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1.
Primary flexor enthesopathy is a recently recognized elbow disorder and should be considered in the differential diagnosis of elbow lameness. For treatment planning purposes, it is important to make a distinction between primary and concomitant forms of the disease. The purpose of this prospective study was to compare radiographic findings for dogs with primary flexor enthesopathy (n = 17), concomitant flexor enthesopathy (n = 24), elbow dysplasia (n = 13), and normal dogs (n = 7). All dogs underwent a complete radiographic examination and each radiographic image was evaluated for the presence or absence of following characteristics: irregular medial humeral epicondyle, spur and calcified body. Additionally, the presence or absence of other elbow disorders (medial coronoid process disease, osteochondritis dissecans, ununited anconeal process, incongruity, subtrochlear sclerosis, and osteoarthritis) was recorded. Radiographic characteristics of flexor enthesopathy were found in 86% of painful joints in the primary flexor enthesopathy group and in 100% of painful joints in the concomitant flexor enthesopathy group. Radiographic characteristics of flexor enthesopathy were not found in sound elbow and elbow dysplasia groups. Frequencies and details of individual radiographic characteristics did not differ between primary and concomitant flexor enthesopathy groups. Findings support the use of radiography as a first screening method for detection of flexor enthesopathy, but not as a technique for distinguishing primary vs. concomitant forms.  相似文献   

2.
Flexor enthesopathy is an important differential diagnosis for elbow lameness in dogs. The disorder can be a primary cause of elbow lameness or concomitant with other elbow pathology. Since treatment differs for primary and concomitant forms of flexor enthesopathy, a noninvasive method for distinguishing between them is needed. In the current prospective study, computed tomographic (CT) examination was performed before and after IV injection of contrast in 17 dogs with primary flexor enthesopathy, 24 dogs with concomitant flexor enthesopathy, 13 dogs with elbow dysplasia, and seven normal dogs. Dogs were assigned to groups based on results of clinical examination and at least three other imaging modalities. Computed tomographic lesions consistent with flexor enthesopathy were found in all clinically affected joints with primary flexor enthesopathy and in 29 of the 30 clinically affected joints with concomitant flexor enthesopathy. Those lesions were not found in sound elbows or joints affected by elbow dysplasia. Flexor lesions detected in dogs with primary flexor enthesopathy were not significantly different from those detected in dogs with the concomitant form. Findings indicated that CT can be applied to detect flexor enthesopathy, but a distinction between the primary and concomitant forms was not always possible. Authors recommend the use of multiple diagnostic techniques for treatment planning in affected dogs.  相似文献   

3.
Objectives: To determine the frequency and radiographic aspect of medial humeral epicondylar lesions as a primary or concomitant finding and to evaluate the association with osteoarthritis. Methods: Medical records of dogs diagnosed with elbow lameness were reviewed. Inclusion criteria for this study were a complete clinical examination, a complete set of digital radiographs and a final diagnosis made by computed tomography or magnetic resonance imaging and arthroscopy. Changes of the medial humeral epicondyle were recorded and correlated with the radiographic osteoarthritis and final diagnosis. Results: Eighty of the 200 elbows showed changes of the medial humeral epicondyle. In 12 of these 80 elbows, changes of the medial epicondyle were the only findings within the joint, and these elbows were diagnosed with primary flexor enthesopathy. In the remaining 68 elbows, other concomitant elbow pathologies were found. In those cases of concomitant epicondylar changes, high grades of osteoarthritis were recorded, while most elbows with primary flexor enthesopathy showed a low grade of osteoarthritis. Clinical significance: Changes of the medial humeral epicondyle are often considered clinically unimportant and are regarded as an expression of osteoarthritis. This study showed the relatively frequent presence of epicondylar changes of which the majority were considered concomitant to a primary elbow problem. If changes of the medial humeral epicondyle are the only pathologic finding (primary flexor enthesopathy) they should be considered as the cause of lameness and not as a sign of osteoarthritis.  相似文献   

