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1.
Tendon and ligament injuries are common causes of impaired performance in equine athletes. Gray‐scale ultrasonography is the current standard method for diagnosing and monitoring these injuries, however this modality only provides morphologic information. Elastography is an ultrasound technique that allows detection and measurement of tissue strain, and may provide valuable mechanical information about equine tendon and ligament injuries. The purpose of this study was to determine the feasibility, reproducibility, and repeatability of elastography; and to describe elastographic characteristics of metacarpal tendons in sound horses. Nineteen legs for 17 clinically sound horses without evidence of musculoskeletal pathology were included. Elastographic images of the superficial and deep digital flexor tendons and the branches of the suspensory ligament (tendon of the interosseous muscle) were described quantitatively and qualitatively. There was no statistically significant difference between operators (P = 0.86) nor within operators (P = 0.93). For qualitative assessments, reproducibility (0.46) was moderate and repeatability (0.78) was good. Similar to human Achilles tendons, equine tendons were classified as predominantly hard using elastography. There was no statistically significant difference in stiffness of the flexor tendons (P = 0.96). No significant difference in stiffness was found with altered leg position during standing (P = 0.84) and while nonweight bearing (P = 0.61). The flexor tendons were softer when imaged in longitudinal versus transverse planes (P < 0.01) however, the suspensory branches were not (P = 0.67). Findings supported future clinical application of elastography as a noninvasive “stall‐side” imaging modality for evaluation of the tendons and ligaments of the distal forelimb in horses.  相似文献   

2.
Iatrogenic lesions to the accessory ligament (carpal check or inferior check) and to the superficial digital flexor tendon of five ponies were monitored utilizing diagnostic ultrasound for a period of 6–24 weeks post-injury. The opposite limb was used as a non-surgical control. Sonographic differences from control limbs were recorded and correlated with the gross and microscopic post-mortem lesions. Early post-surgical sonographic findings included thickening with discrete hypoechoic areas within the injured tissues which corresponded to regions of hemorrhage, edema, and tissue disruption at necropsy. The linear hyperechoic pattern seen in normal tendons was disorganized in the injured portion of the tendons or ligaments. Disruption of the margins of the incised tissues was observed. The initial hypoechoic areas disappeared or decreased in size and became more echoic as healing progressed. The increasing echoic pattern in these areas corresponded to regions of fibrous tissues invasion and collagen deposition. As post-injury time increased, the size of the tendon or ligament decreased, the margins became more distinct, and the internal structure again became more organized (linear). It was concluded that diagnostic ultrasound can be useful in evaluating injury and healing of the accessory ligament and the superficial digital flexor tendon of horses.  相似文献   

3.
In a two-phase study, ultrasound was used to delineate the normal sonographic anatomy of soft tissues of the equine distal limb. The study was limited to the soft tissues of the palmar surface of the limb just proximal to the fetlock joint. In the first phase, cadavers were evaluated with a B-mode ultrasound machine, † Then the limbs were radiographed and dissected to compare their gross, radiographic, and ultrasonographic appearances. In the second phase, nine normal adult horses were ultrasonographically scanned. The sonographic appearance of the normal animals was compared with that of the cadavers. Front and rear limbs of all horses had similar ultrasonographic appearances. Flexor tendons and the suspensory ligament were easily identified as having linear, uniformly intense ecogenicity. The borders of the digital sheath and of the proximal palmar pouch of the fetlock joint had a less organized and less intense ecogenic appearance than the flexor tendons and suspensory ligament, and they were poorly delineated unless distended with fluid. Ultrasonography was used in three lame horses and aided the diagnoses of synovial proliferation in the fetlock joint, tendosynovitis, and bowed tendon. Diagnostic ultrasonography was effective in identifying and characterizing soft-tissue structures of the distal equine limb. It is a valuable, noninvasive diagnostic aid.  相似文献   

