Agreement of Magnetic Resonance Imaging With Computed Tomography in the Assessment for Acute Skull Fractures in a Canine and Feline Cadaver Model

Abstract

Computed tomography (CT) is the imaging modality of choice to evaluate patients with acute head trauma. However, magnetic resonance imaging (MRI) may be chosen in select cases. The objectives of this study were to evaluate the agreement of MRI with CT in the assessment for presence or absence of acute skull fractures in a canine and feline cadaver model, compare seven different MRI sequences (T1-W, T2-W, T2-FLAIR, PD-W, T2*-W, “SPACE” and “VIBE”), and determine agreement of four different MRI readers with CT data. Pre- and post-trauma CT and MRI studies were performed on 10 canine and 10 feline cadaver heads. Agreement of MRI with CT as to presence or absence of a fracture was determined for 26 individual osseous structures and four anatomic regions (cranium, face, skull base, temporomandibular joint). Overall, there was 93.5% agreement in assessing a fracture as present or absent between MRI and CT, with a significant difference between the pre and post trauma studies (99.4 vs. 87.6%; p < 0.0001; OR 0.042; 95% CI 0.034–0.052). There was no significant difference between dogs and cats. The agreement for the different MRI sequences with CT ranged from 92.6% (T2*-W) to 94.4% (PD-W). There was higher agreement of MRI with CT in the evaluation for fractures of the face than other anatomic regions. Agreement with CT for individual MRI readers ranged from 92.6 to 94.7%. A PD-W sequence should be added to the MR protocol when evaluating the small animal head trauma patient.

Comparison of standard T2-weighted turbo spin echo and volumetric interpolated breath-hold examination magnetic resonance imaging sequences in the assessment of articular process dysplasia in Pug dogs with thoracolumbar myelopathy

“…It also con rmed a higher accuracy and interobserver repeatability of VIBE studies compared to T2W-TSE for correct classi cation of caudal articular processes. This is consistent with previous ndings in assessment of other small animal bony changes, such as Hecht et al (11) who found a 93.9% agreement of skull fracture identi cation with VIBE to CT this shows also transferrable use of MRI in looking at bone morphology. Our ndings suggest that VIBE sequences could potentially be considered in place of CT to identify CAP abnormalities.…”

“…Volumetric interpolated breath-hold examination (VIBE) is a form of volumetric imaging using fast 3D gradient-echo sequences that produces T 1 images and was rst introduced by Rofsky in 1999 (6) It has the advantage of improving Z-axis resolution, which makes it possible to obtain high-quality multiplanar and 3D reconstruction images. VIBE has been effectively used in breast (7), human abdominal (8) and musculoskeletal imaging (9) with use in veterinary medicine limited for assessing facial neuritis (10) and skull fractures (11). Hecht et al (11) found VIBE imaging was highly accurate in identifying post mortem skull fractures in animals.…”

“…VIBE has been effectively used in breast (7), human abdominal (8) and musculoskeletal imaging (9) with use in veterinary medicine limited for assessing facial neuritis (10) and skull fractures (11). Hecht et al (11) found VIBE imaging was highly accurate in identifying post mortem skull fractures in animals. MRI of the vertebral column for fracture identi cation has been previously compared to CT and moderate interobserver agreement was found, but up to 79% of fractures in some vertebrae were not recognised, however this was using only single plane MRI sequences (12).…”

Magnetic Resonance Imaging in 50 Captive Non-domestic Felids - Technique and Imaging Diagnoses

“…CT is generally considered the gold standard in the evaluation of acute traumatic head injury. MRI has been shown to have fairly high accuracy in fracture in identification in a canine and feline cadaver model ( 50 ). However, both the brain and cervical spine were imaged in this patient, and only a limited number of sequences and planes were acquired to minimize time under general anesthesia.…”

Are postnatal traumatic events an underestimated cause of porencephalic lesions in dogs and cats?

“…The lack of history for five of the dogs prevents a more exhaustive establishment of a relationship between a possible traumatic event and MRI findings. All the studies were lacking proton density weighted sequences, which are considered the most useful sequences for detecting bone traumatic lesions ( 30 ). In addition, the quality of the MRIs obtained with a low field unit could limit the recognition of subtle signs of head trauma, causing one to underestimate the real number of presumed acquired traumatic cases.…”