4.
Progressive myelomalacia (PMM) is a fatal sequela of acute thoracolumbar intervertebral disc extrusion in dogs, with unpredictable onset in the days after the inciting injury. No single reliable diagnostic test is currently available. Magnetic resonance imaging (MRI) features such as T2-weighted spinal cord hyperintensity and loss of subarachnoid signal in a half-Fourier single-shot turbo spin echo (HASTE) sequence have been associated with PMM, but are sometimes present in other dogs with severe deficits. Magnetic resonance imaging findings in 22 dogs with a clinical or histopathologic diagnosis of PMM and 38 deep pain-negative paraplegic dogs were compared in a retrospective case-control study. Length of T2-weighted hyperintense spinal cord change and HASTE signal loss were significantly associated with clinically evident PMM (P = .0019 and P = .0085), however, there were no significant differences between groups when analysis was restricted to dogs not yet showing clinical signs of PMM. The PMM group also had significantly shorter compressive lesions than the control group (P = 0.026), suggesting a possible role of more severe focal pressure at the extrusion site. A segment of total loss of contrast enhancement in the venous sinuses and meninges, a feature not previously described, was more common in the PMM group and the difference approached significance (P = 0.054). Findings show that MRI features can support the diagnosis in dogs with clinical evidence of PMM, and absence of these features supports absence of PMM at time of imaging. However, their absence does not reliably differentiate dogs with imminent progressive myelomalacia from other dogs with severe deficits following intervertebral disc extrusion.  相似文献   

5.
Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross‐sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow‐up assessments. Associations between standing MRI lesions and chronic lameness following treatment were tested. Abnormalities of the navicular bone (409 horses, 74%), distal interphalangeal joint (362 horses, 65%), and deep digital flexor (DDF) tendon (260 horses, 47%) occurred with the highest frequency. The following abnormalities were significantly associated (P < .05) with chronic lameness following conservative therapy: moderate to severe MRI lesions in the trabecular bone of the navicular bone, mild or severe erosions of the flexor surface of the navicular bone, moderate sagittal/parasagittal DDF tendinopathies, and moderate collateral sesamoidean desmopathies. Also, identification of concurrent lesions of the DDF tendon, navicular bone, navicular bursa, and distal sesamoidean impar ligament was associated with chronic lameness after conservative therapy. Development of effective treatment options for foot lesions that respond poorly to conservative therapy is necessary.  相似文献   

6.
The equine head is an anatomically complex area, therefore advanced tomographic imaging techniques, such as computed tomography or magnetic resonance imaging (MRI), are often required for diagnosis and treatment planning. The purpose of this multicenter retrospective study was to describe MRI characteristics for a large sample of horses with head disorders. Horses imaged over a period of 13 years were recruited. Eighty‐four horses met the inclusion criteria, having neurological (n = 65), sinonasal (n = 14), and soft tissue (n = 5) disorders. Magnetic resonance imaging accurately depicted the anatomy and allowed identification of the primary lesion and associated changes. There were good correlations between MRI findings and intraoperative or postmortem results. Magnetic resonance imaging showed the exact localization of the lesions, their size, and relation to surrounding structures. However, in the neurological group, there were 45 horses with no MRI abnormalities, 29 of which had a history of recurrent seizures, related to cryptogenic epilepsy. Magnetic resonance imaging was otherwise a valuable diagnostic tool, and can be used for studying a broad range of head disorders using either low‐field or high‐field magnets.  相似文献   

7.
Magnetic resonance imaging (MRI) is a common test for dogs with suspected intradural spinal cord lesions, however studies on diagnostic performance for this test are lacking. Objectives of this multi‐institutional, retrospective, case‐control study were to estimate sensitivity and specificity of MRI for (1) distinguishing between histopathologically confirmed intradural spinal cord disease versus degenerative myelopathy in dogs, (2) categorizing intradural spinal cord diseases as neoplastic, inflammatory, or vascular; and (3) determining tumor type within the etiologic category of neoplasia. Additional aims were to (1) determine whether knowledge of clinical data affects sensitivity and specificity of MRI diagnoses; and (2) report interrater agreement for MRI classification of intradural spinal lesions. Cases were recruited from participating hospital databases over a 7‐year period. Three reviewers independently evaluated each MRI study prior to and after provision of clinical information. A total of 87 cases were sampled (17 degenerative myelopathy, 53 neoplasia, nine inflammatory, and eight vascular). Magnetic resonance imaging had excellent (>97.6%) sensitivity for diagnosis of intradural spinal cord lesions but specificity varied before and after provision of clinical data (68.6% vs. 82.4%, P = 0.023). Magnetic resonance imaging had good sensitivity (86.8%) and moderate specificity (64.7–72.5%) for diagnosing neoplasia. Sensitivity was lower for classifying inflammatory lesions but improved with provision of clinical data (48.1% vs. 81.5%, P = 0.015). Magnetic resonance imaging was insensitive for diagnosing vascular lesions (25.0%). Interrater agreement was very good for correctly diagnosing dogs with intradural lesions (? = 0.882–0.833), and good (? = 0.726–0.671) for diagnosing dogs with neoplasia.  相似文献   