4.
Ultrasonography and MRI have become valuable tools for imaging of tendon injuries. The current study examines the histopathologic basis for the imaging abnormalities. Five injured equine forelimbs and two normal contralateral limbs were studied with high resolution real time ultrasound and MRI. Histologic sections were made and correlated with the diagnostic images. All lesions were readily seen by both modalities. Lesions characterized by hemorrhage, edma, and cellular infiltration were sonolucent on ultrasound and bright on MRI images. MRI returned to normal as fibrogenesis ensued. Ultrasound images remained abnormal until fibrillar reallgnment occured with completion of the healing process. High resolution real time ultrasound and MRI both accurately reflect the tissue abnormalities in acute tendon injuries. The injured horse does appear to be an effective model for correlative imaging studies of tendon injuries.  相似文献   

5.
An ultrasonographic study was made at several levels of the palmar metacarpal region of 23 horses (Anglo-Arabian-Andalusian) aged over three years. Lateromedial and palmodorsal measurements were made of tendons and ligaments, following clinical examination to confirm the absence of pathology in this region. Dissection was performed on 23 forelimbs, and these were measured at the same levels to establish a base of reference for the study. These measurements should prove useful in the evaluation of possible pathology in this region.  相似文献   

6.
This study was designed to evaluate the normal anatomy of the digital flexor tendon sheath using contrast radiography and diagnostic ultrasound. Iodinated contrast medium was injected into eight cadaver limbs and the limbs immediately frozen. Lateromedial and dorsopalmar/plantar radiographs were made. These limps were then cut transversely and proximal to distal radiographs of each slab were made. This cross sectional contrast methodology allowed the visualization of the relative size and shape of the superficial and deep digital flexor tendons as well as the potential space taken by effusions of the digital flexor tendon sheath.
The second part of the study used twelve live animals with normal digital flexor tendon sheaths. Ultrasonographic measurement of the structures of the digital flexor tendon sheath at each level were compiled. This documented the ability of diagnostic ultrasound to image: 1) the superficial and deep digital flexor tendons, 2) the proximal and distal ring of the manica flexoria , 3) the straight and oblique sesamoidean ligaments, and 4) the mesotendinous attachments to the superficial and deep flexor tendons. Iodinated contrast medium was then injected into the digital flexor tendon sheath and the ultrasonography repeated. These images were compared with those obtained from contrast radiography and prosections of twenty normal limbs. The iodinated contrast medium enhanced sonographic imaging of the structures of the digital tendon sheath, particularly the abaxial borders of the superficial digital flexor tendon branches and the mesotendinous attachments to the superficial and deep digital flexor tendons.  相似文献   

7.
Vascular alterations play important roles in many orthopedic diseases such as osteoarthritis, tendonitis, and synovitis in both human and equine athletes. Understanding these alterations could enhance diagnosis, prognosis, and treatment. Contrast‐enhanced ultrasound (CEUS) could be a valuable method for evaluation of blood flow and perfusion of these processes in the equine distal limb, however no reports were found describing feasibility or safety of the technique. The goal of this prospective, experimental study was to describe the feasibility and safety of distal limb CEUS in a sample of six horses. For each horse, CEUS of the distal limb was performed after intravenous injections of 5 and 10 ml, as well as intra‐arterial injections of 0.5 and 1 ml contrast medium. Vital parameters were monitored and CEUS images were assessed qualitatively and quantitatively for degree of contrast enhancement. None of the horses had clinically significant changes in their vital parameters after contrast medium injection. One horse had a transient increase in respiratory rate, and several horses had mild increases of systolic blood pressure of short duration after intravenous, but not after intra‐arterial injections. Intra‐arterial injection was possible in all horses and resulted in significantly improved contrast enhancement both quantitatively (P = 0.027) and qualitatively (P = 0.019). Findings from this study indicated that CEUS is a feasible and safe diagnostic test for evaluation of the equine distal limb. Future studies are needed to assess the clinical utility of this test for horses with musculoskeletal diseases.  相似文献   

