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ULTRASONOGRAPHIC ANATOMY OF THE NORMAL CANINE SPINAL CORD AND CORRELATION WITH HISTOPATHOLOGY AFTER INDUCED SPINAL CORD TRAUMA
Authors:Susan T  Finn-Bodner  DVM  MS  Judith A  Hudson  DVM  PhD  Joan R  Coates  DVM  Donald C  Sorjonen  DVM  MS  Stephen T  Simpson  DVM  MS  Nancy R  Cox  DVM  PhD  James C  Wright  DVM  phD  Phillip D  Garrett  DVM  MS  Jan E  Steiss  DVM  phD  Dana M  Vaughn  PhD  Starr C  Miller  BS  Scott A  Brown  DVM  PhD
Institution:Departments of Radiology (Finn-Bodner, Hudson), Small Animal Surgery and Medicine (Coates, Sorjonen, Simpson, Miller), Scott-Ritchey Research Center (Steiss, Vaughn, Cox), Pathobiology (Wright), and Anatomy and Histology (Garrett) at the College of Veterinary Medicine, Auburn University, AL 36849, and the Upjohn Company, Kalama-zoo, MI 49001 (Brown). Auburn University Publication #2444. Supported by the Upjohn Company, (grant #A136849) and the Scott-Ritchey Research Center.
Abstract:Prior to trauma, intraoperative ultrasound of the spinal canal in 31 normal dogs was performed through a hemilaminectomy in the left pedicle of L2. A ventral compressive model of spinal cord injury was performed as part of a clinical drug trial. Maximum ultrasonographic spinal cord diameter ranged from 4.9–7.2 mm (5.7 × 0.6). Significant positive correlation (p = 0.023, r = 0.49) was found between age and spinal cord diameter. The dura mater was a separate, well-defined, echogenic horizontal line in 28 (90%) dogs, dorsally, and in 29 (94%) dogs, ventrally. Cerebrospinal fluid was anechoic. Eighteen (58%) dogs had a well-defined anechoic dorsal subarachnoid space, whereas 22 (71%) had a well-defined ventral space. Pia mater was thin but strongly echogenic and covered spinal cord. Central canal was a double hyperechoic line in 17 (55%) dogs and a single-line in 14 (45%) dogs. A difference in the ultrasonographic appearance between gray and white matter was not seen. Epidural fat and connective tissue was a lobular echogenic material in the ventral epidural space. The periosteal-vertebral body interface was seen as a bright curvilinear echo with distal acoustic shadowing. Spinal cord parenchyma could be classified subjectively into four groups based upon ultrasonographic appearance. Spinal cord parenchyma had a uniform hypoechogenicity in 8 (27%) dogs (Group 1), subtle low level echoes in 7 (23%) dogs (Group 2), multiple clusters of defined echogenic foci in 12 (37%) dogs (Group 3), and multiple sharply-defined linear echoes in 4 (13%) dogs (Group 4). There was a significant relationship between pre-trauma ultrasonographic appearance of the spinal cord and histopathology 21 days after trauma. One (13%) dog in Group 1, 4 (57%) dogs in Group 2,10 (91%) dogs in Group 3, and 3 (75%) dogs in Group 4 had malacia on histological evaluation. Therefore, dogs with echogenic spinal cords or linear echoes within cord parenchyma were significantly more likely to develop malacia rather than Wallerian degeneration after induced spinal cord trauma (p = 0.002). Spinal cord echogenicity may indicate vascularity in a segment of spinal cord and might be prognostic following spinal cord trauma. No complications were found related to intraoperative ultrasound. Hematoma or fibrous tissue formation appeared to impede percutaneous ultrasound of the spinal cord in dogs re-evaluated forty-eight hours and one week after surgery.
Keywords:ultrasonography  echogenicity  spinal cord trauma  spinal cord parenchyma
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