THE APPEARANCE OF THE EQUINE METACARPOPHALANGEAL REGION ON HIGH‐FIELD VS. STANDING LOW‐FIELD MAGNETIC RESONANCE IMAGING

The appearance of the equine metacarpophalangeal (MCP) joint on high‐field (1.5 T) vs. low‐field standing (0.27 T) magnetic resonance (MR) images was evaluated. Objectives were (1) to describe the MR appearance of anatomic structures of clinical interest on images of the equine MCP joint obtained from 20 equine cadaver limbs from horses without lameness using high‐field and low‐field systems, (2) to categorize the clarity of appearance of anatomic structures on low‐field MR images in comparison to high‐field images as a gold standard. We found that larger anatomic structures were visible with sharp margins on both high‐ and low‐field images, smaller structures were less distinct on low‐field images and therefore interpretation of smaller structures on low‐field images must be done with care.     

MAGNETIC RESONANCE IMAGING SCORING OF AN EXPERIMENTAL MODEL OF POST‐TRAUMATIC OSTEOARTHRITIS IN THE EQUINE CARPUS

Magnetic resonance imaging (MRI) is the most sensitive imaging modality to detect the early changes of osteoarthritis. Currently, there is no quantifiable method to tract these pathological changes over time in the horse. The objective of this experimental study was to characterize the progression of MRI changes in an equine model of post‐traumatic osteoarthritis using a semiquantitative scoring system for whole‐organ evaluation of the middle carpal joint. On day 0, an osteochondral fragment was created in one middle carpal joint (OCI) and the contralateral joint (CON) was sham‐operated in 10 horses. On day 14, study horses resumed exercise on a high‐speed treadmill until the completion of the study (day 98). High‐field MRI examinations were performed on days 0 (preosteochondral fragmentation), 14, and 98 and scored by three blinded observers using consensus agreement. Images were scored based on 15 independent articular features, and scores were compared between and within‐groups. On days 14 and 98, OCI joints had significantly (P ≤ 0.05) higher whole‐organ median scores (29.0 and 31.5, respectively), compared to CON joints (21.5 and 20.0, respectively). On day 14, OCI joints showed significant increases in high‐signal bone lesion scores, and osteochondral fragment number and size. On day 98, high‐signal bone lesion, low‐signal bone lesion, osteophyte formation, cartilage signal abnormality, subchondral bone irregularity, joint effusion, and synovial thickening scores were significantly increased in OCI joints. Study results suggest that the MRI whole‐organ scoring system reported here may be used to identify onset and progression of pathological changes following osteochondral injury.     

FUNCTIONALITY OF VETERINARY IDENTIFICATION MICROCHIPS FOLLOWING LOW‐ (0.5 TESLA) AND HIGH‐FIELD (3 TESLA) MAGNETIC RESONANCE IMAGING

The ability to read patient identification microchips relies on the use of radiofrequency pulses. Since radiofrequency pulses also form an integral part of the magnetic resonance imaging (MRI) process, the possibility of loss of microchip function during MRI scanning is of concern. Previous clinical trials have shown microchip function to be unaffected by MR imaging using a field strength of 1 Tesla and 1.5. As veterinary MRI scanners range widely in field strength, this study was devised to determine whether exposure to lower or higher field strengths than 1 Tesla would affect the function of different types of microchip. In a phantom study, a total of 300 International Standards Organisation (ISO)‐approved microchips (100 each of three different types: ISO FDX‐B 1.4 × 9 mm, ISO FDX‐B 2.12 × 12 mm, ISO HDX 3.8 × 23 mm) were tested in a low field (0.5) and a high field scanner (3.0 Tesla). A total of 50 microchips of each type were tested in each scanner. The phantom was composed of a fluid‐filled freezer pack onto which a plastic pillow and a cardboard strip with affixed microchips were positioned. Following an MRI scan protocol simulating a head study, all of the microchips were accurately readable. Neither 0.5 nor 3 Tesla imaging affected microchip function in this study.     