8.
The effect of the chemical shift artifact, resulting from misregistration or phase cancellation at the interface between compact and trabecular bone, on apparent bone thickness was quantified in six isolated equine limbs. Sagittal T1‐weighted spin echo (SE) and in‐phase three‐dimensional spoiled gradient echo (SPGR) images were acquired twice with a 1.5 T magnetic resonance (MR) unit, switching the frequency encoding direction between acquisitions. Out‐of‐phase SPGR images were also obtained. MR images with different frequency encoding directions were compared with each other and to radiographs made from corresponding 3‐mm‐bone sections. Compact bone thickness was significantly different when comparing images acquired with different frequency encoding directions for both SE and SPGR sequences. Significant differences were identified in the frequency but not the phase encoding direction when measurements of compact bone in MR images were compared with measurements obtained from thin section radiographs for the majority of surfaces studied (P<0.05). Correction of MR measurements with the calculated chemical shift abolished these differences (P>0.05). Measurements of compact bone from out‐of‐phase SPGR sequences were significantly different than from in‐phase sequences (P<0.001) with out‐of‐phase measurements greater than in‐phase measurements by an average of 0.38 mm. These results indicate that the chemical shift artifact results in errors in MR evaluation of compact bone thickness when measurements are performed in the frequency encoding direction or in out‐of‐phase images. For better accuracy, measurements should be performed parallel to the phase encoding direction and avoiding out‐of‐phase gradient echo sequences.  相似文献   

9.
Nasopharyngeal and laryngeal evaluation is important when examining horses with upper airway signs for poor performance. Currently endoscopy is the most common method to evaluate the equine upper airway. Ultrasonography of the equine larynx has not previously been described. Using six cadaveric specimens and four standing horses, the ultrasonographic appearance of the equine larynx was established. A scanning technique, including useful acoustic windows and the normal ultrasonographic appearance at each site, is described. Ultrasound allowed visualization of portions of the hyoid apparatus, laryngeal cartilages, associated soft tissues, and intrinsic and extrinsic laryngeal musculature, that are not seen using endoscopy. Additionally, real-time ultrasound allowed observation of the movement of the vocal folds and the arytenoid cartilages during respiration. In three horses with arytenoid chondritis, ultrasonography aided in the diagnosis and localization of arytenoid abcessation and perilaryngeal inflammation. The establishment of this technique will serve as the basis for future investigations in the evaluation of clinical patients with upper airway abnormalities.  相似文献   

10.
Previous studies have proposed that standard ultrasonography may not adequately represent the pertinent anatomic characteristics of the equine proximal suspensory ligament. The purpose of the study was to compare the use of standard ultrasonography, angle contrast ultrasonography, MRI, and histology for identification of the anatomic characteristics of the normal equine suspensory ligament in the forelimb. Horses free from forelimb lameness with no palpable abnormalities in the region of the suspensory ligament were included in the study. The proximal suspensory ligaments in 20 forelimbs were examined using the standard ultrasound technique, angle contrast ultrasound technique, and MRI, followed by histologic evaluation. Total transverse (cross‐sectional) area of the proximal suspensory ligament was estimated using the standard ultrasound and the angle contrast ultrasound techniques, MRI, and histologic sections for the following parameters: total area of the ligament, ligament fibers, muscle, and fat. The proximal suspensory ligament lobe size and tissue distribution were compared and subjectively graded (0–4) for asymmetry. Subjectively, angle contrast ultrasound technique improved differentiation of fibers from the remaining tissue types and allowed identification of the peripheral ligament margin. There was no significant difference in asymmetry scores between modalities. The asymmetry scores of the right and left forelimbs were significantly different with both ultrasound and MRI, based on the level of measurement. The angle contrast ultrasound technique has limitations compared to MRI. However, it provides additional diagnostic information that is not available with the standard ultrasound technique.  相似文献   