8.
Forty-four dogs were referred to our hospital presenting with neurological symptoms such as seizure or paraparesis. Magnetic resonance imaging (MRI) revealed abnormal results in 21 (abnormal MRI group) and normal results in 23 dogs (normal MRI group). Cerebrospinal fluid (CSF) (normal MRI group, n = 22; abnormal MRI group, n = 21) and serum lipid peroxide (LP) concentrations (normal MRI group, n = 11; abnormal MRI group, n = 15) were measured in a number of these dogs, and revealed a significant difference in the CSF/serum LP values (normal MRI group, n = 10; abnormal MRI group, n = 14) between the abnormal and the normal MRI groups (t-test and Mann–Whitney U-test p < 0.05). No other significant differences were observed. CSF/serum LP values exceeding 1.0 were exhibited in 10 of 14 dogs (71%) in the abnormal MRI group, and in 1 of 10 dogs (10%) in the normal MRI group. In the remaining animals, 4 dogs of the abnormal MRI group showed CSF/serum values lower than 1.0, 3 dogs had morphological abnormalities but no abnormal MRI signals in the central nervous system, and 1 dog had an abnormal MRI signal but no pathological abnormality. In the CSF analysis, 3 of 16 dogs (19%) of the abnormal MRI groupshowed abnormal cell counts and/or protein content. We conclude that the CSF/serum LP value can be used for the detection of neurological lesions such as oedema, inflammation and tumour.  相似文献   

9.
Injury to the distal aspects of the deep digital flexor tendon (DDFT) is an important cause of lameness in horses. The purpose of this study was to review the magnetic resonance imaging (MRI) findings of 18 horses affected by DDFT injuries in the foot. The MRI was performed with the horses standing using an open low-field (0.21 T) MRI scanner. The results were compared with those previously reported for horses using high-field MRI. Eighteen of 84 horses (21%) with undiagnosed forefoot pain were found to have lesions affecting the DDFT. The history, clinical findings and results of radiography, diagnostic ultrasonography and nuclear scintigraphy of these horses were reviewed. The duration of lameness ranged from 1 to 12 months, and the severity varied from 1/10 to 6/10. Fifteen horses had unilateral lameness (right fore in nine, left fore in six), whereas three horses were bilaterally foreleg lame. Radiological changes, considered of equivocal significance, were found in six of 18 horses. Ultrasonographic changes involving the DDFT were identified in only one of nine horses. DDFT lesions were detected in both T1- and T2-weighted MRI sequences. Four different types of lesions were identified: core lesions, sagittal splits, dorsal border lesions, and insertional lesions. Combinations of different lesion types within the same horse were common. The types and locations of the DDFT lesions were similar to those previously reported using high-field MRI. The use of low-field standing MRI avoids the necessity for general anesthesia and access to conventional high-field MRI scanners. However, studies comparing the results of standing low-field MRI with high-field MRI (and other imaging procedures) are required before the sensitivity and specificity of the technique can be assessed.  相似文献   

