Canine carpus anatomy review

Comparison between high-field 3 Tesla MRI and computed tomography with and without arthrography for visualization of canine carpal ligaments: A cadaveric study

Emanuele Castelli 1, Antonio Pozzi 1, Karl Klisch 2, Lorenza Scotti 3, Séamus Hoey 4, Matthias Dennler 5

Background
Carpal ligament injuries in dogs are common and can result in significant lameness and functional impairment. Traditional diagnostic methods, including radiography and stressed radiographs, often fail to detect subtle ligament damage. In human medicine, advanced imaging techniques such as MRI arthrography (MRA) and CT arthrography (CTA) are used to diagnose ligament tears. This study aimed to compare the effectiveness of 3 Tesla MRI, CT, MRA, and CTA in visualizing canine carpal ligaments.

Methods
Study Design: Prospective descriptive cadaveric study

Subjects: Nine cadaveric canine limbs from skeletally mature dogs (>20 kg)

Imaging Techniques:
-CT (16-slice scanner, 250 mA, 130 kVp, 1024×1024 matrix)
-CTA (CT with contrast injection into the radiocarpal and middle carpal joints)
-MRI (3 Tesla, multiple sequences)
-MRA (MRI with intra-articular contrast injection)

Assessment:
-Three observers (two board-certified radiologists and one surgical resident) graded ligament visualization on a scale from 0 to 4
-Statistical analysis was performed using ordinal logistic regression with Bonferroni adjustment
-Interobserver agreement was calculated using weighted Cohen’s κ

Results
Overall Comparison:
-MRA provided the best visualization of most carpal ligaments compared to MRI, CT, and CTA (P < .05).
-MRI and MRA were significantly superior to both CT and CTA (P < .05).
-There was no significant difference between CT and CTA.

Ligament-Specific Findings:
-MRA significantly improved the visualization of most ligaments, especially the palmar ulnocarpal and radiocarpal ligaments, radioulnar ligament, and medial and lateral collateral ligaments.
-MRI alone provided good visualization of major palmar stabilizers (e.g., palmar fibrocartilage).
-CTA did not enhance ligament visualization compared to CT.

Interobserver Agreement:
-Agreement was discrete (0.2 < κ ≤ 0.4) for all observers, indicating moderate variability in scoring.

Limitations
-Ex Vivo Study: Freezing and thawing of specimens may have affected ligament visualization.
-Lack of Standardized Contrast Volume: Variability in injected contrast may have influenced results.
-Subjective Scoring System: Observer-based grading introduced potential bias.
-Cadaveric Joints vs. Live Joints: The presence of joint effusion and fibrosis in clinical cases could alter ligament visualization.

Conclusions
-MRA is the most effective technique for visualizing canine carpal ligaments, particularly stabilizers of the antebrachiocarpal joint.
-MRI alone provides excellent soft tissue contrast and may be sufficient for identifying major stabilizers without contrast.
-CTA does not enhance ligament visualization and offers no advantage over CT.
-Clinical Relevance: High-field 3 Tesla MRI and MRA could improve the diagnosis and management of carpal ligament injuries in dogs, aiding in surgical planning and treatment selection.
-Future Research: In vivo studies are needed to validate these findings under clinical conditions.

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