Comparisons of computed tomography, contrast-enhanced computed tomography and standing low-field magnetic resonance imaging in horses with lameness localised to the foot. Part 2: Lesion identification

S. A. Vallance, R. J W Bell, Mathieu Spriet, Philip H Kass, S. M. Puchalski

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Reasons for performing study: No previous study compares computed tomography (CT), contrast-enhanced computed tomography (CECT) and standing low-field magnetic resonance imaging (LFMRI) to detect lesions in horses with lameness localised to the foot. This study will help clinicians understand the limitations of these techniques. Objectives: To determine if CT, CECT and LFMRI would identify lesions within the distal limb and document discrepancies with lesion distribution and lesion classification. Methods: Lesions in specific structures identified on CT and MR images of feet (31 limbs) from the same horse were reviewed and compared. Distributions of lesions were compared using a Chi-squared test and techniques analysed using the paired marginal homogeneity test for concordance. Results: Lesions of the deep digital flexor tendon (DDFT) were most common and CT/CECT identified more lesions than LFMRI. Deep digital flexor tendon lesions seen on LFMRI only were frequently distal to the proximal extent of the distal sesamoid and DDFT lesions seen on CT/CECT only were frequently proximal to the distal sesamoid. Lesions identified on LFMRI only were core (23.3%) or splits (43.3%), whereas lesions identified only on CT were abrasions (29.8%), core (15.8%), enlargement (15.8%) or mineralisation (12.3%). Contrast-enhanced CT improved lesion identification at the DDFT insertion compared to CT and resulted in distal sesamoidean impar ligament and collateral sesamoidean ligament vascular enhancement in 75% of cases. Low-field MRI and CT/CECT failed to identify soft tissue mineralisation and bone oedema, respectively. Conclusions and potential relevance: Multiple lesions are detected with CT, CECT and LFMRI but there is variability in lesion detection and classification. LFMRI centred only on the podotrochlear apparatus may fail to identify lesions of the pastern or soft tissue mineralisation. Computed tomography may fail to identify DDFT lesions distal to the proximal border of the distal sesamoid.

Original languageEnglish (US)
Pages (from-to)149-156
Number of pages8
JournalEquine Veterinary Journal
Volume44
Issue number2
DOIs
StatePublished - Mar 2012

Fingerprint

computed tomography
magnetic resonance imaging
lameness
lesions (animal)
Horses
Foot
Tomography
Magnetic Resonance Imaging
horses
tendons
Tendons
mineralization
ligaments
limbs (animal)
Extremities
Physiologic Calcification
Collateral Ligaments
Ligaments
blood vessels
Blood Vessels

Keywords

  • Computed tomography
  • Contrast enhanced CT
  • Foot
  • Horse
  • Lameness
  • Lesion
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Equine

Cite this

@article{2a8c1a38681841b08e642330679ea16b,
title = "Comparisons of computed tomography, contrast-enhanced computed tomography and standing low-field magnetic resonance imaging in horses with lameness localised to the foot. Part 2: Lesion identification",
abstract = "Reasons for performing study: No previous study compares computed tomography (CT), contrast-enhanced computed tomography (CECT) and standing low-field magnetic resonance imaging (LFMRI) to detect lesions in horses with lameness localised to the foot. This study will help clinicians understand the limitations of these techniques. Objectives: To determine if CT, CECT and LFMRI would identify lesions within the distal limb and document discrepancies with lesion distribution and lesion classification. Methods: Lesions in specific structures identified on CT and MR images of feet (31 limbs) from the same horse were reviewed and compared. Distributions of lesions were compared using a Chi-squared test and techniques analysed using the paired marginal homogeneity test for concordance. Results: Lesions of the deep digital flexor tendon (DDFT) were most common and CT/CECT identified more lesions than LFMRI. Deep digital flexor tendon lesions seen on LFMRI only were frequently distal to the proximal extent of the distal sesamoid and DDFT lesions seen on CT/CECT only were frequently proximal to the distal sesamoid. Lesions identified on LFMRI only were core (23.3{\%}) or splits (43.3{\%}), whereas lesions identified only on CT were abrasions (29.8{\%}), core (15.8{\%}), enlargement (15.8{\%}) or mineralisation (12.3{\%}). Contrast-enhanced CT improved lesion identification at the DDFT insertion compared to CT and resulted in distal sesamoidean impar ligament and collateral sesamoidean ligament vascular enhancement in 75{\%} of cases. Low-field MRI and CT/CECT failed to identify soft tissue mineralisation and bone oedema, respectively. Conclusions and potential relevance: Multiple lesions are detected with CT, CECT and LFMRI but there is variability in lesion detection and classification. LFMRI centred only on the podotrochlear apparatus may fail to identify lesions of the pastern or soft tissue mineralisation. Computed tomography may fail to identify DDFT lesions distal to the proximal border of the distal sesamoid.",
keywords = "Computed tomography, Contrast enhanced CT, Foot, Horse, Lameness, Lesion, Magnetic resonance imaging",
author = "Vallance, {S. A.} and Bell, {R. J W} and Mathieu Spriet and Kass, {Philip H} and Puchalski, {S. M.}",
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T1 - Comparisons of computed tomography, contrast-enhanced computed tomography and standing low-field magnetic resonance imaging in horses with lameness localised to the foot. Part 2

