{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:17:04Z","timestamp":1788927424690,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Veterinary Surgery"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine cutoff values for the diagnosis of atlantoaxial instability (AAI) based on cross\u2010sectional imaging in small\u2010breed dogs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Retrospective multicenter study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample population<\/jats:title><jats:p>Client\u2010owned dogs (<jats:italic>n<\/jats:italic> =\u2009123) and 28 cadavers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Dogs were assigned to three groups: a control group, a \u201cpotentially unstable\u201d group, and an AAI\u2010affected group, according to imaging findings and clinical signs. The ventral compression index (VCI), cranial translation ratio (CTR), C1\u2010C2 overlap, C1\u2010C2 angle, atlantoaxial distance, basion\u2010dens interval, dens\u2010to\u2010axis length ratio (DALR), power ratio, and clivus canal angles were measured on CT or T2\u2010weighted magnetic resonance (MR) images. Receiver operating characteristic (ROC) analysis was performed to define cutoff values in flexed (\u226525\u00b0) and extended (&lt;25\u00b0) head positions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cutoff values for the VCI of \u22650.16 in extended and\u2009\u22650.2 in flexed head positions were diagnostic for AAI (sensitivity of 100% and 100%, specificity of 94.54% and 96.67%, respectively). Cutoff values for the other measurements were defined with a lower sensitivity (75%\u201096%) and specificity (70%\u201097%). A combination of the measurements did not increase the sensitivity and specificity compared with the VCI as single measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cutoff values for several imaging measurements were established with good sensitivity and specificity. The VCI, defined as the ratio between the ventral and dorsal atlantodental interval, had the highest sensitivity and specificity in both head positions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical significance<\/jats:title><jats:p>The use of defined cutoff values allows an objective diagnosis of AAI in small\u2010breed dogs. The decision for surgical intervention, however, should remain based on a combination of clinical and imaging findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vsu.13799","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T07:57:56Z","timestamp":1647417476000},"page":"620-630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small\u2010breed dogs"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0368-2302","authenticated-orcid":false,"given":"Bastien","family":"Planchamp","sequence":"first","affiliation":[{"name":"Division of Small Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9026-9326","authenticated-orcid":false,"given":"Franck","family":"Forterre","sequence":"additional","affiliation":[{"name":"Division of Small Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9693-2301","authenticated-orcid":false,"given":"Beatriz","family":"Vidondo","sequence":"additional","affiliation":[{"name":"Veterinary Public Health Institute, Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty University of Bern  Liebefeld Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1771-7214","authenticated-orcid":false,"given":"Angel M.","family":"Hernandez\u2010Guerra","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine and Surgery Universidad Cardenal Herrera\u2010CEU, CEU Universities  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis N.","family":"Plessas","sequence":"additional","affiliation":[{"name":"Davies Veterinary Specialists Limited  Hitchin UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3481-4737","authenticated-orcid":false,"given":"Martin J.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Clinic for Small Animals, Department of Veterinary Clinical Sciences, Justus\u2010Liebig\u2010 University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja A.","family":"Waschk","sequence":"additional","affiliation":[{"name":"Clinic for Diagnostic Imaging, Vetsuisse Faculty University of Z\u00fcrich  Z\u00fcrich 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