Magnetic resonance imaging of the normal canine thyroid gland.

The magnetic resonance (MR) imaging features of the normal canine thyroid gland were retrospectively compiled from images acquired in 44 dogs presented for a variety of diseases unrelated to the thyroid gland. The appearance of the thyroid gland on different sequences, including pre- and postcontrast T1-weighted, T2-weighted, two-dimensional gradient echo, three-dimensional T2*-weighted gradient echo and proton density weighted images, were described in different image planes. The characteristic shape, location, and intensity of thyroid lobes compared with surrounding structures made them easily detectable in all dogs. The most common location of the thyroid lobes was dorsolateral to the trachea with the maximal cross-sectional area of the lobes located ventral to C2/3 or C3 in more than 85% of the dogs. The majority of the lobes were ovoid on transverse images. An isthmus was seen in one large dog and parathyroid glands could not be seen. The mean maximal thyroid lobe diameter on transverse images was 8.1 mm, being twice the mean diameter of the common carotid artery. Considering the excellent conspicuity and characteristic appearance of the canine thyroid gland, MR imaging can be beneficial in the diagnosis of diffuse thyroid diseases, in differentiating thyroid vs. nonthyroid neck masses and in staging and treatment planning of thyroid tumors in this species.     

Diagnosis of laryngeal dysplasia in five horses using magnetic resonance imaging and ultrasonography

Reasons for performing study: Laryngeal dysplasia due to suspected maldevelopment of the fourth branchial arch has been reported previously in the horse and has been associated with rostral displacement of the palatopharyngeal arch and/or right laryngeal dysfunction. These studies all described the endoscopic and/or anatomical post mortem identification of the disease, but ultrasonography or magnetic resonance imaging (MRI) of this disease have not been described. Hypothesis: MRI and ultrasound findings accurately reflect the anatomical features of presumptive fourth branchial arch abnormality and allow accurate ante mortem diagnosis of this condition and, therefore, appropriate management. Methods: Between February 2008 and January 2009, all horses examined at Rood and Riddle Equine Hospital diagnosed with rostral displacement of the palatopharyngeal arch and/or right laryngeal dysfunction using upper airway endoscopy (n = 5) underwent ultrasonography and MRI of the laryngeal region. Results: All 5 horses that met the inclusion criteria were identified and all underwent laryngeal MRI and ultrasound examinations. Features consistent with laryngeal dysplasia, including lack of the cricothyroid articulation, dorsal extension of the thyroid cartilage lamina, and absence or hypoplasia of the cricopharyngeus muscle, were seen in all cases using both types of imaging. Conclusions and potential relevance: MRI and ultrasonography permit definitive premortem diagnosis of laryngeal dysplasia. Upper airway abnormalities identified using endoscopy can be more fully characterised using MRI and ultrasonography allowing more appropriate recommendations to be made. Preoperative imaging may also prevent inappropriate surgical intervention.     

Comparison of the navicular region of newborn foals and adult horses by magnetic resonance imaging

Magnetic resonance imaging (MRI) was tested for evaluation of the soft tissue structures of the equine digit in 16 limbs, derived from three adult warmblood horses and two newborn warmblood foals. The following measuring sequences were used in sagittal, transversal and coronal planes: spin echo, gradient echo, inversion recovery. The images were made with a 1.5 Tesla Siemens scanner in a CP-Helmholtz circular coil. To compare the visualization of the same tissue structures in adult and in newborn cases the limbs were imaged with the routinely used MRI sequences that are used for mature tissues. In newborn foals the bursa podotrochlearis could not be determined with the used sequences. For both the adult and newborn limbs the most visualization of the same tissue structures including the fluid spaces and growth plates were taken by the inversion recovery sequence. T2 sequence was very informative in adult cases but moderately in newborn foals.     

Thin-slice three-dimensional gradient-echo magnetic resonance imaging of the pituitary gland in healthy dogs

