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Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs

OBJECTIVE: To determine cutoff values for the diagnosis of atlantoaxial instability (AAI) based on cross‐sectional imaging in small‐breed dogs. STUDY DESIGN: Retrospective multicenter study. SAMPLE POPULATION: Client‐owned dogs (n = 123) and 28 cadavers. METHODS: Dogs were assigned to three groups:...

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Autores principales: Planchamp, Bastien, Forterre, Franck, Vidondo, Beatriz, Hernandez‐Guerra, Angel M., Plessas, Ioannis N., Schmidt, Martin J., Waschk, Maja A., Precht, Christina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311214/
https://www.ncbi.nlm.nih.gov/pubmed/35292990
http://dx.doi.org/10.1111/vsu.13799
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author Planchamp, Bastien
Forterre, Franck
Vidondo, Beatriz
Hernandez‐Guerra, Angel M.
Plessas, Ioannis N.
Schmidt, Martin J.
Waschk, Maja A.
Precht, Christina
author_facet Planchamp, Bastien
Forterre, Franck
Vidondo, Beatriz
Hernandez‐Guerra, Angel M.
Plessas, Ioannis N.
Schmidt, Martin J.
Waschk, Maja A.
Precht, Christina
author_sort Planchamp, Bastien
collection PubMed
description OBJECTIVE: To determine cutoff values for the diagnosis of atlantoaxial instability (AAI) based on cross‐sectional imaging in small‐breed dogs. STUDY DESIGN: Retrospective multicenter study. SAMPLE POPULATION: Client‐owned dogs (n = 123) and 28 cadavers. METHODS: Dogs were assigned to three groups: a control group, a “potentially unstable” group, and an AAI‐affected group, according to imaging findings and clinical signs. The ventral compression index (VCI), cranial translation ratio (CTR), C1‐C2 overlap, C1‐C2 angle, atlantoaxial distance, basion‐dens interval, dens‐to‐axis length ratio (DALR), power ratio, and clivus canal angles were measured on CT or T2‐weighted magnetic resonance (MR) images. Receiver operating characteristic (ROC) analysis was performed to define cutoff values in flexed (≥25°) and extended (<25°) head positions. RESULTS: Cutoff values for the VCI of ≥0.16 in extended and ≥0.2 in flexed head positions were diagnostic for AAI (sensitivity of 100% and 100%, specificity of 94.54% and 96.67%, respectively). Cutoff values for the other measurements were defined with a lower sensitivity (75%‐96%) and specificity (70%‐97%). A combination of the measurements did not increase the sensitivity and specificity compared with the VCI as single measurement. CONCLUSION: Cutoff values for several imaging measurements were established with good sensitivity and specificity. The VCI, defined as the ratio between the ventral and dorsal atlantodental interval, had the highest sensitivity and specificity in both head positions. CLINICAL SIGNIFICANCE: The use of defined cutoff values allows an objective diagnosis of AAI in small‐breed dogs. The decision for surgical intervention, however, should remain based on a combination of clinical and imaging findings.
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spelling pubmed-93112142022-07-29 Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs Planchamp, Bastien Forterre, Franck Vidondo, Beatriz Hernandez‐Guerra, Angel M. Plessas, Ioannis N. Schmidt, Martin J. Waschk, Maja A. Precht, Christina Vet Surg Original Article ‐ Research OBJECTIVE: To determine cutoff values for the diagnosis of atlantoaxial instability (AAI) based on cross‐sectional imaging in small‐breed dogs. STUDY DESIGN: Retrospective multicenter study. SAMPLE POPULATION: Client‐owned dogs (n = 123) and 28 cadavers. METHODS: Dogs were assigned to three groups: a control group, a “potentially unstable” group, and an AAI‐affected group, according to imaging findings and clinical signs. The ventral compression index (VCI), cranial translation ratio (CTR), C1‐C2 overlap, C1‐C2 angle, atlantoaxial distance, basion‐dens interval, dens‐to‐axis length ratio (DALR), power ratio, and clivus canal angles were measured on CT or T2‐weighted magnetic resonance (MR) images. Receiver operating characteristic (ROC) analysis was performed to define cutoff values in flexed (≥25°) and extended (<25°) head positions. RESULTS: Cutoff values for the VCI of ≥0.16 in extended and ≥0.2 in flexed head positions were diagnostic for AAI (sensitivity of 100% and 100%, specificity of 94.54% and 96.67%, respectively). Cutoff values for the other measurements were defined with a lower sensitivity (75%‐96%) and specificity (70%‐97%). A combination of the measurements did not increase the sensitivity and specificity compared with the VCI as single measurement. CONCLUSION: Cutoff values for several imaging measurements were established with good sensitivity and specificity. The VCI, defined as the ratio between the ventral and dorsal atlantodental interval, had the highest sensitivity and specificity in both head positions. CLINICAL SIGNIFICANCE: The use of defined cutoff values allows an objective diagnosis of AAI in small‐breed dogs. The decision for surgical intervention, however, should remain based on a combination of clinical and imaging findings. John Wiley & Sons, Inc. 2022-03-16 2022-05 /pmc/articles/PMC9311214/ /pubmed/35292990 http://dx.doi.org/10.1111/vsu.13799 Text en © 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article ‐ Research
Planchamp, Bastien
Forterre, Franck
Vidondo, Beatriz
Hernandez‐Guerra, Angel M.
Plessas, Ioannis N.
Schmidt, Martin J.
Waschk, Maja A.
Precht, Christina
Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs
title Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs
title_full Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs
title_fullStr Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs
title_full_unstemmed Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs
title_short Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs
title_sort determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small‐breed dogs
topic Original Article ‐ Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311214/
https://www.ncbi.nlm.nih.gov/pubmed/35292990
http://dx.doi.org/10.1111/vsu.13799
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