10.
OBJECTIVE: To assess joint geometry and highlight potential evidence of physiologic incongruity in cubital (elbow) joints of large, small, and chondrodystrophic breeds of dogs. SAMPLE POPULATION: Nonarthritic elbow joints obtained from cadavers of mature dogs of large breeds (n = 19), small breeds (14), or chondrodystrophic breeds (8). PROCEDURE: Magnetic resonance imaging was used to quantify interosseous gaps at 6 defined positions and 2 sagittal planes of the humeroantebrachial region by use of a fat-suppressed 3-dimensional gradient-echo sequence. RESULTS: Interosseous gaps in the more medially located sagittal plane were significantly narrower at the level of the anconeal process than at any other position of the joint in large-breed dogs, compared with results for small- or chondrodystrophic-breed dogs. In both sagittal planes, the gaps were significantly wider at the center of the ulnar trochlear notch than at any other position. Significant correlation between body weight and width of the interosseous gaps was found only in large-breed dogs and was found in both sagittal planes at the center of the ulnar trochlear notch (r, 0.834 and r, 0.680, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: In large-breed dogs, the interosseous gap was especially narrow at the level of the anconeal process and its diametric position. This suggests less ability to compensate intra-articular steps in dogs with short ulna syndrome, which predisposes to failure of the union between the anconeal process and olecranon. Geometric incongruity may be regarded as clinically normal in nonarthritic humeroulnar joints. The degree of geometric incongruity increases with body weight.  相似文献   

11.
OBJECTIVE: To test the effects of computed tomography (CT) image plane and window settings on diagnostic certainty for CT characteristics associated with dysplastic elbow joints (elbow joint dysplasia) in dogs and to provide optimal display guidelines for these CT characteristics. SAMPLE POPULATION: CT images of 50 dysplastic elbow joints from 49 lame dogs and 10 elbow joints from 5 sound dogs. PROCEDURES: CT image data were obtained in transverse, sagittal, and dorsal planes. Each plane was examined by use of 3 Hounsfield unit (HU) window settings. Two veterinary radiologists independently evaluated sets of CT images for evidence of 7 CT characteristics. Effect of elbow joint status, image plane, and window settings on diagnostic certainty for these CT characteristics was tested by use of a visual analogue scale. RESULTS: Diagnostic certainty for abnormalities of the medial coronoid process (MCP) and radial incisure was highest in the transverse plane, subchondral defects or sclerosis of the trochlea humeri was highest in the dorsal plane, and joint incongruity was highest in the sagittal plane. Certainty for hypoattenuating subchondral defects or fissures was highest at 2,500 or 3,500 HUs, whereas certainty for subchondral sclerosis was highest at 1,500 HUs and lowest at 3,500 HUs. CONCLUSIONS AND CLINICAL RELEVANCE: Diagnostic certainty for CT characteristics of elbow joint dysplasia in dogs was affected by image display variables. Diagnostic certainty for altered subchondral bone density was primarily influenced by window settings, whereas structural MCP abnormalities and joint incongruity were influenced most by image plane.  相似文献   

12.
Navicular syndrome is a multifactorial disease process in horses with multiple structures in the foot contributing to lameness. Surgical debridement is a treatment option for lesions of the navicular bursa and deep digital flexor tendon. This retrospective case series describes the magnetic resonance imaging (MRI) appearance of the navicular bursa following bursoscopy. Seven horses (three being bilaterally affected) with forelimb lameness isolated to the foot, and pre- and post-operative MRI were included. All limbs had concurrent lesions associated with the deep digital flexor tendon, navicular bone, impar ligament, collateral sesamoidean ligament and/or distal interphalangeal joint. All bursae developed or had progression of proliferative bursal tissue following surgery. At recheck MRI, following rehabilitation protocols, almost all horses had improved to resolved lameness with relatively unchanged concurrent lesions despite the navicular bursa appearance worsening. Outcomes for return to work were poor with only two horses going back to the previous level of work.  相似文献   

13.
Magnetic resonance (MR) images of 40 dogs with histologically confirmed primary and secondary intracranial tumours were reviewed. Forty-one tumours were diagnosed by means of MR imaging (MRI). MRI findings allowed diagnosis of a neoplastic lesion in 37/41 cases. Based on MRI features, differentiation between neoplastic and non-neoplastic lesions was possible in 24/27 (89%) primary brain tumours and in 13/14 (92%) secondary brain tumours. Diagnosis of tumour type based on MRI features was correct in 19/27 (70%) primary tumours and in 13/14 secondary tumours. The results of this study show that MRI is a good diagnostic imaging modality to detect neoplastic lesions and to diagnose tumour type in dogs. However, as some neoplasms show equivocal MRI features the technique has limitations in the detection of some intracranial tumours and in predicting tumour type.  相似文献   

