Use of standing low-field magnetic resonance imaging to assess oblique distal sesamoidean ligament desmitis in three Thoroughbred racehorses

Mizobe, Fumiaki; Okada, Jun; Shinzaki, Yuta; Nomura, Motoi; Kato, Tomohiro; Yamada, Kazutaka; Spriet, Mathieu

doi:10.1292/jvms.15-0656

Cited by 8 publications

(14 citation statements)

References 19 publications

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“…Injuries to the SDSL and ODSL are rare, but in recent years have become better defined by improvements in imaging. [1][2][3][4][5][6] However, ultrasonography of these structures can be technically challenging, and previous studies have detected lesions ultrasonographically in only 7% (2/27) and 20% (9/45) of cases, respectively, with the remainder diagnosed under general anaesthesia with the use of high-field (1-1.5T) MRI. [1][2] However, both of these studies failed to describe specific ultrasonographic imaging planes optimised for detecting DSL injury.…”

Section: Accepted Articlementioning

confidence: 99%

Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses

Hawkins

O’Leary

Bolt

et al. 2021

Equine Veterinary Journal

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Background: Injuries to the oblique (ODSL) or straight (SDSL) distal sesamoidean ligaments are a recognised cause of distal limb lameness in the horse. However, there are only limited publications addressing common diagnostic features and prognosis. Objectives: 1) Report findings on ultrasonography and standing low-field magnetic resonance imaging (sMRI) in horses with ODSL or SDSL injury; 2) Identify clinical variables associated with lesion type; 3) Identify factors associated with return to soundness in horses with ODSL or SDSL injury. Study design: Retrospective case series. Methods: Horses with a primary diagnosis of ODSL or SDSL injury confirmed with a combination of diagnostic analgesia and detection of a lesion on imaging (ultrasonographic +/-advanced imaging) were included. Return to soundness and performance follow-up data were obtained. Results: Fifty-one horses were included. SDSL injuries were more common in the forelimb (13/21, 62%) while ODSL injuries had equal frequency in fore-(15/30, 50%) and hindlimbs (15/30, 50%). ODSL injuries were more likely than SDSL injuries in the proximal third of the ligament (OR 13, 95% CI 2.3-74.3; p=0.004) and often presented with periligamentar swelling (20/30;67%) and focal pain (22/28;79%). Lesions were frequently detected using ultrasonography (35/42;83%) and sMRI examination (18/25;72%). Only 27/49 cases (55%) returned to soundness, with only 15/49 (31%) returning to intended use. There were no significant associations between outcome and clinical features or treatment. Main limitations: There was no comparative "gold standard" to validate lesions such as highfield MRI or histopathology. Conclusions: In contrast to previous studies, ODSL and SDSL injuries were readily identified ultrasonographically using appropriate views, and with sMRI. Given the limited availability, cost and general anaesthetic risks associated with high-field MRI, more focus should be placed on optimising the ultrasonographic examination. Owners of affected horses should be informed of the guarded prognosis for return to full use.

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Section: Accepted Articlementioning

confidence: 99%

Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses

Hawkins

O’Leary

Bolt

et al. 2021

Equine Veterinary Journal

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“…'U-shaped', the system allows the patient to stand astride the magnet, scanning each limb individually (Hallmarq, 2018; Mair et al, 2016) ( Figure 3). This design enables scanning of structures as high as the carpus and tarsus, however movement artefacts are commonly seen in areas above the fetlock due to slight swaying of the patient (Mizobe et al, 2016). Nonetheless, it is the lower resolution ability of the low-field that allows for this movement whilst continuing to generate high quality images (Sherlock et al, 2008).…”

Section: Low-field Mrimentioning

confidence: 99%

“…In comparison, the low-field system is more cost efficient to install and maintain with a higher number of installations within practices nationwide (Mizobe et al, 2016;Swagemaker et al, 2016). This document is the Accepted Manuscript version of a Published Work that appeared in final form in the Veterinary Nurse, copyright © MA Healthcare, after peer review and technical editing by the publisher.…”