11.
Radiography is the most commonly applied imaging modality in equine practice and forms an essential part of the diagnostic work-up of lame horses. Radiographic signs of musculoskeletal pathology are frequently localized at sites of soft tissue attachment, which are often not clearly visible on radiographs. Different lesions carry different prognoses and require a variety of treatments, and a good knowledge of the position of the synovial structures in the distal limb of the horse is essential for practitioners in the interpretation of radiographs. This study describes a new technique for creating three-dimensional (3D) models of the synovial structures and superimposing them onto radiographs for the purpose of teaching radiographic anatomy. A set of standard radiographs was acquired of the metacarpophalangeal and the distal interphalangeal joints of a fresh cadaver leg while the leg was positioned in a material-testing machine to mimic the weight-bearing horse. Computed tomography of the same regions was performed after injection of negative contrast medium into the joints. 3D reconstructions of the joints were created using grayscale thresholding and polynomial surface meshing in Mimics. The resulting 3D reconstructions were superimposed on top of the radiographs using Adobe© Photoshop© CS3 Extended, thus allowing the visualization of the joint anatomy in relation to the bone on all projections. The main advantage of this technique is that it allows synovial structures to be visualized on radiographs where they are normally indistinct, which will serve as a teaching aid for anatomy.  相似文献   

12.
A technique for regional delivery of contrast medium to the foot of the horse to increase the diagnostic utility of computed tomography (CT) for the characterization of soft tissue structures within the hoof capsule was developed. An intraarterial catheter was placed under ultrasound guidance into the medial palmar artery at the level of the carpus to facilitate a steady-state infusion of iodinated contrast medium. Two 5 mm collimated contiguous acquisition CT scans were performed in 10 horses without lameness or radiographic evidence of distal sesamoid bone degeneration. CT examination was performed before and during regional arterial infusion of iodinated contrast medium administered at a rate of 2 ml/s. Cross-sectional area and mean pre- and post-contrast attenuation of the deep digital flexor tendon and the collateral ligaments of the distal interphalangeal joint were quantified from CT images. Soft tissue anatomy of the foot was also qualitatively characterized from pre- and postcontrast images. Catheterization was successful and without complication in all horses. The evaluated tendons and ligaments were clearly visible and had a small (8-20 Hounsfield Unit) but significant (P < 0.05, paired t-test) increase in attenuation during the steady-state infusion of contrast medium. This study should enhance the diagnostic potential of CT by providing baseline quantitative data for comparison with horses affected with soft tissue injuries in the distal extremity causing lameness that is alleviated with a palmar digital nerve block.  相似文献   

13.
Positron emission tomography (PET) is a highly sensitive, noninvasive imaging technique for quantifying biological functions of tissues. However, at the time of this study, PET imaging applications had not been reported in the horse. The aim of this exploratory study was to determine whether a portable high‐resolution PET scanner could be used to image the equine distal limb. Images of the front feet and fetlocks of three research horses, with known lesions localized to the distal front limbs, were acquired under general anesthesia after administration of 18F‐fluorodeoxyglucose (18F‐FDG), with doses ranging from 1.5 to 2.9 MBq/kg. The radiation exposure measured during imaging was slightly higher than 99mTechnetium scintigraphy. However, the use of general anesthesia allowed the proximity and the contact time with the patient to be minimized for the staff involved. 18F‐FDG uptake was evident throughout the soft tissues, with the highest uptake in the coronary band and the lowest uptake in the tendons. Anatomic structures could be discriminated due to the high contrast between soft tissue and bone. Detected lesions included lysis of the flexor cortex of the navicular bone, lesions of flexor tendons and suspensory ligament, and abnormal uptake through the lamina of a laminitic subject. Findings indicated that tomographic molecular imaging is feasible in the equine distal limb and could be useful as a future diagnostic technique for clinical and research studies, especially those involving tendinopathy/desmopathy and laminitis.  相似文献   