OBJECTIVE: To evaluate thin-slice 3-dimensional gradient-echo (GE) magnetic resonance imaging (MRI) of the pituitary gland in healthy dogs. ANIMALS: 11 healthy dogs. PROCEDURES: By use of a 0.2-Tesla open magnet, MRI of the skull was performed with T1-weighted GE sequences and various protocols with variations in imaging plane, slice thickness, and flip angle before and after administration of contrast medium; multiplanar reconstructions were made. The pituitary region was subjectively assessed, and its dimensions were measured. Image quality was determined by calculation of contrast-to-noise and signal-to-noise ratios. RESULTS: Best-detailed images were obtained with a T1-weighted GE sequence with 1-mm slice thickness and 30 degrees flip angle before and after administration of contrast medium. Images with flip angles > 50 degrees were of poor quality. Quality of multiplanar reconstruction images with 1-mm slices was better than with 2-mm slices. The bright signal was best seen without contrast medium. With contrast medium, the dorsal border of the pituitary gland was clearly delineated, but lateral borders were more difficult to discern. CONCLUSIONS AND CLINICAL RELEVANCE: MRI of the canine pituitary gland with a 0.2-Tesla open magnet should include a T1-weighted GE sequence with 1-mm slice thickness and flip angle of 30 degrees before and after administration of contrast medium. The neurohypophysis was best visualized without contrast medium. The MRI examination permitted differentiation between the pituitary gland and surrounding structures.     

Comparison of lameness outcomes in horses with acute or chronic digital lameness that underwent magnetic resonance imaging

ABSTRACT

Aims: To compare the outcome, in terms of lameness score or return to athletic function, of horses with acute vs. chronic digital lameness that underwent magnetic resonance imaging (MRI) of the distal limb and to compare the proportion of horses that received intra-articular therapy of the distal interphalangeal (DIP) joint and pattern of diagnostic analgesia in these groups.

Methods: This is a retrospective study of horses (n?=?95) with acute (≤12 weeks; n?=?46) or chronic (>12 weeks; n?=?49) digital lameness that underwent MRI of the distal limb from 2009–2016, at two equine referral centres in the USA. Criteria for inclusion in the study were that a majority of lameness localised distal to the fetlock, and that lameness assessments for ≥12 months following MRI could be obtained from the medical record or the owner could be interviewed regarding their horse's athletic function. Outcome was characterised by an improvement score where 2?=?return to work at a previous or higher level or lameness improved by one grade or more, 1?=?return to work at a lower level or lameness improved by less than one grade, and 0?=?did not return to work or lameness grade worsened. Whether horses had received intra-articular therapy of the DIP joint and the pattern of diagnostic analgesia prior to MRI was also obtained from medical records or by interviewing the owner.

Results: There was a difference (p?=?0.004) in the proportion of horses assigned to improvement scores of 0, 1 and 2 between horses with acute or chronic lameness. There was no evidence of a difference in the likelihood of having received intra-articular therapy of the DIP joint prior to MRI between horses with chronic or acute lameness (p = 0.085). Similarly, there was no evidence of a difference in the pattern of diagnostic analgesia prior to MRI between the two groups (p = 0.94). Eighty-two percent of owners of horses with acute and 62% of those with horses with chronic lameness had a positive opinion of the utility of MRI as a diagnostic modality.

Conclusion: In a population of horses with digital lameness undergoing MRI, a difference in the outcome, in terms of lameness score or return to athletic function was identified between horses with acute lameness compared to those with chronic lameness.

Clinical relevance: Horses with digital lameness that undergo MRI when the lameness is acute may have an improved prognosis due to accurate diagnosis and earlier application of appropriate therapy.     

Pharmacokinetics of acyclovir in adult horses

Objective: To determine the pharmacokinetics of acyclovir administered intravenously (IV) and orally to healthy adult horses. Design: Random cross‐over with an approximate 1‐week washout period between trials. Setting: University veterinary medical teaching hospital. Animals: Six healthy adult research herd horses. Interventions and main results: Acyclovir was administered IV (10 mg/kg in 1 L isotonic crystalloid solution over 60 minutes) and orally (20 mg/kg) to healthy adult horses. Plasma samples were obtained and acyclovir concentrations were determined by high‐pressure liquid chromatography. Peak concentration (mean±SD) for IV acyclovir was 13.74±5.88 μg/mL at the completion of the 1‐hour infusion. The half‐life of the distribution phase (α) was 0.16 hours while the half‐life of the elimination phase (β) was 9.6 hours. The steady‐state volume of distribution was 3.93±1.21 L/kg. We were unable to measure pharmacokinetics after PO acyclovir as plasma concentrations were below the lower limits of detection in all 6 horses. Conclusions: IV administration of acyclovir to healthy adult horses achieves concentrations within the sensitivity range described for equine herpes virus‐type 1. The oral bioavailability of acyclovir in horses is low and additional studies are required.     

