Computed Tomography Enhances Diagnostic Accuracy in Challenging Medial Coronoid Disease Cases: An Imaging Study in Dog Breeding Appeal Cases.,Veterinary and Comparative Orthopaedics and Traumatology

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Computed Tomography Enhances Diagnostic Accuracy in Challenging Medial Coronoid Disease Cases: An Imaging Study in Dog Breeding Appeal Cases.
Veterinary and Comparative Orthopaedics and Traumatology ( IF 1.3 ) Pub Date : 2020-07-26 , DOI: 10.1055/s-0040-1714299
Jan Wennemuth ₁ , Bernd Tellhelm ₁ , Nele Eley ₁ , Kerstin von Pückler ₁

Affiliation

Abstract

Objectives The aim of this study was to determine the radiographic sensitivity in detecting medial coronoid disease (MCD), using computed tomography (CT) as reference in dogs presented for an official second opinion, and to compare the medial coronoid process (MCP) in fragmented and fissured MCP as well as those unaffected by MCD.

Materials and Methods The data of dogs, presented for official second opinion radiographs and CT, were reviewed by three board-certified observers and in accordance with the International Elbow Working Group guidelines regarding MCD. Radiographic delineation, radiopacity and Hounsfield Units (HU) of the MCP were recorded additionally and the correlation between radiography and CT was investigated.

Results Sensitivity and specificity of radiography compared with CT yielded values of 83.6% for the former and 83.5% for the latter. False-negative grading in radiography correlated significantly (p = 0.0001) with a present fissure line in CT. The mean delineation (p = 0.03) and mean HU of fragmented MCP (p = 0.0045) were significantly reduced compared with fissured MCP and no significant differences in measured HU for fissured MCP were detected in comparison to elbows unaffected by MCD.

Conclusion The results of the present study show substantial agreement between radiography and CT in second opinion cases. However, sensitivity is reduced compared with not preselected cases. A present fissure line in CT was significantly associated with a false-negative grading in radiography. Therefore, CT imaging of the elbows is strongly recommended in cases of appeal.

Authors' Contributions

All authors contributed to the study concept, design, data acquisition, analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.

中文翻译：

计算机体层摄影术提高了具有挑战性的内侧冠状动脉疾病病例的诊断准确性：一项在狗育种上诉案件中的影像学研究。

摘要

目的这项研究的目的是确定计算机冠状动脉疾病（MCD）的放射线敏感性，使用计算机断层扫描（CT）作为提出官方意见的犬只的参考，并比较碎片化的冠状动脉内侧过程（MCP）裂变的MCP以及不受MCD影响的裂变。

材料和方法三副经过董事会认证的观察员并根据国际肘部工作组有关MCD的指南，对提供给官方第二意见X光片和CT的狗的数据进行了审查。此外，还记录了MCP的放射线描边，射线不透性和Hounsfield单位（HU），并研究了放射线照相与CT的相关性。

结果与CT相比，射线照相的敏感性和特异性产生的数值分别为83.6％和83.5％。X线摄影中的假阴性分级与CT中的当前裂隙线显着相关（p = 0.0001）。与裂隙MCP相比，碎裂MCP的平均轮廓（p = 0.03）和平均HU（p = 0.0045）显着降低，与未受MCD影响的肘部相比，裂隙MCP的测量HU没有明显差异。

结论本研究结果表明，在第二意见病例中，放射线照相和CT之间存在实质性一致性。但是，与未预选的情况相比，灵敏度降低了。CT中存在的裂痕线与放射线照相的假阴性分级显着相关。因此，强烈建议在有上诉的情况下对肘部进行CT成像。