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- J Vet Sci. 2009 Jun;10(3):225-232 DOI: 10.4142/jvs.2009.10.3.225 |
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Effect of multi-planar CT image reformatting on surgeon diagnostic
performance for localizing thoracolumbar disc extrusions in dogs
Jason B. King1, Jeryl C. Jones2, John H. Rossmeisl Jr2,*, Tisha A. Harper2, Otto I Lanz2, Stephen R. Werre3 |
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1Department of Clinical Sciences, School of Veterinary Medicine, University of California, Davis, California 95616, USA
2Department of Small Animal Clinical Sciences, and 3Study Design and Statistical Analysis Lab, Virginia-Maryland Regional
College of Veterinary Medicine, Virginia Polytechnic and State University, Blacksburg, Virginia 24061, USA
* jcjones@vt.edu |
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Accurate pre-operative localization and removal of disc
material are important for minimizing morbidity in dogs
with thoracolumbar disc extrusions. Computed tomography
(CT) is an established technique for localizing disc extrusions
in dogs, however the effect of multi-planar reformatting
(MPR) on surgeon diagnostic performance has not been
previously described. The purpose of this study was to test
the effect of MPR CT on surgeon diagnostic accuracy,
certainty and agreement for localizing thoracolumbar disc
extrusions in dogs. Two veterinary surgeons and one
veterinary neurologist who were unaware of surgical findings
independently reviewed randomized sets of two-dimensional
(2D) and MPR CT images from 111 dogs with confirmed
thoracolumbar disc extrusions. For each set of images,
readers recorded their localizations for extruded disc
material and their diagnostic certainty. For MPR images,
readers also recorded views they considered most helpful.
Diagnostic accuracy estimates, mean diagnostic certainty
scores and inter-observer agreement were compared using
surgery as the gold standard. Frequencies were compared
for MPR views rated most helpful. Diagnostic accuracy
estimates were significantly greater for MPR vs. 2D CT
images in one reader. Mean diagnostic certainty scores
were significantly greater for MPR images in two readers.
The change in agreement between 2D and MPR images
differed from zero for all analyses (site, side, number
affected) among all three readers. Multi-planar views rated
most helpful with the highest frequency were oblique
transverse and curved dorsal planar MPR views. Findings
from this study indicate that multi-planar CT can improve
surgeon diagnostic performance for localizing canine
thoracolumbar disc extrusions.
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