Section: Low-field Mrimentioning

confidence: 99%

Advanced equine diagnostics — magnetic resonance imaging

Riley

2018

The Veterinary Nurse

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Magnetic resonance imaging (MRI) has become one of the most valuable pieces of diagnostic equipment in equine practice. Both standing and general anaesthetic units are available in the UK and with growing popularity and public understanding, clinicians have an increased ability to utilise this modality. Considered 'gold standard' in terms of lameness diagnostics, MRI is non-invasive and has the capacity to enable precise diagnosis and treatment to be provided. MRI does not use ionising radiation and to date there has been no conclusive evidence to suggest any negative biological hazards associated with its use in patients or technicians. Ensuring the environment the unit is kept in is regulated, with minimal outside radiofrequency interference, and a clear gauss line adhered to, MRI can be calibrated via external services electronically or manually by appropriately trained staff. Patient care and procedural understanding are crucial elements of the veterinary nurse's role, identifying possible complications and implementing nursing interventions appropriately are vital to the successful management of the equine MRI patient. Key points  MRI allows detailed cross-sectional imaging of the target structures using multiple planes to depict up to 500 images per hoof.  MRI does not use ionising radiation, reducing the biological hazards associated with its use compared to that of radiography or computed tomography.  MRI is sensitive enough to depict evidence of pre-fractural damage, hairline fractures and singular lobe ligament damage.  Cost effective and with a multi-modal ability to identify soft tissue and osseous pathology.

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“…Injury of the OSLs is often reported on MRI as diffuse or focal increased signal as well as enlargement of the ligament. In multiple studies, desmopathy of the obliques was the most commonly diagnosed soft tissue injury in the fetlock/pastern region . These studies are limited by a lack of histopathology, the gold standard, to corroborate their imaging diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging and histopathological evaluation of equine oblique sesamoidean ligaments

Ellis

Barrett

Selberg

et al. 2020

Equine Veterinary Journal

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Background Pathology involving the oblique sesamoidean ligaments (OSLs) is commonly diagnosed during magnetic resonance imaging (MRI) of the equine distal limb. Presence of striations within the ligament and magic angle artefact can result in an incorrect diagnosis of pathological change. No studies have been performed using histopathology, the gold standard, to corroborate their imaging diagnosis. Objectives (a) To determine which MRI characteristics are associated with normal vs abnormal OSLs and (b) to evaluate the ability of MRI to correctly identify abnormal vs normal oblique sesamoidean ligaments using histopathology as the gold standard. Study design Observational, cross‐sectional study. Methods Cadaver limbs (n = 77) were obtained from horses (n = 21) subjected to euthanasia at the hospital. MRI and histopathology was performed on each of the limbs. MRI scoring was performed for multiple MRI characteristics, and each limb was deemed normal or abnormal. Histopathology scoring was performed to give an overall score of normal or abnormal. Mixed model logistic regression was performed to evaluate which MRI characteristics were associated with normal vs abnormal OSLs using backwards elimination and a significance level of <0.1. Sensitivity and specificity were also calculated. Results The sensitivity and specificity of MRI to correctly identify abnormal OSLs was 81% (95% CI 54%‐96%) and 90% (95% CI 79%‐96%) respectively. Based on logistic regression, increased cross‐sectional area at the origin (OR: 26.77, 95% CI 1.1‐4640, P = .07), increased ligament hyperintensity (OR: 9.59, 95% CI 1.23‐155; P = .04) and reduction in striations (increased hypointensity score) (OR: 7.8, 95% CI 0.72‐218, P = .07) were associated with abnormal OSL. Main limitations Lameness exam was not performed on any of the horses prior to euthanasia. Findings can only be applied to chronic, degenerative changes, rather than an acute injury. Conclusions Increased cross‐sectional area and changes in the signal intensity are associated with pathology within the OSLs. Medial to lateral size asymmetry and striation pattern variation can occur in histologically normal OSLs and should be interpreted with caution if other signs of pathology are absent.

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Use of standing low-field magnetic resonance imaging to assess oblique distal sesamoidean ligament desmitis in three Thoroughbred racehorses

Cited by 8 publications

References 19 publications

Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses

Retrospective analysis of oblique and straight distal sesamoidean ligament desmitis in 52 horses

Advanced equine diagnostics — magnetic resonance imaging

Magnetic resonance imaging and histopathological evaluation of equine oblique sesamoidean ligaments

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