1. Esame TC in corso di Displasia del gomito del cane
- Author
-
Murino, Carla
- Abstract
Introduction: Canine Elbow dysplasia (CED) is one of the most common cause of artropathy in large and giant size dogs. At least 4 forms of CED are described: Ununited Anconeal Process (UAP); Osteocondritis dissecans (OCD) of the humeral condyle; fragmented medial coronoid process (FMCP); elbow incongruity (EI) for short radius, short ulna or underdeveloped ulnar troclear notch. CED is often assessed using computed tomography (CT), particularly in case of inconsistent or not definitive radiographical diagnosis. However, until now there is not any standardized protocol for the elbow CT. A number of procedures have been proposed, but they all require a great stressful positioning of the cervical spine since the head is pulled laterally or caudally, in order to avoid beam-hardening and streak artifacts. The aim of this study was to describe CT findings in dogs with CED and to propose a new, non-stressful procedure for CT of the canine elbow using a lateral recumbent position and a specifically designed positioning device. Material and Methods: The study was performed at the Interdepartmental Radiology Veterinary Centre of the University Federico II of Naples and it was developed in two steps: first, a retrospective analysis of CT exams of the elbow performed on dogs affected by suspect CED, from January 2005 to December 2011; and second, a prospective analysis of CT exams performed with the new proposed procedure, from January 2012 to December 2016. All of the CT exams were performed on dogs under general anesthesia. In all subjects, both elbows were studied at the same time. In the new procedure, the dogs were placed on the CT bed ever in the lateral recumbent position with the forelimbs cranially pulled and, in order to obtain the best elbow alignment and to remove the air gap between the neck and the forelimbs, a purpose-handmade positioning device, shaped from polyurethane foam, was used. For comparative purposes, in two dogs, the elbow CT was also performed using a previously described procedure, i.e. in sternal recumbent position with the forelimbs parallel one to each other and cranially extended and the head and neck laterally and caudally pulled. All of the CT exams were obtained using 1 mm thick contiguous axial slices at 120 kV and 200–260 mAs, together with a bone convolution filter, and evaluated on a workstation equipped with a DICOM software, using a bone window [window level (WL) 500, window width (WW) 3000]. In order to improve the evaluation, multiplanar reconstruction (MPR) and three dimensional volume rendering (3D-VR) images were obtained too. For each joint, the presence or absence of a primary lesion (FCP, OCD, UAP, EI), possibly associated to a “Kissing Lesions” (KL), was assessed. Furthermore, each joint was analytically assessed for the visualization of relevant anatomical landmarks such as the medial coronoid process, humero-radio-ulnar joint space, anconeal process, humeral condyle, subchondral bone, proximal radial and ulnar relationship. In addition, the presence of sclerosis, periarticular osteophites, subchondral cyst-like lesions, deformed, fissured or fragmented medial coronoid process, incongruence from short radius, short ulna or underdeveloped ulnar troclear notch were evaluated too. CT quality was assessed measuring the image noise represented by the standard deviation of Hounsfiel unit (HU) in a region of interes (ROI) manually traced around the bones of the elbows at three omologous level. Data obtained were compared using the Wilcoxon rank test for paired data, with a significance level of p
- Published
- 2017