GROSS AND HISTOPATHOLOGIC CORRELATION OF LOW‐FIELD MAGNETIC RESONANCE IMAGING FINDINGS IN THE STIFLE OF ASYMPTOMATIC HORSES

With the recent introduction of a 0.25T rotating MRI system, clinical evaluation of the equine stifle joint is now possible in the average equine athlete. A recent publication described common abnormalities of horses with stifle lameness detected with a low‐field MRI system; however, postmortem corroboration of the lesions detected was not possible. Therefore, our objective was to compare postmortem findings with low‐field MRI findings in equine cadaver stifle joints. Ten fresh cadaver stifle joints from horses without clinical signs of stifle disease were evaluated using low‐field MRI, gross dissection, and histopathology. In eight stifles, either the lateral or medial cranial meniscotibial ligament had an irregular shape, fiber separation, or moderate abnormal signal intensity (SI) on all sequences. In five stifles, the medial femoral condyle had articular cartilage fibrillation with or without an osteochondral defect over the weight bearing surface of the medial femoral condyle. All stifles had abnormal SI on all sequences within the patellar ligaments that corresponded with adipose tissue infiltrating between the collagen bundles. Other abnormalities identified included articular cartilage fibrillation of the tibial condyles in three stifles, and articular cartilage fibrillation with chondral defects in the patella in three stifles. All abnormalities detected with low‐field MRI were corroborated by gross dissection. Findings from the current study supported the use of low‐field MRI for detection of stifle joint lesions in horses and demonstrated that some stifle joint pathologies may be subclinical in horses.     

RADIOLOGIC ANATOMIC VARIATION OF THE CARPUS IN HORSES WITH CARPAL LAMENESS AND CONTROL HORSES

Our purpose was to describe the variation of the radiologic appearance of the carpus of horses of different breeds, discipline, and gender with lameness related to the carpus and control horses, with particular reference to the ulnar carpal bone. Two hundred and eighty‐six sets of carpal radiographs from 222 horses were analyzed. Breed, gender, discipline, and cause of lameness were recorded. Chi square tests were used to test for associations between radiologic findings and gender, breed and discipline, to test for associations between different radiologic findings, and to test for associations between radiologic findings and causes of lameness. Bonferroni correction was applied when necessary. The shape of the ulnar carpal bone and most of the anatomic variants, with the exception of the first carpal bone and a radiolucent area in the second carpal bone, were not breed or gender related. Radiolucent areas and associated fragments on the palmaromedial aspect of the ulnar carpal bone can be an incidental finding in horses from all disciplines.     

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.     

ACCURACY OF LOW‐FIELD MAGNETIC RESONANCE IMAGING VERSUS RADIOGRAPHY FOR GUIDING INJECTION OF EQUINE DISTAL INTERPHALANGEAL JOINT COLLATERAL LIGAMENTS

Desmopathy of the distal interphalangeal joint collateral ligament is a common cause of lameness in the horse and carries a variable prognosis for soundness. Intralesional treatment has been proposed for improving outcome; however, limited reports describe methods for injecting this ligament. The purpose of this study was to compare accuracy of low‐field magnetic resonance imaging (MRI) vs. radiography for injecting the collateral ligament of the distal interphalangeal joint. Equine cadaver digit pairs (n = 10) were divided by random assignment to injection of the ligament by either technique. An observer unaware of injection technique determined injection success based on postinjection MRI and/or gross sections acquired from the proximal, middle, and distal portions of the ligament. McNemar's test was performed to determine statistical difference between injection techniques, the number of injection attempts, and injection of the medial or lateral collateral ligament. Magnetic resonance imaging guided injection was successful more frequently than radiographic‐guided injection based on postinjection MRI (24 of 30 vs. 9 of 30; P = 0.0006) and gross sections (26 of 30 vs. 13 of 30; P = 0.0008). At each level of the ligament (proximal, middle, and distal), MRI‐guided injection resulted in more successful injections than radiographic guidance. Statistical significance occurred at the proximal aspect of the collateral ligament based on postinjection MRI (P = 0.0143) and the middle portion of the ligament based on gross sections (P = 0.0253). Findings supported future testing of standing, low‐field MRI as a technique for delivering intralesional regenerative therapy in live horses with desmopathy of these collateral ligaments.     

SALINE ARTHROGRAPHY OF THE DISTAL INTERPHALANGEAL JOINT FOR LOW‐FIELD MAGNETIC RESONANCE IMAGING OF THE EQUINE PODOTROCHLEAR BURSA: FEASIBILITY STUDY

