Diagnostic Imaging in Intervertebral Disc Disease

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Abstract

Imaging is integral in the diagnosis of canine intervertebral disc disease (IVDD) and in differentiating subtypes of intervertebral disc herniation (IVDH). These include intervertebral disc extrusion (IVDE), intervertebral disc protrusion (IVDP) and more recently recognized forms such as acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary intervertebral disc extrusion (IIVDE). Many imaging techniques have been described in dogs with roles for survey radiographs, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Given how common IVDH is in dogs, a thorough understanding of the indications and limitations for each imaging modality to aid in diagnosis, treatment planning and prognosis is essential to successful case management. While radiographs can provide useful information, especially for identifying intervertebral disc degeneration or calcification, there are notable limitations. Myelography addresses some of the constraints of survey radiographs but has largely been supplanted by cross-sectional imaging. Computed tomography with or without myelography and MRI is currently utilized most widely and have become the focus of most contemporary studies on this subject. Novel advanced imaging applications are being explored in dogs but are not yet routinely performed in clinical patients. The following review will provide a comprehensive overview on common imaging modalities reported to aid in the diagnosis of IVDH including IVDE, IVDP, ANNPE, HNPE, and IIVDE. The review focuses primarily on canine IVDH due to its frequency and vast literature as opposed to feline IVDH.

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Most cited references 203

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A reliability study was conducted. To develop a classification system for lumbar disc degeneration based on routine magnetic resonance imaging, to investigate the applicability of a simple algorithm, and to assess the reliability of this classification system. A standardized nomenclature in the assessment of disc abnormalities is a prerequisite for a comparison of data from different investigations. The reliability of the assessment has a crucial influence on the validity of the data. Grading systems of disc degeneration based on state of the art magnetic resonance imaging and corresponding reproducibility studies currently are sparse. A grading system for lumbar disc degeneration was developed on the basis of the literature. An algorithm to assess the grading was developed and optimized by reviewing lumbar magnetic resonance examinations. The reliability of the algorithm in depicting intervertebral disc alterations was tested on the magnetic resonance images of 300 lumbar intervertebral discs in 60 patients (33 men and 27 women) with a mean age of 40 years (range, 10-83 years). All scans were analyzed independently by three observers. Intra- and interobserver reliabilities were assessed by calculating kappa statistics. There were 14 Grade I, 82 Grade II, 72 Grade III, 68 Grade IV, and 64 Grade V discs. The kappa coefficients for intra- and interobserver agreement were substantial to excellent: intraobserver (kappa range, 0.84-0.90) and interobserver (kappa range, 0.69-0.81). Complete agreement was obtained, on the average, in 83.8% of all the discs. A difference of one grade occurred in 15.9% and a difference of two or more grades in 1.3% of all the cases. Disc degeneration can be graded reliably on routine T2-weighted magnetic resonance images using the grading system and algorithm presented in this investigation.

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Author and article information

Contributors

Ronaldo C. da Costa: URI : http://loop.frontiersin.org/people/262924/overview

Steven De Decker: URI : http://loop.frontiersin.org/people/204297/overview

Melissa J. Lewis: URI : http://loop.frontiersin.org/people/839549/overview

Holger Volk: URI : http://loop.frontiersin.org/people/202497/overview

Journal

Journal ID (nlm-ta): Front Vet Sci

Journal ID (iso-abbrev): Front Vet Sci

Journal ID (publisher-id): Front. Vet. Sci.

Title: Frontiers in Veterinary Science

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2297-1769

Publication date (Electronic): 22 October 2020

Publication date Collection: 2020

Volume: 7

Electronic Location Identifier: 588338

Affiliations

Author Affiliations: Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH, United States; Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States; Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States; Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States; Professor in Small Animal Clinical Sciences, College of veterinary Medicine, Texas A&M University, TX, United States; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States; Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States; Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, United Kingdom; The Royal Veterinary College, University of London, Hertfordshire, United Kingdom; CVS referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom; Faculty of Veterinary Medicine, Institute of Veterinary Pathology, Leipzig University, Leipzig, Germany; Division of Clinical Neurology, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany/Europe; Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, United States; Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany/Europe.

[1] ¹Department of Veterinary Clinical Sciences, The Ohio State University , Columbus, OH, United States

[2] ²Department of Clinical Sciences and Services, Royal Veterinary College , London, United Kingdom

[3] ³Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine , West Lafayette, IN, United States

[4] ⁴Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hanover , Hanover, Germany

Author notes

Edited by: Daisuke Hasegawa, Nippon Veterinary and Life Science University, Japan

Reviewed by: Shinji Tamura, Tamura Animal Clinic, Japan; Itay Srugo, VetNeuro, Israel

*Correspondence: Ronaldo C. da Costa dacosta.6@ 123456osu.edu

This article was submitted to Veterinary Neurology and Neurosurgery, a section of the journal Frontiers in Veterinary Science

Article

DOI: 10.3389/fvets.2020.588338

PMC ID: 7642913

PubMed ID: 33195623

SO-VID: d5b07d45-fa98-4dc3-ad39-9614c162faa8

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 28 July 2020

Date accepted : 09 September 2020

Page count

Figures: 15, Tables: 0, Equations: 0, References: 203, Pages: 24, Words: 19135

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Karger: Neurology and Neuroscience

Most cited references 203

Magnetic resonance classification of lumbar intervertebral disc degeneration.

MR diffusion tensor spectroscopy and imaging.

In vivo fiber tractography using DT-MRI data

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Cited by 29

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