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, Maria (2022). Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs. Veterinary surgery, 51(4), pp. 620-630. Wiley 10.1111/vsu.13799

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > DKV - Clinical Radiology
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > Small Animal Clinic
05 Veterinary Medicine > Department of Clinical Research and Veterinary Public Health (DCR-VPH) > Veterinary Public Health Institute
05 Veterinary Medicine > Department of Clinical Research and Veterinary Public Health (DCR-VPH)

UniBE Contributor:

Planchamp, Bastien; Forterre, Franck; Vidondo, Beatriz Teresa and Precht, Maria Christina

Subjects:

600 Technology > 610 Medicine & health
600 Technology > 630 Agriculture

ISSN:

1532-950X

Publisher:

Wiley

Language:

English

Submitter:

Pubmed Import

Date Deposited:

17 Mar 2022 11:09

Last Modified:

27 Apr 2022 00:14

Publisher DOI:

10.1111/vsu.13799

PubMed ID:

35292990

BORIS DOI:

10.48350/167516

URI:

https://boris.unibe.ch/id/eprint/167516

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