Abnormalities of the deep digital flexor tendon, navicular bone, and collateral sesamoidean ligament can be difficult to visualize using magnetic resonance imaging (MRI) if bursal fluid is absent. The use of saline podotrochlear bursography improves podotrochlear apparatus evaluation, however, the technique has disadvantages. The objective of this prospective feasibility study was to describe saline arthrography of the distal interphalangeal joint as an alternative technique for improving MRI visualization of the deep digital flexor tendon, navicular bone, collateral sesamoidean ligament, and podotrochlear bursa, and to compare this technique with saline podotrochlear bursography. Eight paired cadaver forelimbs were sampled. Saline podotrochlear bursography or saline arthrography techniques were randomly assigned to one limb, with the alternate technique performed on the contralateral limb. For precontrast and postcontrast studies using each technique, independent observers scored visualization of the dorsal aspect of the deep digital flexor tendon, palmar aspect of the navicular bone, collateral sesamoidean ligament, and podotrochlear bursa. Both contrast techniques improved visualization of structures over precontrast MR images and visualization scores for both techniques were similar. Findings from this study demonstrated that saline arthrography is feasible and comparable to saline podotrochlear bursography for producing podotrochlear bursa distension and separation of the structures of the podotrochlear apparatus on nonweight bearing limbs evaluated with low‐field MRI. Clinical evaluation of saline arthrography on live animals is needed to determine if this technique is safe and effective as an alternative to saline podotrochlear bursography in horses with suspected pathology of the podotrochlear apparatus.     

MAGNETIC RESONANCE IMAGING ANATOMY OF THE NORMAL EQUINE LARYNX AND PHARYNX

The purpose of the present study was to describe normal magnetic resonance (MR) imaging anatomy of the equine larynx and pharynx and to present the optimal protocol, sequences, and possible limitations of this examination technique. Using a 0.3 T unit, the laryngeal and pharyngeal regions was imaged in two horses. The protocol consisted of sagittal and transverse T2-weighted (T2w) fast spin echo, transverse T1-weighted (T1w) spin echo, and dorsal high-resolution T1w gradient echo (both pre- and postcontrast enhancement) sequences. Euthanasia was performed at the end of the imaging procedure. Macroscopic anatomy of the cadaver sections were compared with the MR images in transverse, midsagittal, and parasagittal planes. There was good differentiation of anatomic structures, including soft tissues. The laryngeal cartilages, hyoid apparatus, and upper airway muscle groups with their attachments could be clearly identified. However, it was not always possible to delineate individual muscles in each plane. Most useful were both T2w and T1w transverse sequences. Intravenous application of contrast medium was helpful to identify blood vessels. The MR images corresponded with the macroscopic anatomy of cadaver sections.     

EFFECTS OF STIFLE FLEXION ANGLE AND SCAN PLANE ON VISIBILITY OF THE NORMAL CANINE CRANIAL CRUCIATE LIGAMENT USING LOW‐FIELD MAGNETIC RESONANCE IMAGING

Low‐field magnetic resonance imaging (MRI) is commonly used to evaluate dogs with suspected cranial cruciate ligament injury; however, effects of stifle positioning and scan plane on visualization of the ligament are incompletely understood. Six stifle joints (one pilot, five test) were collected from dogs that were scheduled for euthanasia due to reasons unrelated to the stifle joint. Each stifle joint was scanned in three angles of flexion (90°, 135°, 145°) and eight scan planes (three dorsal, three axial, two sagittal), using the same low‐field MRI scanner and T2‐weighted fast spin echo scan protocol. Two experienced observers who were unaware of scan technique independently scored visualization of the cranial cruciate ligament in each scan using a scale of 0–3. Visualization score rank sums were higher when the stifle was flexed at 90° compared to 145°, regardless of the scan plane. Visualization scores for the cranial cruciate ligament in the dorsal (H (2) = 19.620, P = 0.000), axial (H (2) = 14.633, P = 0.001), and sagittal (H (2) = 8.143, P = 0.017) planes were significantly affected by the angle of stifle flexion. Post hoc analysis showed that the ligament was best visualized at 90° compared to 145° in the dorsal (Z = ?3.906, P = 0.000), axial (Z = ?3.398, P = 0.001), and sagittal (Z = ?2.530, P = 0.011) planes. Findings supported the use of a 90° flexed stifle position for maximizing visualization of the cranial cruciate ligament using low‐field MRI in dogs.     