14.
Charles R.  Pugh  DVM  MS  Phillip J.  Johnson  BVSc  MS  Gregory  Crawley  DVM  MS  Susan T.  Finn  DVM  MS 《Veterinary radiology & ultrasound》1994,35(3):183-188
The equine shoulder region is difficult to investigate by conventional imaging modalities. Diagnostic ultrasound has proven valuable for investigation of soft tissue injuries of the human shoulder. In a horse with shoulder lameness, the authors employed diagnostic ultrasound to augment the use of conventional radiography. A defect in the subchondral bone layer of the medial humeral tuberosity, with adjacent bony fragments were clearly identified with ultrasound. Ultrasound was used for initial evaluation of the bicipital tendon and bursa. The technique was subsequently used to follow and evaluate the post-operative condition of the proximal cranial humerus, bicipital tendon and bursa in this patient. The bicipital regions of 2 immature and 3 adult normal horses were also examined with to illustrate the normal ultrasonographic anatomy of the cranial shoulder region.  相似文献   

15.
Gastroscopy with air insufflation was performed in 10 ponies, after which a transcutaneous ultrasound examination of the stomach and duodenum was performed immediately and at 1, 2, and 4 h postgastroscopy, and 24 h after feeding. Stomach measurements included the dorsoventral and craniocaudal dimensions, as well as the stomach depth from the skin surface and stomach wall thickness at the different time periods. Gastric wall folding was observed in one pony, becoming most distinct 2–4 h postgastroscopy. An undulating stomach wall was noted in eight other ponies postgastroscopy. These observations appeared to be a response to the deflation of the stomach as the insufflated air was released gradually. Gas was detected in the duodenum after the gastroscopy. The parameters measured were noted to be useful to evaluate the extent of stomach distension due to air or feed. The ultrasonographic appearance of the stomach can, therefore, be altered by gastroscopy and this should be borne in mind when examining horses with suspected gastric disease.  相似文献   

16.
Distal tarsal pain is a common reason for hind limb lameness, but diagnosis cannot always be made on radiographic examination. Scintigraphy may allow detection of subtle changes undetected by other diagnostic methods. We hypothesized that (1) distal tarsal pain would be associated with a loss of the expected pattern of radiopharmaceutical uptake (RU) detected in normal horses, (2) distal tarsal RU would be greater in limbs with tarsal pain than without pain, (3) RU in painful tarsi with radiographic evidence of osteoarthritis (OA) would be greater than in distal tarsal pain with no radiographic evidence of OA. The study aimed to describe radiopharmaceutical distribution in the distal tarsal region of horses with distal tarsal pain, and to compare this with the contralateral limb and results from horses without tarsal pain. Retrospective evaluation of scintigraphic images of the distal tarsal region was performed for 52 horses with distal tarsal pain: 15 with no radiographic evidence of OA (Group 1) and 37 with radiographic evidence (Group 2). The images were assessed using vertical and horizontal profile analysis across the distal tarsal region and regions of interest comparisons between the distal tarsal region and tibia within each horse (RU ratio). Painful limbs in unilaterally lame horses from Groups 1 and 2 had a significantly greater RU ratio than the respective contralateral limbs, and were significantly greater than the RU ratio in normal horses. On plantar images, mean region of interest counts were greater in the lame than the contralateral limb in Group 2 but not in Group 1. Although there was a positive correlation between lame and contralateral limb RU ratio in group 1, this was lost in group 2 horses. In lame limbs, the normal vertical activity profile was lost in 85% of group 1 and all of group 2, and the normal horizontal activity profile was lost in all of group 1 and 96% of group 2. There was a significant effect of lameness, but not of group on sites of peak activity on all profiles. The results of this study indicate that distal tarsal pain is associated with loss of the expected pattern of RU detected in normal horses. The findings also suggest that distal tarsal RU in lame limbs is greater than in limbs without pain, and that painful limbs with radiographic evidence of OA have a greater RU than painful limbs without radiographic evidence of OA.  相似文献   

