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Comparison of magnetic resonance imaging with standing cervical radiographs for evaluation of vertebral canal stenosis in equine cervical stenotic myelopathy
Author(s) -
Janes J. G.,
Garrett K. S.,
McQuerry K. J.,
Pease A. P.,
Williams N. M.,
Reed S. M.,
MacLeod J. N.
Publication year - 2014
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12221
Subject(s) - medicine , myelopathy , magnetic resonance imaging , stenosis , radiography , radiology , spinal canal stenosis , cervical canal , spinal stenosis , spinal canal , spinal cord , cervix , cancer , psychiatry , lumbar
Summary Reasons for performing study The sensitivity and specificity of lateral cervical radiographs to evaluate horses suspected of cervical stenotic myelopathy ( CSM ) are limited by the assessment being restricted to the sagittal plane. Objective To determine whether magnetic resonance imaging ( MRI ) allows for a more accurate identification of stenosis than lateral cervical radiographs in horses with CSM . Study design Case control study. Methods Nineteen Thoroughbred horses with CSM (17 males, 2 females, age 6–50 months) were compared to 9 control Thoroughbreds (6 males, 3 females, age 9–67 months). Ante mortem , the subjects had neurological examinations and standing cervical radiographs with sagittal ratios calculated from C 3 to C 7. Intact cervical column MRI scans and histological examinations of the spinal cord were performed post mortem . Morphometric parameters were measured on the vertebral canal, spinal cord and intervertebral foramen. Results Radiographic cervical canal height measurements categorised by standard minimal sagittal diameter intravertebral and intervertebral ratios produced several false positive and false negative determinations of canal stenosis as defined by spinal cord histopathology. Post mortem MRI measurements of canal area and cord canal area ratio more accurately predicted sites of cord compression in CSM cases. No differences in spinal cord measurements were observed when comparing CSM to control horses, but each of the vertebral canal parameters achieved significance at multiple sites. Conclusions Vertebral canal area and cord canal area ratio are better parameters to predict the location of cervical canal stenosis compared to only the sagittal plane of canal height. Additional visual planes and measurements obtained by MRI , specifically vertebral canal area and the cord canal area ratio, will provide a more accurate method to identify regions of canal stenosis than lateral cervical radiographs. The development of MRI or computed tomography equipment capable of evaluating the cervical column of mature horses may substantially enhance evaluation of CSM patients. The Summary is available in Chinese – see Supporting information.