MAGNETIC RESONANCE IMAGING FEATURES OF PROXIMAL METACARPAL AND METATARSAL INJURIES IN THE HORSE

Magnetic resonance (MR) imaging abnormalities in horses with lameness localized to the proximal metacarpal or metatarsal region have not been described. To accomplish that, the medical records of 45 horses evaluated with MR imaging that had lameness localized to either the proximal metacarpal or metatarsal region were reviewed. Abnormalities observed in the proximal suspensory ligament or the accessory ligament of the deep digital flexor tendon included abnormal high signal, enlargement, or alteration in shape. Twenty-three horses had proximal suspensory ligament desmitis (13 hindlimb, 10 forelimb). Sixteen horses had desmitis of the accessory ligament of the deep digital flexor tendon. One horse had desmitis of the proximal suspensory ligament and the accessory ligament of the deep digital flexor tendon on the same limb and one horse had desmitis of the proximal suspensory ligament on one forelimb and desmitis of the accessory ligament of the deep digital flexor tendon on the other forelimb. Four horses did not have abnormalities in the proximal suspensory ligament or accessory ligament of the deep digital flexor tendon. Eighty percent of horses with forelimb proximal suspensory ligament desmitis and 69% of horses with hindlimb proximal suspensory ligament desmitis returned to their intended use. Sixty-three percent of horses with desmitis of the accessory ligament of the deep digital flexor tendon were able to return to their intended use. MR imaging is a valuable diagnostic modality that allows diagnosis of injury in horses with lameness localized to the proximal metacarpal and metatarsal regions. The ability to accurately diagnose the source of lameness is important in selecting treatment that will maximize the chance to return to performance.     

LOW‐FIELD MAGNETIC RESONANCE IMAGING APPEARANCE OF POSTARTHROSCOPIC MAGNETIC SUSCEPTIBILITY ARTIFACTS IN HORSES

An awareness of magnetic susceptibility artifacts is important for interpreting prepurchase and postoperative magnetic resonance imaging (MRI) studies in horses. These artifacts occur when a metallic or a paramagnetic substance creates a local magnetic field deformity. Aims of the current experimental study were to determine prevalence of these artifacts after arthroscopy in a sample of nonlame horses, and to describe effects of time and type of pulse sequence on low‐field MRI signal intensity and detection of the artifacts. Ten, nonlame Standardbred horses were prospectively recruited. All horses underwent arthroscopy of both metacarpophalangeal joints for purposes unrelated to the study. Serial low‐Field MRI examinations were performed on each horse and each joint (before, and 6 and 12 weeks postsurgery). In two horses, more detailed longitudinal evaluations were performed with additional MRI examinations. Magnetic susceptibility artifacts were detected postoperatively at the surgical access sites in eight metacarpophalangeal joints at both 6 and 12 weeks after surgery (40% prevalence). Neither of the two longitudinally followed horses had artifacts at any time. Artifacts were only detected on gradient echo (GRE) sequences. Findings indicated that magnetic susceptibility artifacts can be present in postarthroscopy MRI studies in horses and can persist up to 12 weeks after arthroscopy. For this sample of horses, the artifacts did not interfere with evaluation of the joint. Further longitudinal studies are needed to determine the full duration of magnetic susceptibility artifact persistence in affected tissues.     

3 TESLA MAGNETIC RESONANCE IMAGING OF THE OCCIPITOATLANTOAXIAL REGION IN THE NORMAL HORSE

The aim of this study was to describe the appearance of the ligamentous structures of the occipitoatlantoaxial (OAA) region in the normal horse by 3 tesla (3T) magnetic resonance imaging (MRI). The MRI images of the longitudinal odontoid ligament, tectorial membrane, dorsal and ventral atlantoaxial ligaments, dorsal atlantooccipital membrane with its reinforcing ligaments, and the lateral atlantooccipital ligaments of 10 horse cadavers were evaluated. All ligaments and membranes were identified in all planes, except for the lateral atlantooccipital ligament in the sagittal plane due to its cranioventrolateral course. All were iso to mildly hypointense to musculature of the neck in T1W with the exception of the tectorial membrane that was moderately hypointense; moderately hypointense in PD‐SPIR, and markedly hypointense (isointense to cortical bone) in T2W. The PD‐SPIR was the best sequence to identify all ligaments and membranes from their cranial and caudal attachments. The longitudinal odontoid ligament, ventral atlantoaxial ligament, and reinforcing bands of the dorsal atlantooccipital membrane presented a characteristic striped heterogeneous signal behavior thought to be due to fibrocartilaginous content. The remaining ligaments and membranes showed homogeneous signal intensity. Special anatomical features in this species such as the fan‐shaped longitudinal odontoid ligament, absence of the transverse ligament and presence of the ventral atlantoaxial ligament were documented. Ligamentous structures that stabilize the equine OAA region were described with MRI in this study and these findings could serve as an anatomic reference for those cases where instability of this region is suspected.     