14.
The presented paper presents updated information concerning magnetic resonance imaging (MRI) of shoulder joint, elbow joint and knee joint in dogs. It describes indications, planes, standard sequences, slice thickness to perform MRI examination of above mentioned joints. Besides general information about basic physics use in magnetic resonance imaging, and practical information about magnetic resonance and it usage in orthopedic examination are given.  相似文献   

15.
Radiographic flexor cortical lysis indicates advanced degenerative change and its earlier recognition may improve case outcome. Aims of this prospective, diagnostic accuracy study were to determine effects of radiographic beam angle and observer on accuracy of lesion detection. The sample included 36 limbs from 31 horses. Palmaroproximal–palmarodistal oblique (skyline) radiographs were acquired at standard (n = 38) and more shallow (alternate) angles (n = 58). Images were independently reviewed by four experience levels of five observers each (n = 20) for the presence and severity of flexor cortical lysis. Observers also reported their confidence in these answers. Responses were compared based on seeing a standard skyline or multiple projections. The definitive presence (or absence) and severity of lysis was based upon radiologist consensus agreement. When assessed by observer, the identification of lysis and the assessment of its severity was most similar to that of radiologists when observers of all levels of experience were able to view multiple skyline projections (P = 0.399, P = 0.174). Using multiple views to detect lysis resulted in improved sensitivity (85.3% vs. 97.2%, P < 0.001), decreased specificity (82.8% vs. 74.5%, P = 0.03), and improved interobserver agreement (86.0% vs. 90.2%, P = 0.21). On average, observers of all levels of experience became more confident viewing multiple projections (P < 0.001). Skyline radiographs using a flatter angle of incidence improve radiographic detection and characterization of flexor cortical lysis severity, may allow the beam to be tangential to the more distal portion of the navicular bone, and are recommended when flexor cortical lysis is suspected.  相似文献   

16.
Diagnosing high intracranial pressure by clinical and diagnostic imaging is particularly challenging for chronic or slow‐growing lesions. The aim of this prospective case‐control study is to determine whether the neuroscore and brain magnetic resonance imaging (MRI) are related to the direct measurement of intracranial pressure in sheep affected by intracranial slow‐growing lesions due to chronic cerebral coenurosis (Coenurus cerebralis). Seventeen affected and 10 control sheep were included. All animals underwent a neurological examination, MRI of the brain, and direct measurement of intracranial pressure. The severity of clinical signs and MRI findings were scored. Data were statistically analyzed. The invasive intracranial pressure value was higher in affected animals. A severely altered neuroscore is related to an increased intracranial pressure beyond the normal threshold (< 0.05). The volume of the calvarium was larger in affected animals than in control animals (P = 0.0001) and was positively influenced by the presence and volume of the parasitic cyst (r = 0.7881, P < 0.01). Several degrees of deviation and deformation of both the ventricular system and brain parenchyma were detected by MRI. Subjective MRI findings were not associated with intracranial hypertension. In conclusion, this study shows that in sheep affected by slow‐growing lesions, severe alterations in the neuroscore and the results of objective MRI are related to an increased intracranial pressure beyond the normal threshold.  相似文献   

17.
Lateral digital flexor tendonitis is a rarely reported cause of hind limb lameness in performance horses. The purpose of this retrospective study was to describe clinical and diagnostic imaging findings for a group of horses with lateral digital flexor tendinitis within the tarsal sheath. Equine cases with a diagnosis of lateral digital flexor tendonitis and magnetic resonance imaging (MRI) studies of the affected region were retrieved from North Carolina University's medical record database. Recorded data for included horses were signalment; findings from history, physical examination, lameness examination, and all diagnostic imaging studies; treatment administered; and outcome. Four horses met inclusion criteria. Lameness was mild/moderate in severity and insidious in onset in all patients. Responses to flexion tests were variable. All horses showed positive improvement (70–90%) in lameness after tarsal sheath analgesia. Radiographic, scintigraphic, and ultrasonographic findings were inconclusive. For all horses, MRI characteristics included increased T2, PD, and STIR signal intensity within the lateral digital flexor tendon in the area of the tarsal sheath. Tarsal sheath effusion was slight in three horses, and mild/moderate in one horse. With medical treatment, two horses were sound at 6‐month followup, one horse was sound at 1‐year followup, and one horse had a slight persistent lameness (grade 1/5) at 9‐month followup. Findings supported the use of MRI for diagnosing lateral digital flexor tendonitis within the tarsal sheath in horses. Affected horses may have a good prognosis for return to athletic performance following appropriate medical treatment.  相似文献   

