Validation of two-dimensional kinematic analysis of walk and sit-to-stand motions in dogs

OBJECTIVE: To assess the intra- and interobserver repeatability of 2-dimensional (2-D) kinematic analysis of walk and sit-to-stand motions in dogs. ANIMALS: 10 healthy adult Labrador Retrievers. PROCEDURES: 10 dogs were filmed during walk and sit-to-stand motions. Five trials were recorded for each dog, 3 of which were digitized. Two observers manually marked 15 landmarks on each frame during the motions of interest for these 3 trials. Each observer repeated the procedure approximately 1 week later. The 2-D joint angles were calculated. Intra- and interobserver coefficients of multiple correlations (CMCs) were calculated for each joint angle-time history. RESULTS: Intraobserver repeatability, assessed as the mean CMCs of 12 joint angle measurements made for 10 dogs by 2 observers, was good or excellent in 23 of 24 (96%) mean CMCs of the joints measured. Interobserver variation, assessed by comparing CMCs of measurements made by 2 observers on 10 dogs on 2 days, was good or excellent in 161 of 240 (67%) CMCs of joints measured. CONCLUSIONS AND CLINICAL RELEVANCE: Intraobserver repeatability of 2-D kinematic measurements made on digitized videotapes was excellent. Interobserver repeatability of these measurements was acceptable.     

INTRA- AND INTEROBSERVER VARIABILITY OF ULTRASONOGRAPHIC MEASUREMENTS OF THE THYROID GLAND IN HEALTHY BEAGLES

The repeatability of ultrasonographic measurements of the canine thyroid gland was evaluated. The variability of three different parameters (the maximal length, width, and height) within observer, between observer and between dogs was assessed based on three different measurements made by each of three observers infive healthy beagle dogs. From the three parameters, the volume of the gland was estimated using a formula of a rotation ellipse. The height and the volume had the lowest intra- and interobserver variability, while measurements of the length had the biggest intra- and interobserver variability. The mean values, with their 90% confidence interval were: height = 0.53cm [0.33-0.73], length = 2.45cm [2.04-2.85], width = 0.62cm [0.46- 0.78], volume = 0.38 cm3 [0.20-0.55].     

Reference ranges and reliability of transabdominal ultrasonographic renal dimensions in thoroughbred horses

The aims of this study were to establish a normal reference range (mean ± 2 SD) and assess reliability of renal dimensions obtained using transabdominal ultrasonography in Thoroughbred horses (n = 7). A minimum of three ultrasonographic cineloops were obtained from each intercostal space and the left paralumbar fossa by two observers daily for three consecutive days. Renal length, width, and thickness and cortex, medulla, and pelvic dimensions were obtained. Measurements were undertaken by both observers, who were unaware of prior measurements, to assess reproducibility and measured on three separate occasions to evaluate short-term measurement repeatability. Measurements from images obtained by both operators were compared to evaluate image repeatability. The left kidney was consistently identified in the left 15th-17th intercostal space and the paralumbar fossa with maximal length in the 16th intercostal space (12.7 ± 2.0 cm) and maximal width in the paralumbar fossa (7.9 ± 1.1 cm). The right kidney was consistently identified in the right 15th-17th intercostal space with maximal length and maximal width in the 15th intercostal space (16.0 ± 0.7 cm and 7.9 ± 1.0 cm). Reproducibility, image repeatability, measurement repeatability were good to excellent, although were less good for the smaller structures. There were no differences in renal dimensions between horses. Overall renal ultrasonography was reliable and a normal reference range for Thoroughbred horses was established. Renal dimensions vary between rib spaces. As repeatability and reproducibility were excellent for renal length and width, it may be prudent to use those measurements in rib spaces where parameters were maximal.     

