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Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations.
J Vet Intern Med. 2017 May; 31(3):842-848.JV

Abstract

BACKGROUND

Prognostic tools to predict early postoperative motor function recovery (MFR) after thoracolumbar intervertebral disk herniation (IVDH) in paraplegic dogs represent an opportunity to timely implement novel therapies that could shorten recovery times and diminish permanent neurological dysfunctions.

HYPOTHESIS

Fractional anisotropy (FA) values obtained using diffusion tensor imaging have a higher prognostic value than a lesion extension ratio in T2-weighted images (T2W-LER) and clinical assessment of deep pain perception (DPP) for MFR.

ANIMALS

Thirty-five paraplegic dogs with diagnosis of acute or subacute thoracolumbar IVDH.

METHODS

Prospective, descriptive observational study. At admission, absence or presence of DPP, T2W-LER, and FA values was evaluated. MFR was assessed within 4 weeks after decompressive surgery. Values of T2W-LER and FA of dogs with and without MFR were compared using t-tests. All 3 methods were evaluated for their sensitivity and specificity as a prognostic factor.

RESULTS

No differences were found between groups regarding T2W-LER. FA values differed statistically when measured caudally of lesion epicenter being higher in dogs without MFR compared to dogs with MFR (P = .023). Logistic regression analysis revealed significance in FA values measured caudally of the lesion epicenter (P = .033, area under the curve = 0.72). Using a cutoff value of FA = 0.660, the technique had a sensitivity of 80% and a specificity of 55%. Evaluation of DPP had a sensitivity of 73.3% and specificity of 75% (P = .007).

CONCLUSIONS AND CLINICAL IMPORTANCE

Evaluation of DPP showed a similar sensitivity and a better specificity predicting early MFR than quantitative magnetic resonance imaging.

Authors+Show Affiliations

Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany. Centre of Systems Neuroscience, Hannover, Germany.Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.Institute of Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine Hannover, Hannover, Germany.Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany.Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany. Centre of Systems Neuroscience, Hannover, Germany.

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

28440586

Citation

Wang-Leandro, A, et al. "Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs With Intervertebral Disk Herniations." Journal of Veterinary Internal Medicine, vol. 31, no. 3, 2017, pp. 842-848.
Wang-Leandro A, Siedenburg JS, Hobert MK, et al. Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations. J Vet Intern Med. 2017;31(3):842-848.
Wang-Leandro, A., Siedenburg, J. S., Hobert, M. K., Dziallas, P., Rohn, K., Stein, V. M., & Tipold, A. (2017). Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations. Journal of Veterinary Internal Medicine, 31(3), 842-848. https://doi.org/10.1111/jvim.14715
Wang-Leandro A, et al. Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs With Intervertebral Disk Herniations. J Vet Intern Med. 2017;31(3):842-848. PubMed PMID: 28440586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Preoperative Quantitative Magnetic Resonance Imaging and Clinical Assessment of Deep Pain Perception as Prognostic Tools for Early Recovery of Motor Function in Paraplegic Dogs with Intervertebral Disk Herniations. AU - Wang-Leandro,A, AU - Siedenburg,J S, AU - Hobert,M K, AU - Dziallas,P, AU - Rohn,K, AU - Stein,V M, AU - Tipold,A, Y1 - 2017/04/25/ PY - 2016/10/20/received PY - 2017/01/25/revised PY - 2017/03/16/accepted PY - 2017/4/26/pubmed PY - 2017/11/1/medline PY - 2017/4/26/entrez KW - Canine KW - Diffusion tensor imaging KW - Paraplegia KW - Spinal cord injury SP - 842 EP - 848 JF - Journal of veterinary internal medicine JO - J. Vet. Intern. Med. VL - 31 IS - 3 N2 - BACKGROUND: Prognostic tools to predict early postoperative motor function recovery (MFR) after thoracolumbar intervertebral disk herniation (IVDH) in paraplegic dogs represent an opportunity to timely implement novel therapies that could shorten recovery times and diminish permanent neurological dysfunctions. HYPOTHESIS: Fractional anisotropy (FA) values obtained using diffusion tensor imaging have a higher prognostic value than a lesion extension ratio in T2-weighted images (T2W-LER) and clinical assessment of deep pain perception (DPP) for MFR. ANIMALS: Thirty-five paraplegic dogs with diagnosis of acute or subacute thoracolumbar IVDH. METHODS: Prospective, descriptive observational study. At admission, absence or presence of DPP, T2W-LER, and FA values was evaluated. MFR was assessed within 4 weeks after decompressive surgery. Values of T2W-LER and FA of dogs with and without MFR were compared using t-tests. All 3 methods were evaluated for their sensitivity and specificity as a prognostic factor. RESULTS: No differences were found between groups regarding T2W-LER. FA values differed statistically when measured caudally of lesion epicenter being higher in dogs without MFR compared to dogs with MFR (P = .023). Logistic regression analysis revealed significance in FA values measured caudally of the lesion epicenter (P = .033, area under the curve = 0.72). Using a cutoff value of FA = 0.660, the technique had a sensitivity of 80% and a specificity of 55%. Evaluation of DPP had a sensitivity of 73.3% and specificity of 75% (P = .007). CONCLUSIONS AND CLINICAL IMPORTANCE: Evaluation of DPP showed a similar sensitivity and a better specificity predicting early MFR than quantitative magnetic resonance imaging. SN - 1939-1676 UR - https://www.unboundmedicine.com/medline/citation/28440586/Comparison_of_Preoperative_Quantitative_Magnetic_Resonance_Imaging_and_Clinical_Assessment_of_Deep_Pain_Perception_as_Prognostic_Tools_for_Early_Recovery_of_Motor_Function_in_Paraplegic_Dogs_with_Intervertebral_Disk_Herniations_ L2 - https://doi.org/10.1111/jvim.14715 DB - PRIME DP - Unbound Medicine ER -