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Imaging review for Intervertebral disc disease from Canine Spinal Cord Injury Consortium (CANSORT-SCI)

December 27, 2024

Ronaldo C. da Costa, Steven De Decker, Melissa J. Lewis, Holger Volk and the Canine Spinal Cord Injury Consortium (CANSORT-SCI)

Background
Intervertebral disc disease (IVDD) is the most common spinal condition in dogs, accounting for 2.3–3.7% of veterinary hospital admissions. IVDD encompasses various herniation types: intervertebral disc extrusion (IVDE), protrusion (IVDP), acute non-compressive nucleus pulposus extrusion (ANNPE), hydrated nucleus pulposus extrusion (HNPE), and intradural/intramedullary extrusion (IIVDE). Effective imaging is critical for diagnosis, treatment planning, and prognosis.

Methods
This review synthesizes research on the effectiveness of imaging modalities for IVDD diagnosis, including survey radiography, myelography, computed tomography (CT), and magnetic resonance imaging (MRI). It evaluates imaging performance for distinguishing IVDD types, focusing on IVDE, IVDP, ANNPE, HNPE, and IIVDE. Advanced modalities, such as CT-myelography and MRI, are highlighted.

Results

  1. Survey Radiography: Limited sensitivity (51–61%) for detecting IVDD and no direct diagnostic capability. Calcification correlates poorly with clinical extrusion.

  2. Myelography: Effective for IVDE with 72–99% accuracy but has invasive risks like post-myelographic seizures.

  3. CT: Useful for IVDE, especially in small breeds, with an 81–91% sensitivity in non-contrast studies. CT-myelography enhances sensitivity to 97%.

  4. MRI: Gold standard for IVDD, offering nearly 100% diagnostic accuracy. Differentiates IVDD types with high sensitivity and assesses spinal cord damage and prognosis.

Limitations

  • Radiography is non-specific and prone to interobserver variability.

  • Myelography and CT

  • Myelography carry procedural risks and may require follow-up imaging.

  • MRI’s availability and cost limit its routine application, and low-field MRI may underperform in large or small animals.

Conclusions
Modern imaging modalities significantly improve IVDD diagnosis, with MRI providing the most accurate and comprehensive insights. CT is practical for screening but may need supplementary imaging for non-mineralized or chronic cases. Understanding imaging limitations and matching them with case requirements optimizes diagnostic strategies.

Figure 5. Intervertebral disc (IVD) maturation from young to early and late stage IVDD where the first column shows illustrative representations throughout the stages (A–E), middle column shows Pfirrmann grading via T2W MR images and last column showing Thompson grading of canine IVD. AF, annulus fibrosus; CEP, cartilaginous end plate; NP, nucleus pulposus. Pfirrmann grade and Thompson grade images adapted with permission from Bergknut et al. (90) and Thompson et al. (91).

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