AGREEMENT BETWEEN A-MODE AND B-MODE ULTRASONOGRAPHY IN THE MEASUREMENT OF OCULAR DISTANCES

It is generally accepted that A-mode ultrasonography is more accurate than B-mode in measuring intraocular dimensions. Consequently, A-mode ultrasonography is the procedure of choice in ocular biometry while B-mode ultrasonography is used principally for diagnostic purposes. In this study, we investigated the agreement between measurement of intraocular distances using A- and B-mode ultrasonography on freshly enucleated camel eyes. Our results suggest that relative to average A-mode values, B-mode overestimates corneal thickness (bias = 0.06 mm) and anterior chamber depth (bias = 0.03 mm), while it underestimates lens thickness (bias = -0.11 mm), vitreous chamber depth (bias = -0.32 mm) and axial length (bias = -0.40 mm). In general, difference between A- and B-mode values is larger for deeper intraocular dimensions. This implies that the two methods are more likely to give different readings for measurements of lens thickness, vitreous chamber depth and axial length.     

Evaluation of intra- and interobserver reliability and image reproducibility to assess usefulness of high-resolution ultrasonography for measurement of anterior segment structures of canine eyes

OBJECTIVE: To evaluate the usefulness of high-resolution ultrasonography (HRUS) for measurements of anterior segment structures in canine eyes. ANIMALS: 4 clinically normal Beagles. PROCEDURE: Images were obtained from 8 eyes with a handheld 20-MHz transducer. Eleven anterior segment structures on each image were measured 5 times by 2 independent observers. Coefficients of variation (CVs) for measurements were used to assess intraobserver reliability. Interobserver reliability was assessed by comparing measurements obtained by the 2 observers from the same images. Five images were sequentially obtained from 2 locations (ie, superior and temporal) to evaluate image reproducibility. Anterior segment structures were measured once on each image; image reproducibility was assessed by use of the CV for each parameter measured. Imaging location was assessed by comparison of CV for measurements from each location. RESULTS: CVs were < 10% for observer A for all measurements except the ciliary cleft area (11.63%). The CVs were > 10% for observer B for measurements of the angle recess area (18.51%) and ciliary cleft width (17.44%) and area (16.01%). Significant differences in measurements between observers were found for 5 of 11 anterior segment structures. Imaging the superior aspect of the globe provided the most reproducible images, although image reproducibility was still somewhat variable, with the highest and lowest CVs for measurements of 33.01% and 11.32%, respectively, in the superior position. CONCLUSIONS AND CLINICAL RELEVANCE: High-resolution ultrasound images can be used to reliably measure various anterior segment structures. Clinically relevant findings in the anterior segment of canine eyes may be detectable by use of HRUS.     

Intraobserver and interobserver agreement, reproducibility, and accuracy of computed tomographic measurements of pituitary gland dimensions in healthy dogs

OBJECTIVE: To determine the reproducibility and accuracy of computed tomographic (CT) measurements of pituitary gland dimensions in healthy dogs. ANIMALS: 35 healthy sexually intact adult dogs. PROCEDURES: 2 observers independently viewed CT images of the skull in 35 dogs twice. Pituitary gland height, width, length, and volume and pituitary gland height-to-brain area ratio (P:B ratio) were measured or calculated. Intraobserver and interobserver agreement indexes (AIs) were calculated for pituitary gland dimensions. Computed tomography was performed also on 5 phantoms, and both observers measured phantom dimensions twice. True-value AIs were calculated for the phantom study. RESULTS: The mean +/- SD interobserver AI between observer 1 and 2 for pituitary gland height and the P:B ratio was 0.90 +/- 0.07. The intraobserver AI for pituitary gland height and the P:B ratio was 0.97 +/- 0.04 for observer 1 and 0.94 +/- 0.04 for observer 2. The intra and interobserver AIs for the other dimensions were lower than those for pituitary gland height and the P:B ratio. All phantom dimensions on CT images were underestimated significantly, compared with their true values. CONCLUSIONS AND CLINICAL RELEVANCE: The intra- and interobserver AIs for pituitary gland dimension measurements on CT images were high. However, the same observer preferably should perform serial measurements. Window settings influence pituitary gland dimension measurements, and predetermined window settings are recommended to make comparisons among dogs. Pituitary gland dimension measurements made from CT images in our study underestimated the true values.     