Thrombelastography in 26 healthy horses with and without activation by recombinant human tissue factor

Objectives – To develop a standardized technique for thrombelastography (TEG) analysis in healthy adult horses, with and without the ex vivo addition of tissue factor (TF) as an activator. To determine reference intervals for TEG parameters in the horse, and to determine if traditional coagulation tests correlate with TEG. Design – Prospective, observational. Setting – Veterinary teaching hospital. Animals – Twenty‐six healthy adult horses. Interventions – None. Measurements and Main Results – Thrombelastography with (TF‐TEG) and without (TEG) the addition of TF performed by 4 operators. Coagulation profiles (prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen, antithrombin, and fibrinogen degradation products) were assessed in a subset of horses. Mean values (SD) for TEG parameters in healthy horses were: reaction time (R)=17.0 minutes (3.0 min), K time (K)=5.8 minutes (2.3 min), clotting rate (Ang)=42° (14°), maximum clot strength (maximum amplitude [MA])=60.3 mm (5.7 mm), CL30=97.0% (2.0%), LY30=0.8% (0.6%), CL60=92% (5.9%), LY60=3.2% (2.5%). Mean values (SD) for TF‐TEG parameters were: R‐TF=6.6 minutes (1.4 min), K‐TF=3.1 minutes (1.0 min), Ang‐TF=50.9° (9°), MA‐TF=62.3 mm (5.1 mm), CL30‐TF=97.8% (1.6%), LY30‐TF=0.6% (0.5%), CL60‐TF=90.8% (4.2%), and LY60‐TF=3.6% (1.9%). The addition of TF decreased R and K and increased Ang. TF‐TEG had a narrower SD for R, K, Ang, CL60 and LY60 compared with TEG. Interoperator differences were reduced by the addition of TF. Regression analysis indicated a positive relationship between MA and fibrinogen concentrations (P=0.02) and R‐TF time and prothrombin time (P=0.03). Conclusion – TF‐TEG using the described protocol may minimize variability in data obtained across institutions or users. However, due to the variability associated with different operators, it is recommended that each laboratory set up individual reference intervals with the personnel who will perform the assay, and that the assay protocols and data obtained are compared on a regular basis.     

The use of magnetic resonance imaging for the assessment of distal limb wounds in horses: A pilot study

The utility of magnetic resonance (MR) imaging in the evaluation of equine solar foot penetrations is well established. The objective of this pilot study was to evaluate the utility of MR imaging in assessment of equine distal limb wounds excluding solar penetrations. Low-field MR images of 23 horses that had previously sustained distal limb wounds were reviewed in consensus by two ECVDI diplomats. Structures (bone; synovial structure; subcutaneous tissue and skin; and ligament/tendon) were identified as normal or abnormal on MR images, radiographs and ultrasound images and reports. All abnormalities were described. The presence of artefacts and their effect on image interpretation were also noted for each modality. Comparisons were made between imaging modalities, and it was noted if MR imaging influenced case management. Abnormalities of the bone were identified in 26% of horses on MR images and 17% of horses on radiographs; there were no osseous abnormalities identified on radiographs that were not identified on MR images, and additional features and better characterisation of lesions were noted on MR images. Tendon/ligament abnormalities were identified in 57% horses on MR and 47% of horses on ultrasound images. Magnetic susceptibility artefacts compromised MR image interpretation in 17% of horses. MR imaging of equine distal limb wounds allowed identification of both osseous and tendon/ligament abnormalities in more cases than either radiography or ultrasonography, and altered case management in 20/23 horses. Although MR imaging should not replace conventional imaging, this study highlights that MR imaging of equine distal limb wounds can yield information not detected on conventional imaging which may direct treatment and affect prognostication.     

Use of standing low‐field magnetic resonance imaging to diagnose middle phalanx bone marrow lesions in horses

Bone marrow lesions (BMLs) (also known as ‘bone bruises’, ‘bone oedema’, ‘bone contusions’ and ‘occult fractures’) within the middle phalanx were diagnosed by standing low field magnetic resonance imaging (MRI) in 7 horses. The lesions were characterised by low signal intensity on T1‐ and T2*‐weighted gradient echo sequences, mildly increased signal intensity on T2 fast spin echo sequences, and high signal intensity on short tau inversion recovery (STIR) sequences. Four distinct patterns of abnormal signal were identified: BML associated with osteoarthritis of either the proximal or distal interphalangeal joints; BML associated with soft tissue injury; BML associated with acute trauma; and BML unassociated with any other injury or lameness (assumed to represent bone response to biomechanical stress). Repeat MRI was undertaken in 4 cases. In most cases the BML resolved with rest and time, although lameness was persistent in 2 horses (one of which had an associated osteoarthritis of the proximal interphalangeal joint).     