17.
ULTRASONOGRAPHY OF THE EQUINE STIFLE   总被引:3,自引:0,他引:3  
Ten stifles from 5 clinically sound adult horses were scanned by high-resolution ultrasound. Normal anatomic structures seen consistently included the subcutaneous tissue, the medial, middle and lateral patellar ligaments, the medial and lateral collateral ligaments, the femoral trochlear ridges, and menisci. Cruciate ligaments could not be visualized in the standing horse. Four stifle specimens obtained from 2 of these normal horses at necropsy were scanned in a water bath to create optimal technical conditions. The sonographic appearance of stifle specimens was similar to that found in live horses. Results from ultrasonographic examination of 3 horses with stifle abnormalities were described to illustrate some applications of ultrasonography in the evaluation of the equine stifle. In these horses, ultrasound was a valuable diagnostic tool to study joint effusion, synovial thickening, articular cartilaginous and subchondral defects, and soft tissue/bony injuries.  相似文献   

18.
The equine small intestine is challenging to evaluate ultrasonographically. In humans, hydrosonography has been used to improve ultrasonographic images of the small intestine. We hypothesized that fasting horses for 24 h would enhance the ability to image the small intestine transabdominally by separating intestinal loops and reducing intraluminal gas, and that the administration of intragastric contrast agent would further improve that ability. Ten healthy horses were examined ultrasonographically under three treatment conditions: (a) regular diet, (b) after a 24‐h fast, and (c) fasted plus intragastric administration of water and mineral oil. During each phase of the study, 30‐s video clips were obtained from four predetermined abdominal windows, and were examined to determine diagnostic quality. Fasting improved the ability to obtain high‐quality images of the small intestine significantly. The addition of contrast agent resulted in qualitative improvement in image quality, but differences did not result in statistically significant improvement.  相似文献   

19.
Effect of tibial tuberosity advancement (TTA) on the patellar ligament has not been described. Our purpose was to evaluate the patellar ligament radiographically and ultrasonographically before and after a TTA. Twenty‐one stifles (20 dogs) were evaluated preoperatively (T0), and at six (n=18) (T1) and 16 weeks (n=17) (T2) postTTA. Radiographically, proximal and distal thickness of the patellar ligament was assessed and a ratio to the total length of the ligament was calculated to compensate for the magnification. Ultrasound evaluation included measurements of the transverse thickness and cross‐sectional area at three different levels, as well as a subjective score of ligament changes. In comparison with T0, all radiographic and ultrasonographic measurements increased significantly, 6 weeks postoperatively (P≤0.04), and did not change 16 weeks postoperatively compared with T1. The subjective score worsened significantly from T0 to T1 and T0 to T2 (P<0.0001), and improved significantly from T1 to T2 (P=0.02). Larger cage size was associated with a more severe increase in radiographic proximal thickness to total length ratio and ultrasonographic middle transverse area at both follow‐up examinations (P0.02). Dogs in which arthrotomy was not performed appeared to have ultrasonographically less changes. In conclusion, patellar desmopathy was a common postoperative sequel to TTA. Surgical trauma, arthrotomy, perfusion injury, complete vs. partial cranial cruciate ligament rupture, larger tibial advancement, postoperative activity or altered insertion angle of the patellar ligament at the tibial tuberosity are suggested causes, that should be elucidated in a larger study cohort.  相似文献   

20.
An anatomic study of the equine digit using magnetic resonance imaging (MRI) was performed. Seventeen isolated forelimbs and one hindleg of nine warmblood horses were imaged in transverse, sagittal, and dorsal planes with a 1.5 Tesla magnet using T1-, T2- proton density-weighted spin echo sequences as well as T2 gradient echo sequences. One scan plane in each horse was compared with corresponding anatomic and histologic sections. The best imaging planes to visualize various anatomic structures were determined. Fibrocartilage was visualized in the insertion of the deep digital flexor tendon and the suspensory ligament as well as in the distal sesamoidean ligaments. The correlation of MRI images with anatomic and histologic sections confirmed that all of the anatomic structures in the equine digit could be evaluated in PD and T2 studies.  相似文献   

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