REPEATABILITY AND REPRODUCIBILITY OF TRANSABDOMINAL ULTRASONOGRAPHIC INTESTINAL WALL THICKNESS MEASUREMENTS IN THOROUGHBRED HORSES

The aims of this study were to assess the repeatability and reproducibility of transabdominal ultrasonography to assess intestinal wall thickness in adult Thoroughbred horses (n=8). Ultrasonographic cineloops were captured by one examiner from each horse for five consecutive days. During each examination at least three cineloops were obtained for five different intestinal tract locations. Measurements were performed by three separate observers to assess reproducibility and measured on three separate occasions by three observers to evaluate short‐term repeatability. The repeatability of measurements from the duodenum (0.3 ± 0.04 cm), jejunum (0.29 ± 0.05 cm), ventral colon (0.37 ± 0.01 cm), and cecum (0.42 ± 0.03 cm) were good ( P >0.291). The reproducibility of measurements from the duodenum, jejunum, and ventral colon were good ( P >0.394). Reproducibility of measurement of the cecal wall was inadequate ( P =0.01), although the maximum difference between observers was 0.07 cm. It was possible to image all areas on all days, with the exception of the duodenum, which could not be imaged in one horse, on 1 day. Equine intestinal wall measurements are therefore repeatable and reproducible with the exception of reproducibility of the measurements of cecal wall. Although an accepted clinical technique, measurement of cecal wall thickness from intestinal ultrasound images in a clinical setting must be interpreted with care.     

Effects of animal position and number of repeated measurements on selected two-dimensional and M-mode echocardiographic variables in healthy dogs

OBJECTIVE: To evaluate the effects of positioning and number of repeated measurements on intra- and interobserver variability of echocardiographic measurements in dogs. DESIGN: Prospective study. ANIMALS: 4 healthy dogs. PROCEDURE: Each observer performed 24 examinations, separately assessing each dog 6 nonconsecutive times (3 times with the dog in lateral recumbency and 3 with the dog in a standing position). Variables evaluated included M-mode measurements of left ventricular end-diastolic and left ventricular end-systolic diameters, left ventricular free-wall thickness in diastole and systole, interventricular septal thickness in diastole and systole, left ventricular shortening fraction, and 2-dimensional measurements of the left atrial diameter-to-aortic diameter ratio. RESULTS: All coefficients of variation (range, 3.4% to 26.6%) were similar between operators and positions and were < 15% for 27 of 32 values. For both operators, repeatability of the measurements was better for left ventricular end-systolic diameter, left ventricular free-wall thickness in diastole, left ventricular free-wall thickness in systole, and the left atrial diameter-to-aortic diameter in the standing position, and similar for both positions for shortening fraction and left ventricular end-diastolic diameter. No effect of cardiac cycle was observed. CONCLUSIONS AND CLINICAL RELEVANCE: Within-day variability of conventional echocardiography performed with the dog in the standing position was at least as good as that obtained with the dog in lateral recumbency for most measured variables. Single measurements of each variable may be sufficient for trained observers examining dogs that do not have an arrhythmia. The standing position should be used, particularly for stressed or dyspneic dogs.     

ASSESSMENT OF THE REPEATABILITY OF FELINE ECHOCARDIOGRAPHY USING CONVENTIONAL ECHOCARDIOGRAPHY AND SPECTRAL PULSE-WAVE DOPPLER TISSUE IMAGING TECHNIQUES