Standing low-field magnetic resonance imaging in horses with chronic foot pain

Objective Conventional imaging modalities can diagnose the source of foot pain in most cases, but have limitations in some horses, which can be overcome by using magnetic resonance imaging (MRI). However, there are no reports of the MRI appearance and prevalence of foot lesions of a large series of horses with chronic foot lameness. Methods In the present study, 79 horses with unilateral or bilateral forelimb lameness because of chronic foot pain underwent standing low‐field MRI to make a definitive diagnosis. Results Of the 79 horses, 74 (94%) had alterations in >1 structure in the lame or lamest foot. Navicular bone lesions occurred most frequently (78%) followed by navicular bursitis (57%), deep digital flexor tendonopathies (54%) and collateral desmopathy of the distal interphalangeal joint (39%). Effusion of the distal interphalangeal joint was also a frequent finding (53%). Conclusion Low‐field MRI in a standing patient can detect many lesions of the equine foot associated with chronic lameness without the need for general anaesthesia.     

Normal reference intervals and the effects of sample handling on dynamic viscoelastic coagulometry (Sonoclot) in healthy adult horses

Objective

To determine reference intervals and the effect of sample agitation and rest time on Sonoclot analysis in healthy adult horses.

Design

Original prospective study.

Setting

University veterinary medical teaching hospital.

Animals

Sixty healthy adult horses.

Interventions

Blood was collected for assessment of complete blood count, serum biochemical analysis, and Sonoclot analysis.

Measurements and Main Results

Horses were determined to be healthy based upon physical examination, CBC, and serum biochemistry analysis. Blood was analyzed in a glass bead‐containing cuvette using the Sienco Sonoclot analyzer following 2 rest periods (30 mins and 240 min) and with 2 sample handling interventions (agitated and nonagitated), to obtain values for clot rate, time‐to‐peak, activated clotting time, and platelet function. This study failed to detect a significant difference when a rest time of 30 minutes was compared with 240 minutes, but based on wide limits of agreement the 2 rest times were not considered interchangeable. Agitation at both rest times significantly affected all Sonoclot analyses leading to changes indicative of hypercoagulability.

Conclusions

Sample agitation and rest time should be taken into consideration when developing preanalytical guidelines for Sonoclot analysis in horses. Calculated reference intervals were relatively wide. Further research is needed to evaluate the clinical utility of Sonoclot analysis in horses.     

Measurement of intraocular pressure in healthy anesthetized horses during hoisting

Objective

To measure intraocular pressure (IOP) in horses during hoisting after induction of anesthesia.

Anatomical, magnetic resonance imaging and histological findings in the accessory ligament of the deep digital flexor tendon of forelimbs in nonlame horses

Reasons for performing the study: Detailed magnetic resonance imaging (MRI) and histological appearances of the accessory ligament of the deep digital flexor tendon (AL‐DDFT) have not been documented previously in detail. Objectives: To: 1) describe anatomical connections between the AL‐DDFT and adjacent structures; 2) describe high‐field and low‐field MRI and histological appearances of the AL‐DDFT in the forelimb of horses with no carpal or proximal metacarpal pain; and 3) assess the relationship between age, breed, gender, height, weight and MRI findings. Methods: Ten forelimbs were dissected to determine anatomical relationships among the AL‐DDFT and adjacent structures. High‐ and low‐field MR images of the AL‐DDFT and related structures from 29 cadaver limbs of nonlame horses were analysed subjectively and objectively. The relationship between age, breed, gender, height, weight and MRI findings was assessed using a Chi‐squared test. Twelve ALs‐DDFT were examined histologically. Histological and MRI findings were compared subjectively. Results: Fibrous bundles were seen between the AL‐DDFT and the lateral aspect of the superficial digital flexor tendon (n = 9) and the DDFT (n = 2). The AL‐DDFT had low to intermediate signal intensity in most limbs in most high‐field and low‐field MRI sequences. In 69% of limbs, oblique bands of higher signal intensity than the rest of the ligament were identified in high‐field images of the AL‐DDFT. The cross‐sectional area of the AL‐DDFT in the proximal 7 cm of the metacarpal region ranged from 68.1–299 mm². There was no significant relationship between age, gender, weight or height and either the cross‐sectional area of the AL‐DDFT or the presence of oblique higher signal intensity bands. Histological examination revealed that the AL‐DDFT had thick collagen bundles arranged in large crimps and sometimes crossing in oblique directions. The cellularity was greater than in the deep digital flexor tendon in all limbs. Conclusion and potential relevance: The large variability in the MRI appearance and size of the AL‐DDFT in nonlame horses should be borne in mind when interpreting MR images of lame horses.