Abstract
The use of contrast enhanced magnetic resonance imaging (MRI) for the detection of orthopedic pathologies in equine patients is poorly described. In few studies, enhanced MRI allowed to differentiate active lesions from chronic ones and to classify ambiguous lesions. The aim of this clinical prospective pilot study is to describe and compare the MRI lesions observed in horses with lameness localized to the foot using a single intravenous bolus dose of gadolinium contrast versus regional intraarterial bolus of contrast agent. Ten horses that underwent contrast enhanced MRI were included in the study. Gadolinium was injected intravenously in 3 patients and in 7 horses contrast agent was administered by intraarterial regional delivery. Regions of interest (ROI) were collected from both pre- and post-contrast images and ratios between pre- and post-contrast ROIs were calculated. No adverse reactions were noted after contrast agent injection. Injured structures that revealed greater increase in signal in post-contrast images were the deep digital flexor tendon (DDFT), the navicular spongiosa and the peritendinous tissues. Regional intraarterial administration of gadolinium provided higher ratio of contrast enhancement. Enhanced MRI using both intravenous or intraarterial injection of gadolinium, increased the diagnostic capability of MRI in horses with foot lesions. Nevertheless, regional intraarterial administration of gadolinium was considered the best choice due to the higher signal and lower volumes of contrast agent required.
Highlights
Magnetic resonance imaging (MRI) is widely used in the diagnosis of orthopaedic disease in horses
The aim of this study is to describe the effectiveness of enhanced magnetic resonance imaging (MRI) in equine patients with lameness localized to the foot region using a single intravenous bolus dose of gadolinium contrast versus regional intraarterial bolus of contrast agent and comparing the contrast enhancement obtained using the systemic injection versus the loco-regional administration of contrast agent
An erosion of the flexor cortex of the navicular bone was observed in both pre-contrast T1W and STIR sequences, showing an intense enhancement after contrast agent injection. In this pilot study we described the effectiveness of enhanced MRI in equine patients with lameness localized to the foot using a single intravenous bolus dose of gadolinium contrast versus regional intraarterial bolus of contrast agent and comparing the contrast enhancement obtained using the systemic injection versus the loco-regional administration of contrast agent
Summary
Magnetic resonance imaging (MRI) is widely used in the diagnosis of orthopaedic disease in horses. As a consequence of the high sensitivity of MRI in detection of changes within soft tissues, understanding which lesions are involved in the current clinical process may be difficult (Judy et al, 2010; Severaid and Judy, 2012). Holowinsky et al (2010) observed that resolution of tendons and ligaments lesions on STIR images was related to an improvement of the lameness. The high capability of enhanced CT and MRI in soft tissue lesion detection has been proved but the administration of an appropriate systemic dose of intravenous contrast agent is not practical due to the large volume required. To significantly reduce the contrast agent dose and injection time, regional intraarterial administration contrast agent has been used in CT studies of the equine distal limb and head, and a small but statistically significant increase in attenuation of soft tissue was observed (Puchalski et al, 2007; Open Veterinary Journal, (2018), Vol 8(4): 471-478
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