The objective of this study was to determine the intraoperator, intraobserver, and interobserver repeatability in a series of conventional echocardiographic parameters and in some of the newer measurements of diastolic function, including color M-mode flow propagation velocity, isovolumic relaxation time and pulsed-wave Doppler tissue imaging velocities. Four healthy cats were each scanned five times over a 3-day period. The repeatability of these echocardiographic analyses was compared using Bland-Altman analysis (intraoperator repeatability). After a minimum of 5 weeks, one scan was randomly selected from each cat, and was remeasured by the original observer and the results compared using a standard paired Student's t-test (intraobserver repeatability). One scan from each cat was then randomly selected and two observers, with similar levels of experience, measured each of these scans. The repeatability of these echocardiographic analyses was compared using Bland-Altman analysis (interobserver repeatability). The conventional two-dimensional (2D), M-mode and spectral Doppler measurements were repeatable in both their acquisition and measurement by a single investigator; there was a greater degree of variation between the two observers. The predominant (S', E', and A') pulsed-wave Doppler tissue imaging velocities from the left apical four-chambered view, generally had a coefficient of variation of approximately 20% (range 9.62-34.08%). However, with pulsed-wave Doppler tissue imaging, velocities recorded during the isovolumic phases, the velocity of the tricuspid annulus, and the radial fiber velocity within the interventricular septum, frequently had coefficients of variation in excess of 20% and should therefore be interpreted with caution.     

An interobserver and intraobserver study of buccal mucosal bleeding time in Greyhounds

Two observers experienced with the buccal mucosal bleeding-time technique using a standardised device (Surgicutt) performed the test on 20 Greyhounds, to evaluate interobserver and intraobserver repeatability. The interobserver and intraobserver repeatability were both about 2 minutes. The results indicated that, for any two readings within a dog, the buccal mucosal bleeding time may differ by up to +/- 2 minutes. A single reading was accurate to within +/- 80 seconds. Sixty-one Greyhounds were used to establish a reference interval for the buccal mucosal bleeding time, and to assess the relationship between the buccal mucosal bleeding time and plasma von Willebrand factor concentration. The mean was 129.5 (SD 44.2) seconds. The reference interval was 53 to 235 seconds, which was slightly lower than non-greyhounds. No significant correlation (r=-0. 18, P=0.17) between the buccal mucosal bleeding time and plasma von Willebrand factor concentration was found in the 61 Greyhounds, where plasma von Willebrand factor concentration was in the range 29 to 160 Canine Units dL(-1).     

Normal Canine Prostate Gland: Repeatability,Reproducibility, Observer‐Dependent Variability of Ultrasonographic Measurements of the Prostate in Healthy Intact Beagles

Most prostatic diseases in dogs are associated with prostatomegaly, and transabdominal ultrasonography has become the imaging modality of choice for evaluation of the prostate gland in the dog. The aim of the present study was to assess the reproducibility, the repeatability and interobserver variations of sonographic measurements of prostate and to determine which measurement had the lowest variability. Length and height of prostate gland were measured on longitudinal views, width of the prostate gland and height of left and right lobes of the gland on transversal views. The within‐day and between‐day variabilities of the prostatic parameters were determined by performing 1350 (270 length, 270 height, 270 width, 270 height of right lobe and 270 height of left lobe) examinations on ten healthy intact beagle dogs on six different days, in a two‐week period (three days for the five dogs, three different days for the five others). Three observers with different levels of experience in ultrasonography performed the examinations. The lowest within‐day and between‐day standard deviation and coefficient of variation values were observed for the width of the prostate. The width of the gland measured on transverse frozen images seems to be the most reliable measurement for evaluating size of prostate glands in healthy dogs, although the shape, position, outline, and echogenicity of the prostate should also be assessed.     

Observer variation in field data describing foot shape in dairy cattle

A qualitative scoring method was devised to describe foot shape in dairy cattle, which relied solely on visual observations. Four independent trained observers used the method to assess the foot shape of 248 cows located on three farms on two different occasions, and the percentages of agreement and near-agreement for intra-observer and interobserver variation on scores for foot shape were calculated. Score assessment methods were suitable for describing features with a broad variation within one score value; reducing the number of observers did not improve best agreement between separate observations by more than 80 per cent.     

