Vet360 Vol 4 Issue 4 August 2017 Vet 360 - Page 30

ADVERTORIAL for wobblers too. MRI will always be better at show- ing intervertebral disc protrusions, and tumours, but a correctly exposed CT can give a lot of information, and once again, may be available when MRI is not an option. Also, a CT myelogram provides excellent diag- nostic image quality. Orthopaedics CT truly comes into its own for orthopaedic work within veterinary medicine Figure 1: CT of the elbow joint If you are looking for Incomplete Ossification of Hu- meral condyles, or Fragmented Coronoid process- es you can see much more detail than you ever will from a plain radiograph. Some PACS systems include option for surgery planning, which allows you a full reconstruction view and ability to import the desired option of implant to allow for informed surgical deci- sions prior to the surgery. Elbows The elbow is a joint where good quality CT images can be used to assess small bone fragments, as con- ventional X-rays have a 2D representation of a 3D structure which in turn makes it hard to accurately assess where a fragment of bone or a irregularity are. The ability to view the elbow from all angles with the sagittal and axial plains does increase the diagnostic accuracy above that of plain films. (Figure 1) Stifles Once again the ability to perform 3 dimensional re- constructions of CT images means that for accurately assessing the stifle CT can be very valuable, especially of you want to assess the shape of the intercondylar notch. A study in 2009 (Sammii et al) found a sen- sitivity and specificity of up to 100 per cent for the identification of tears of the cranial cruciate ligament Figure 2: CT of the hock joint Hocks The hock is such a complicated joint, that a CT scan would be imperative work out which bones are in- volved in a complexed pathology, to help with surgical planning, and for prognosis. (Figure 2) For more information on vet-specific CT scanners or other imaging equipment op- tions, contact Tim Perks at BCF Technology South Africa +27 82 616 4685 www.bcftech- nology.co.za Summary Whenever you take a radiograph you are trying on a plain image to take a 3D structure and look at it as if it’s a 2D struc- ture, but with CT you can see much more minor changes in detail. The ability to generate a 3D model of a malformed bone and use it for surgical planning is a great step toward a successful surgery and patient recovery. CT is also becom- ing more regularly used for design of custom made implants for specific surgeries. The quality of the 3D reconstructions available now is remarkable – the ability to rotate an image around on the screen in front of the owner gives you a great tool for explaining exactly what the issue is, and how you are intending to treat it. All modern CT scanners now enable you to do 3D reconstructions, which can better enable you to visualise the pathol- ogy and how it is affecting the body, and the best surgical route to it, for biopsy or removal. The main thing to remember though when considering the imaging modality for any patient, is the balance of the infor- mation you will receive against the time, radiation dose and money that it will cost. CT will never replace plain X-ray for the initial assessment of a critically injured patient, and careful consideration should always be made, and asking the advice of a Veterinary Radiologist prior to scanning can help you to ensure the right modality is being used. vet360 Issue 04 | AUGUST 2017 | 30