A comparative study between high-definition volumetric imaging computed tomography and multi-slice computed tomography in the detection of acute thoraco-lumbar disc extrusions in dogs

Ross C Elliott,Chad F Berman,Remo G Lobetti

doi:10.4102/jsava.v92i0.2010

Ross C Elliott, Chad F Berman + Show 1 more

Open Access

https://doi.org/10.4102/jsava.v92i0.2010

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Abstract

Computed tomography (CT) is commonly used to image intervertebral disc extrusion (IVDE) in dogs. The current gold standard for CT imaging is the use of multi-slice CT (MS CT) units. Smaller high-definition volumetric imaging (HDVI) mobile CT has been marketed for veterinary practice. This unit is described as an advanced flat panel. The goal of this manuscript was to evaluate the ability of the HDVI CT in detecting IVDE without the need for CT myelography, compared with the detection of acute disc extrusions with a MS CT without the need for MS CT myelogram. Retrospective blinded analyses of 219 dogs presented for thoraco-lumbar IVDE that had a HDVI CT (n = 123) or MS CT (n = 96) were performed at a single referral hospital. A total of 123 cases had HDVI CT scans with surgically confirmed IVDE. The IVDE was identified in 88/123 (72%) dogs on pre-contrast HDVI CT. The remaining 35/128 (28%) cases required a HDVI CT myelogram to identify the IVDE. Ninety-six cases had MS CT scans with surgically confirmed IVDE. The IVDE was identified in 78/96 (81%) dogs on the pre-contrast MS CT. The remaining 18/96 (19%) cases had a MS CT myelogram to identify the IVDE. Multi-slice CT detected IVDE significantly more than HDVI CT (p = 0.032). This study showed that the ability of HDVI CT for detecting IVDE is lower than that of MS CT. The HDVI CT system may be useful in smaller referral practices, with a lower case load where space is limited.

Highlights

Thoraco-lumbar intervertebral disc disease is a common condition in the small animal patient (Griffin, Levine & Kerwin 2009)
A wide range of breeds was presented in this study for suspected thoraco-lumbar intervertebral disc extrusion with the two most common breeds being the dachshund followed by the pekingese (Table 1)
The hypothesis was supported in the sense that across all breeds of dogs, pre-contrast high-definition volumetric imaging (HDVI) computed tomography (CT) detected acute intervertebral disc extrusions less often when compared with pre-contrast multi-slice CT (MS CT)

Summary

Introduction

Thoraco-lumbar intervertebral disc disease is a common condition in the small animal patient (Griffin, Levine & Kerwin 2009). A hemilaminectomy is considered the technique of choice to decompress the spinal cord (Aikawa et al 2012; McKee 1992; Langerhuus & Miles 2017) Advanced imaging studies such as myelography, computed tomography (CT) or magnetic resonance imaging (MRI) are essential to correctly identify the site of disc extrusion (Cooper et al 2014; Noyes et al 2017; Robertson & Thrall 2011; Schroeder et al 2011). Magnetic resonance imaging has the highest rate of identification of thoraco-lumbar disc extrusion in dogs of around 98% (Cooper et al 2014; Noyes et al 2017; Robertson & Thrall 2011), but is relatively more expensive and time-consuming (25–145 min per examination) to acquire than both CT and myelography (4–45 min per examination) (Cooper et al 2014; Hecht et al 2009; Robertson & Thrall 2011)

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