Ocular complications of persistent hyperplastic primary vitreous in three dogs

Persistent hyperplastic primary vitreous (PHPV) syndrome associated with either severe ocular complications or multiple ocular lesions was diagnosed in three young dogs, a Samoyed, a Spanish Pachon, and a mixed breed dog. Due to opacification of the anterior ocular structures, B-mode and color-flow Doppler ultrasonography were performed to aid diagnosis. The Samoyed presented with unilateral hyphema; the Spanish Pachon presented with unilateral secondary glaucoma associated with uveitis and hyphema OD and leucocoria OU; and the mixed breed presented with bilateral leucocoria. B-mode ultrasonography of the Samoyed revealed a subcapsular cataract and a hyperechoic tubular structure attached from the optic disk to the posterior lens capsule. In the Spanish Pachon B-mode ultrasonography of the right eye indicated microphakia, cataract formation, and a retrolental mass with a thin hyperechoic strand stretching from the optic disk to the posterior lens; and for the right eye cataract formation, PHPV, retinal detachment, and vitreous hemorrhage. In the mixed breed dog, B-mode ultrasonography of both eyes indicated microphthalmia, retrolental mass, and hyperechoic lenses. By color-flow Doppler imaging, blood flow was present in the retrolental mass of the right eye suggesting a persistent hyaloid artery.     

Doppler ultrasonographic features of thoracic limb arteries in clinically normal horses

OBJECTIVES: To determine blood flow velocities and indices from spectral waveforms obtained by use of Doppler ultrasonography of thoracic limb arteries of horses and to assess interobserver and patient variability associated with the technique. ANIMALS: 9 clinically normal adult horses. PROCEDURE: Left thoracic limb arteries of 8 nonsedated horses were examined at 5 sites by use of pulsed-wave Doppler ultrasonography to determine a range of values for peak systolic, end diastolic, and mean velocities and resistive and pulsatility indices. Interobserver and patient variabilities were determined by 2 operators repeating similar measurements on 1 horse 8 times at weekly intervals. RESULTS: A range of values for each variable measured at the 5 selected sites was obtained. For each variable, strong positive correlations (R > or = 0.7) were detected for > 70% of the site-to-site comparisons made (excluding the coronary band). Among horses, resistive index varied least, whereas over time, mean velocity varied least. Waveform characteristics were consistent with resistive (n = 5) or nonresistive (4) patterns. In the single-horse experiment, waveform characteristics were consistent throughout the 8 weeks, and operator effects were not detected. CONCLUSIONS AND CLINICAL RELEVANCE: Doppler ultrasonography of no one site resulted in more reliable measurements of blood flow characteristics in thoracic limb arteries of horses. Mean velocity and resistive index were the least variable measurements made. Pulsed-wave Doppler ultrasonography may be a useful technique for evaluating diseases that alter normal thoracic limb arterial blood flow in horses.     

TWO-DIMENSIONAL ECHOCARDIOGRAPHY IN THE NORMAL CAT

Two-dimensional echocardiography (2DE) and M-mode echocardiography were used to image the heart of 13 clinically healthy cats. Seven awake cats and six cats tranquilized with a combination of acetylpromazine and ketamine were studied. Six cats were studied by 2DE on 3 consecutive days to assess repeatability of the study. Long-axis and short-axis echocardiographic tomograms were obtained from the right parasternal location, and these images were used to determine internal cardiac dimensions, ventricular and septal wall thicknesses, repeatability of the study, and interobserver variability. Some but not all parameters were significantly (P < 0.05) related to body weight. Significant correlations (P <0.05) were found between measurements obtained by long-axis and by short-axis image planes. Comparison of parameters measured by 2DE and M-mode echocardiography demonstrated minimal differences between mean values. Repeatability of the 2DE study was good with 14 of 16 parameters having a mean percent error less than 10%. Interobserver variability was acceptable for some but not all parameters. The study indicates that repeatable 2DE tomograms can be obtained in the cat and that quantitation of cardiac anatomy is possible with this imaging technique.     

Repeatability and Intra‐ and Inter‐observer Agreement of Cervical Vertebral Sagittal Diameter Ratios in Horses with Neurological Disease

Background

Sagittal ratio values (SRVs) of cervical vertebrae are used for ante‐mortem diagnosis of cervical vertebral stenotic myelopathy, but intraobserver and interobserver variability in measurement may influence radiographic interpretation of vertebral stenosis in horses with neurological disease.

