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Intraobserver, interobserver, and intermethod agreement for results of myelography, computed tomography-myelography, and low-field magnetic resonance imaging in dogs with disk-associated wobbler syndrome

Steven De DeckerDepartment of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

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Ingrid M. V. L. GielenDepartment of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

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Luc DuchateauDepartment of Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

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Nuria Corzo-MenéndezDavies Veterinary Specialists, Manor Farm Business Park, Higham Rd, Higham Gobion, Hertfordshire, SG5 3H3, England.

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Henri J. J. van BreeDepartment of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

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Kaatje KromhoutDepartment of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

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Tim BosmansDepartment of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

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Luc M. L. Van HamDepartment of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.

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Abstract

Objective—To determine intraobserver, interobserver, and intermethod agreement for results of myelography, computed tomography-myelography (CTM), and low-field magnetic resonance imaging (MRI) in dogs with disk-associated wobbler syndrome (DAWS).

Design—Prospective cross-sectional study.

Animals—22 dogs with DAWS.

Procedures—All dogs underwent myelography, CTM, and low-field MRI. Each imaging study was interpreted twice by 4 observers who were blinded to signalment and clinical information of the patients. The following variables were assessed by all 3 techniques: number, site, and direction of spinal cord compressions; narrowed intervertebral disk spaces; vertebral body abnormalities; spondylosis deformans; and abnormal articular facets. Intervertebral foraminal stenosis was assessed on CTM and MRI images. Intraobserver, interobserver, and intermethod agreement were calculated by κ and weighted κ statistics.

Results—There was very good to good intraobserver agreement for most variables assessed by myelography and only moderate intraobserver agreement for most variables assessed by CTM and low-field MRI. There was moderate to fair interobserver and intermethod agreement for most variables assessed by the 3 diagnostic techniques. There was very good or good intraobserver, interobserver, or intermethod agreement for the site and direction of the worst spinal cord compression as assessed by all the imaging modalities; abnormal articular facets and intervertebral foraminal stenosis were the least reliably assessed variables, with poor interobserver agreement regardless of imaging modality used.

Conclusions and Clinical Relevance—There was considerable variation in image interpretation among observers and between use of various imaging modalities; these imaging techniques should be considered complementary in assessment of dogs with DAWS.

Abstract

Objective—To determine intraobserver, interobserver, and intermethod agreement for results of myelography, computed tomography-myelography (CTM), and low-field magnetic resonance imaging (MRI) in dogs with disk-associated wobbler syndrome (DAWS).

Design—Prospective cross-sectional study.

Animals—22 dogs with DAWS.

Procedures—All dogs underwent myelography, CTM, and low-field MRI. Each imaging study was interpreted twice by 4 observers who were blinded to signalment and clinical information of the patients. The following variables were assessed by all 3 techniques: number, site, and direction of spinal cord compressions; narrowed intervertebral disk spaces; vertebral body abnormalities; spondylosis deformans; and abnormal articular facets. Intervertebral foraminal stenosis was assessed on CTM and MRI images. Intraobserver, interobserver, and intermethod agreement were calculated by κ and weighted κ statistics.

Results—There was very good to good intraobserver agreement for most variables assessed by myelography and only moderate intraobserver agreement for most variables assessed by CTM and low-field MRI. There was moderate to fair interobserver and intermethod agreement for most variables assessed by the 3 diagnostic techniques. There was very good or good intraobserver, interobserver, or intermethod agreement for the site and direction of the worst spinal cord compression as assessed by all the imaging modalities; abnormal articular facets and intervertebral foraminal stenosis were the least reliably assessed variables, with poor interobserver agreement regardless of imaging modality used.

Conclusions and Clinical Relevance—There was considerable variation in image interpretation among observers and between use of various imaging modalities; these imaging techniques should be considered complementary in assessment of dogs with DAWS.

Contributor Notes

Dr. De Decker's present address is Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, Hertfordshire AL97TA, England.

Supported by the Institute for the Promotion of Innovation by Science and Technology (IWT) in Flanders.

Presented in abstract form at the 23rd Symposium of the European Society of Veterinary Neurology, Cambridge, England, September 2010.

Address correspondence to Dr. De Decker (sdedecker@rvc.ac.uk).