DISTAL INTERPHALANGEAL ARTICULAR CARTILAGE ASSESSMENT USING LOW‐FIELD MAGNETIC RESONANCE IMAGING

The suitability of low‐field magnetic resonance (MR) imaging for assessment of articular cartilage has been questioned, based on insufficient image quality. The purposes of this study were to describe the MR anatomy of the normal distal interphalangeal (DIP) cartilage, and to evaluate the sensitivity and accuracy of low‐field MR imaging for identification of cartilage erosions that were created ex vivo. Imaging sequences included sagittal and dorsal multiple‐oblique T1‐weighted gradient‐recalled echo (GRE) and sagittal dual echo sequences. In the thickest regions, normal cartilage appeared as a trilaminar structure on high‐resolution T1‐weighted GRE sequences. All 8 mm large full‐thickness erosions were correctly identified (100% sensitivity and accuracy) using T1‐weighted GRE sequences. Sensitivity and accuracy ranged from 80% to 100% and 10% to 80%, respectively, for detecting focal full‐thickness erosions and from 35% to 80% and 35% to 60%, respectively, for detecting partial thickness erosions, using T1‐weighted GRE sequences. Superficial irregularities were not diagnosed using any sequence. Overall, fewer cartilage alterations were detected with sagittal dual echo sequences than with sagittal T1‐weighted GRE sequences. The dorsal multiple‐oblique plane was useful to detect linear dorsopalmar erosions. A combination of T1‐weighted GRE sequences in two planes has potential for identification of severe DIP cartilage erosion in anesthetized horses using low‐field MR imaging.     

TRUNCATION ARTIFACT IN MAGNETIC RESONANCE IMAGES OF THE CANINE SPINAL CORD

The truncation artifact in magnetic resonance (MR) images is a line of abnormal signal intensity that occurs parallel to an interface between tissues of markedly different signal intensity. In order to demonstrate the truncation artifact in sagittal images of the canine spinal cord and the effect of changing spatial resolution, we conducted an experimental in vitro study. A section of fixed canine spinal cord was imaged using a 1.5T magnet. Spatial resolution was increased by increasing the acquisition matrix and reconstruction matrix, producing series of T2‐weighted (T2w) images with the following pixel sizes: A, 1.6 (vertical) × 2.2 mm² (horizontal); B, 1.2 × 1.7 mm²; C, 0.8 × 1.1 mm²; D, 0.4 × 0. 6 mm². Plots of mean pixel value across the cord showed variations in signal intensity compatible with truncation artifact, which appeared as a single, wide central hyperintense zone in low‐resolution images and as multiple narrower zones in high spatial resolution images. Even in images obtained using the highest spatial resolution available for the MR system, the edge of the spinal cord was not accurately defined and the central canal was not visible. The experiment was repeated using an unfixed spinal cord specimen with focal compression applied to mimic a pathologic lesion. Slight hyperintensity was observed within the spinal cord at the site of compression although the cord was normal histologically. Results of this study suggest that caution should be applied when interpreting hyperintensity affecting the spinal cord in T2w sagittal images of clinical patients because of the possibility that the abnormal signal could represent a truncation artifact.     

THORACOLUMBAR INTRADURAL DISC HERNIATION IN EIGHT DOGS: CLINICAL,LOW‐FIELD MAGNETIC RESONANCE IMAGING,AND COMPUTED TOMOGRAPHIC MYELOGRAPHY FINDINGS

Intradural disc herniation is a rarely reported cause of neurologic deficits in dogs and few published studies have described comparative imaging characteristics. The purpose of this retrospective cross sectional study was to describe clinical and imaging findings in a group of dogs with confirmed thoracolumbar intradural disc herniation. Included dogs were referred to one of four clinics, had acute mono/paraparesis or paraplegia, had low field magnetic resonance imaging (MRI) and/or computed tomographic myelography, and were diagnosed with thoracolumbar intradural disc herniation during surgery. Eight dogs met inclusion criteria. The prevalence of thoracolumbar intradural disc herniation amongst the total population of dogs that developed a thoracolumbar intervertebral disc herniation and that were treated with a surgical procedure was 0.5%. Five dogs were examined using low‐field MRI. Lesions that were suspected to be intervertebral disc herniations were observed; however, there were no specific findings indicating that the nucleus pulposus had penetrated into the subarachnoid space or into the spinal cord parenchyma. Thus, the dogs were misdiagnosed as having a conventional intervertebral disc herniation. An intradural extramedullary disc herniation (three cases) or intramedullary disc herniation (two cases) was confirmed during surgery. By using computed tomographic myelography (CTM) for the remaining three dogs, an intradural extramedullary mass surrounded by an accumulation of contrast medium was observed and confirmed during surgery. Findings from this small sample of eight dogs indicated that CTM may be more sensitive for diagnosing canine thoracolumbar intradural disc herniation than low‐field MRI.