Objectives

To determine intraobserver repeatability in SRVs, intra‐ and interobserver agreement in SRVs and whether or not agreement was influenced by animal age.

Animals

Forty‐two horses (>1 year old) with neurological disease from which laterolateral computed radiographic images of C2–C7 were obtained.

Methods

Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra‐ and intervertebral SRVs was determined using Bland–Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and >3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined.

Results

Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3–4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were >0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites.

Conclusions and Clinical Importance

Within and between observers, measurement error may limit the diagnostic accuracy of SRVs and result in discrepancies of diagnosis and treatment and warrants consideration when used clinically in horses with neurological disease.     

DOPPLER ULTRASONOGRAPHIC ESTIMATION OF RENAL AND OCULAR RESISTIVE AND PULSATILITY INDICES IN NORMAL DOGS AND CATS

Resistive index (RI) and pulsatility index (PI) are indirect measurements of blood flow resistance that may be used to evaluate vascular changes in renal and ophthalmologic diseases. To our knowledge, no reports are available describing values for renal and ocular PI index in the unsedated dog and ocular RI and PI indices in the unsedated cat. The purpose of this study was to measure normal values for both intrarenal and ocular RI and PI within the same subject in unsedated clinically normal dogs and cats. Twenty-seven dogs and 10 cats were considered healthy by means of physical examination, CBC, biochemical profile, urinalysis, and ultrasonography. Systolic blood pressure was measured by Doppler ultrasonography. Intrarenal and ocular arteries were scanned by pulsed Doppler ultrasonography to calculate RI and PI. No significant differences were noted between the values obtained for the right vs. the left kidney and eye. The upper values of these indices were calculated as mean+2 standard deviations resulting in 0.72 and 1.52 for dog renal RI and PI; 0.7 and 1.29 for cat renal RI and PI; 0.76 and 1.68 for dog ocular RI and PI; and 0.72 and 1.02 for cat ocular RI and PI.     

Observer agreement study of cervical-vertebral ratios in horses

Reason for performing study: Different examiners or the same examiner were observed at different times producing slightly different results when obtaining cervical‐vertebral ratios. If the difference is substantial, then measurement variability would have an important impact of radiographic interpretation. Objective: To quantify agreement and repeatability of these measurements. Methods: An observer agreement study was performed using 75 horses. Measurements were made at C3–4 and C6–7 by a board‐certified radiologist and an imaging resident. Intra‐ and interobserver agreement was quantified using Bland‐Altman plots. Repeatability was assessed as the percentage of differences between duplicate measurements by the radiologist that were within ± 2 s.d. of the differences. Results: At C3–4, the limits of agreement for the intra‐vertebral ratio were between ‐5 and 4% for the intra‐ and ‐5 and 6% for interobserver comparison. For the intervertebral ratio, they were between ‐9 and 8% for the intra‐ and ‐10 and 10% for interobserver comparison. At C6–7, the limits of agreement for the intra‐vertebral ratio were between ‐6 and 5% for the intra‐ and ‐6 and 8% for interobserver comparison. For the intervertebral ratio, they were between ‐7 and 7% for the intra‐ and ‐6 and 13% for interobserver comparison. At C3–4, all measurements were 95% repeatable (differences typically ≤4% and always ≤8%) for the intra‐vertebral ratio and 96% repeatable (differences typically ≤8% and always ≤11%) for the intervertebral ratio. At C6–7, all measurements were 98% repeatable (differences typically ≤6% and always ≤7%) for the intravertebral ratio and 92% repeatable (differences typically ≤6% and always ≤10%) for the intervertebral ratio. Conclusions: Cervical‐vertebral ratios typically varied by 5–10% within and between examiners. Potential relevance: When using cervical‐vertebral ratios in practice, the impact of measurement agreement should be factored into the interpretation of the test result because measurement variability may lead to misdiagnosis and limit the clinical usefulness of these tests.     