18.
Radiography, magnetic resonance imaging (MRI), and ultrasonography are commonly used for diagnosis of shoulder osteochondrosis and osteochondritis dissecans (OC/OCD) in dogs, however there is a lack of published information on the relative diagnostic sensitivities of these modalities. The purpose of this prospective study was to compare diagnostic sensitivities of these modalities for detecting shoulder OC/OCD in a group of dogs, using arthroscopy as the reference standard. Inclusion criteria were history and clinical findings consistent with osteochondrosis and/or osteochondritis dissecans involving at least one shoulder. With informed client consent, both shoulders for all included dogs were examined using standardized radiography, ultrasonography, MRI, and arthroscopy protocols. One of three veterinary surgeons recorded clinical and arthroscopic findings without knowledge of diagnostic imaging findings. One of two veterinary radiologists recorded diagnostic imaging findings without knowledge of clinical and arthroscopic findings. Eighteen client‐owned dogs (n = 36 shoulders) met inclusion criteria. Diagnostic sensitivity, specificity, and accuracy (correct classification rate) values for detecting presence or absence of shoulder osteochondrosis/osteochondritis dissecans were as follows: radiography (88.5%, 90%, 88.9%), ultrasonography (92%, 60%, 82.6%), and MRI (96%, 88.9%, 94.4%). Odds of a correct diagnosis for MRI were 3.2 times more than ultrasonography and two times more than radiography. For MRI detection of lesions, the sagittal T2 or PD‐FAT SAT sequences were considered to be most helpful. For radiographic detection of lesions, the additional supinated‐mediolateral and pronated‐mediolateral projections were considered to be most helpful. Findings from the current study support more evidence‐based diagnostic imaging recommendations for dogs with clinically suspected shoulder osteochondrosis or osteochondritis dissecans.  相似文献   

19.
The purpose of this study was to describe normal magnetic resonance imaging and computed tomographic anatomy of pastern and coffin joints in Egyptian buffalo using cadaveric distal limbs. This study was achieved using twelve fresh cadaveric distal limbs from adult healthy buffaloes of both sexes. These cadaveric limbs were scanned using a 1 Tesla MRI scanner and CT scanner, injected with red latex, frozen at −20°C for 1 week, and then sectioned into sagittal, dorsal and transverse slices. The obtained MR and CT images were selected to be matched with their corresponding anatomical cross-sections for identification and evaluation of the clinically correlated anatomical structures of the pastern and coffin joints. The difference in signal intensities on CT and MRI scans amongst the tissues allowed clear differentiation of major bone and soft tissue structures of the pastern and coffin joints. CT provided a high spatial resolution of bone and soft tissue structures, however, MRI allowed a better and higher resolution and definition between soft tissues. The current study provided a normal CT and MRI anatomic reference which could help veterinary clinicians for interpretation and diagnosis of the clinically affected pastern and coffin joints in buffalo.  相似文献   

20.
The cervical spine of 27 dogs with cervical pain or cervical myelopathy was evaluated using magnetic resonance imaging (MRI). Spin echo T1, T2, and post-contrast T1 weighted imaging sequences were obtained with a 0.5 Tesla magnet in 5 dogs and a 1.5 Tesla magnet in the remaining 22 dogs. MRI provided for visualization of the entire cervical spine including the vertebral bodies, intervertebral discs, vertebral canal, and spinal cord. Disorders noted included intervertebral disc degeneration and/or protrusion (12 dogs), intradural extramedullary mass lesions (3 dogs), intradural and extradural nerve root tumors (3 dogs), hydromyelia/syringomyelia (1 dog), intramedullary ring enhancing lesions (1 dog), extradural synovial cysts (1 dog), and extradural compressive lesions (3 dogs). The MRI findings were consistent with surgical findings in 18 dogs that underwent surgery. Magnetic resonance imaging provided a safe, useful non-invasive method of evaluating the cervical spinal cord.  相似文献   

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