Advances in the Canine Cranial Cruciate Ligament, 2nd edition

(Wang) #1

21


Magnetic Resonance Imaging

of the Stifle

Peter V. Scrivani


Introduction and image acquisition


Joints limit motion between bones to a partic-
ular range, and also dissipate stress during use
(Dyceet al. 2002). The ability to perform these
functions is based on the type of joint (synovial,
cartilaginous, fibrous), bone conformation, and
supporting soft tissues (Dyceet al. 2002). There-
fore, a loss of function is manifested as excessive
motion, restricted motion, or pain. In dogs the
most common cause of joint dysfunction is
osteoarthritis, a chronic degenerative disease of
the articular cartilage and underlying bone that
results from a combination of genetic and envi-
ronmental factors. Other common arthropathies
are due to inflammatory, traumatic, or neoplas-
tic causes. Relative to this information and to
the stifle joint in particular, the aims of magnetic
resonance imaging (MRI) are: (i) to provide an
early diagnosis of osteoarthritis; (ii) to provide
a more specific diagnosis of the arthropathy;
(iii) to guide therapy decisions; (iv) to offer a
more detailed prognosis; and (v) to assess any
response to treatment. MRI is apt to improve
patient care and help achieve one of these
goals.
The beneficial impact of musculoskeletal
MRI in humans is undisputed. However, only
minimal evidence is yet available in veterinary


medicine that MRI actually improves patient
care relative to the cost of the examination and
additional anesthesia time. Even though MRI is
considered accurate for diagnosing cruciate lig-
ament rupture (CR) in dogs (Galindo-Zamora
et al. 2013), competing diagnostic modali-
ties, such as radiography, ultrasonography, or
arthroscopy, offer additional benefits such as
guiding therapy without the need for anesthesia
or providing the ability to treat an underlying
problem during the same procedure. However,
MRI has shown much promise and may have
advantages in the early detection of lesions in
the cranial cruciate ligament (CrCL), subchon-
dral bone, articular cartilage or menisci, or for
establishing the cause of lameness that has not
been diagnosed by conventional methods. As
such, MRI is being used more frequently to
examine the stifle joint in dogs. The anatomy
of the stifle joint has been described previously
(Pujolet al. 2011).
MRI recognition of joint lesions is based
on alterations of signal intensity (SI) and
morphologic changes (Rubin 2005). For subtle
lesions, detecting these changes depends on
acquiring images with high contrast and spatial
resolution (Rubin 2005). It is difficult to make
exact recommendations for optimal image
acquisition because of different scanners (e.g.,

Advances in the Canine Cranial Cruciate Ligament, Second Edition. Edited by Peter Muir. © 2018 ACVS Foundation.
This Work is a co-publication between the American College of Veterinary Surgeons Foundation and Wiley-Blackwell.


155
Free download pdf