Observer variability of tibial plateau slope measurement in 40 dogs with cranial cruciate ligament-deficient stifle joints

OBJECTIVE: To determine (1) the inter- and intraobserver variability in measurement of tibial plateau angle (TPA), (2) whether this inter- and intraobserver variability is related to the characteristics of the dog (age, size, and amount of degenerative joint disease [DJD]) and the experience level of the observer, and (3) the extent of any relationship between interobserver variability of TPA and the variability of the observers' selection of the specific cranial and caudal points along the tibial plateau. STUDY DESIGN: Examination of tibial radiographs of 40 dogs clinically affected with a cranial cruciate ligament (CrCL)-deficient stifle joint. METHODS: Eleven different observers, divided into 3 groups based on their level of experience with the tibial plateau leveling osteotomy (TPLO) technique, measured the TPA on all 40 radiographs on 5 different occasions. The degree of DJD present in the stifle joint was independently graded as an overall measure and then again as it specifically related to the cranial and caudal points along the tibial plateau. The total observed variabilities of the TPA were assessed with reference to interobserver differences, intraobserver differences, and among the groups of observers with respect to the different dog characteristics. Finally, the specific points selected on the radiographs were reexamined to determine whether any variability was present in cranial and caudal point selection. RESULTS: The interobserver standard deviation of the TPA measurements for each dog was 0.8 degrees, and the intraobserver standard deviation was 1.5 degrees. The TPA measurements obtained by the 11 observers differed significantly from each other (P <.001); however, there was no significant difference of TPA among the different groups of observers (P =.67). There was no significant correlation observed between either the inter- or intraobserver variability and the dog characteristics. Specific point data and their relationship to the various variables of dog characteristics and inter- and intraobserver TPA variability revealed significant correlations only to the amount of DJD present at the caudal point (P =.001). CONCLUSIONS: Interobserver variation, but no significant group variation, was present. Overall DJD did not appear to be related to the variability in TPA angle measurement. Most of the interobserver variability was attributable to variability in horizontal point selection at both the cranial and caudal points and vertical point selection at the caudal point. It appears that degenerative changes that specifically obscure the points on the tibial plateau, especially at the caudal point, are responsible for most of the interobserver variation. CLINICAL RELEVANCE: The desired postoperative TPA of 5 degrees is dependent on a precise initial measure of TPA preoperatively. This study indicates that there is statistically significant interobserver variability with measurement of TPA, which, therefore, can result in a similar amount of variability with the final tibial plateau slope obtained postoperatively.     

COMPARISON OF NONCONTRAST COMPUTED TOMOGRAPHY AND HIGH‐FIELD MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF GREAT DANES WITH CERVICAL SPONDYLOMYELOPATHY

Computed tomography (CT) provides excellent bony detail, whereas magnetic resonance (MR) imaging is superior in evaluating the neural structures. The purpose of this prospective study was to assess interobserver and intermethod agreement in the evaluation of cervical vertebral column morphology and lesion severity in Great Danes with cervical spondylomyelopathy by use of noncontrast CT and high‐field MR imaging. Fifteen client‐owned affected Great Danes were enrolled. All dogs underwent noncontrast CT under sedation and MR imaging under general anesthesia of the cervical vertebral column. Three observers independently evaluated the images to determine the main site of spinal cord compression, direction and cause of the compression, articular process joint characteristics, and presence of foraminal stenosis. Overall intermethod agreement, intermethod agreement for each observer, overall interobserver agreement, and interobserver agreement between pairs of observers were calculated by use of kappa (κ) statistics. The highest overall intermethod agreements were obtained for the main site of compression and direction of compression with substantial agreements (κ = 0.65 and 0.62, respectively), whereas the lowest was obtained for right‐sided foraminal stenosis (κ = 0.39, fair agreement). For both imaging techniques, the highest and lowest interobserver agreements were recorded for the main site of compression and degree of articular joint proliferation, respectively. While different observers frequently agree on the main site of compression using both imaging techniques, there is considerable variation between modalities and among observers when assessing articular process characteristics and foraminal stenosis. Caution should be exerted when comparing image interpretations from multiple observers.