程进行总结,通过一般检查、神经学检查和MRI扫描,诊断为椎间盘疝出。其中有3例为椎间盘突出,2例为椎间盘脱出,2例为椎间盘膨出。主要的MRI表现为椎间盘退变,T2加权像上的椎间盘信号降低,脊髓、硬膜囊不同程度的受压和变形。这些结果表明MRI扫描可对椎间盘组织是否发生退变以及椎间突出的程度进行准确判断,在犬椎间盘疝出的诊断与治疗中有极高的应用价值。     

Evaluation of T2‐weighted versus short‐tau inversion recovery sagittal sequences in the identification and localization of canine intervertebral disc extrusion with low‐field magnetic resonance imaging

Sagittal T2‐weighted sequences (T2‐SAG) are the foundation of spinal protocols when screening for the presence of intervertebral disc extrusion. We often utilize sagittal short‐tau inversion recovery sequences (STIR‐SAG) as an adjunctive screening series, and experience suggests that this combined approach provides superior detection rates. We hypothesized that STIR‐SAG would provide higher sensitivity than T2‐SAG in the identification and localization of intervertebral disc extrusion. We further hypothesized that the parallel evaluation of paired T2‐SAG and STIR‐SAG series would provide a higher sensitivity than could be achieved with either independent sagittal series when viewed in isolation. This retrospective diagnostic accuracy study blindly reviewed T2‐SAG and STIR‐SAG sequences from dogs (n = 110) with surgically confirmed intervertebral disc extrusion. A consensus between two radiologists found no significant difference in sensitivity between T2‐SAG and STIR‐SAG during the identification of intervertebral disc extrusion (T2‐SAG: 92.7%, STIR‐SAG: 94.5%, P = 0.752). Nevertheless, STIR‐SAG accurately identified intervertebral disc extrusion in 66.7% of cases where the evaluation of T2‐SAG in isolation had provided a false negative diagnosis. Additionally, one radiologist found that the parallel evaluation of paired T2‐SAG and STIR‐SAG series provided a significantly higher sensitivity than T2‐SAG in isolation, during the identification of intervertebral disc extrusion (T2‐SAG: 78.2%, paired T2‐SAG, and STIR‐SAG: 90.9%, P = 0.017). A similar nonsignificant trend was observed when the consensus of both radiologists was taken into consideration (T2‐SAG: 92.7%, paired T2‐SAG, and STIR‐SAG = 97.3%, P = 0.392). We therefore conclude that STIR‐SAG is capable of identifying intervertebral disc extrusion that is inconspicuous in T2‐SAG, and that STIR‐SAG should be considered a useful adjunctive sequence during preliminary sagittal screening for intervertebral disc extrusion in low‐field magnetic resonance.