T2 - Lesion identification

AU - Vallance, S. A.

AU - Bell, R. J W

AU - Spriet, Mathieu

AU - Kass, Philip H

AU - Puchalski, S. M.

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N2 - Reasons for performing study: No previous study compares computed tomography (CT), contrast-enhanced computed tomography (CECT) and standing low-field magnetic resonance imaging (LFMRI) to detect lesions in horses with lameness localised to the foot. This study will help clinicians understand the limitations of these techniques. Objectives: To determine if CT, CECT and LFMRI would identify lesions within the distal limb and document discrepancies with lesion distribution and lesion classification. Methods: Lesions in specific structures identified on CT and MR images of feet (31 limbs) from the same horse were reviewed and compared. Distributions of lesions were compared using a Chi-squared test and techniques analysed using the paired marginal homogeneity test for concordance. Results: Lesions of the deep digital flexor tendon (DDFT) were most common and CT/CECT identified more lesions than LFMRI. Deep digital flexor tendon lesions seen on LFMRI only were frequently distal to the proximal extent of the distal sesamoid and DDFT lesions seen on CT/CECT only were frequently proximal to the distal sesamoid. Lesions identified on LFMRI only were core (23.3%) or splits (43.3%), whereas lesions identified only on CT were abrasions (29.8%), core (15.8%), enlargement (15.8%) or mineralisation (12.3%). Contrast-enhanced CT improved lesion identification at the DDFT insertion compared to CT and resulted in distal sesamoidean impar ligament and collateral sesamoidean ligament vascular enhancement in 75% of cases. Low-field MRI and CT/CECT failed to identify soft tissue mineralisation and bone oedema, respectively. Conclusions and potential relevance: Multiple lesions are detected with CT, CECT and LFMRI but there is variability in lesion detection and classification. LFMRI centred only on the podotrochlear apparatus may fail to identify lesions of the pastern or soft tissue mineralisation. Computed tomography may fail to identify DDFT lesions distal to the proximal border of the distal sesamoid.

AB - Reasons for performing study: No previous study compares computed tomography (CT), contrast-enhanced computed tomography (CECT) and standing low-field magnetic resonance imaging (LFMRI) to detect lesions in horses with lameness localised to the foot. This study will help clinicians understand the limitations of these techniques. Objectives: To determine if CT, CECT and LFMRI would identify lesions within the distal limb and document discrepancies with lesion distribution and lesion classification. Methods: Lesions in specific structures identified on CT and MR images of feet (31 limbs) from the same horse were reviewed and compared. Distributions of lesions were compared using a Chi-squared test and techniques analysed using the paired marginal homogeneity test for concordance. Results: Lesions of the deep digital flexor tendon (DDFT) were most common and CT/CECT identified more lesions than LFMRI. Deep digital flexor tendon lesions seen on LFMRI only were frequently distal to the proximal extent of the distal sesamoid and DDFT lesions seen on CT/CECT only were frequently proximal to the distal sesamoid. Lesions identified on LFMRI only were core (23.3%) or splits (43.3%), whereas lesions identified only on CT were abrasions (29.8%), core (15.8%), enlargement (15.8%) or mineralisation (12.3%). Contrast-enhanced CT improved lesion identification at the DDFT insertion compared to CT and resulted in distal sesamoidean impar ligament and collateral sesamoidean ligament vascular enhancement in 75% of cases. Low-field MRI and CT/CECT failed to identify soft tissue mineralisation and bone oedema, respectively. Conclusions and potential relevance: Multiple lesions are detected with CT, CECT and LFMRI but there is variability in lesion detection and classification. LFMRI centred only on the podotrochlear apparatus may fail to identify lesions of the pastern or soft tissue mineralisation. Computed tomography may fail to identify DDFT lesions distal to the proximal border of the distal sesamoid.

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KW - Contrast enhanced CT

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KW - Lameness

KW - Lesion

KW - Magnetic resonance imaging

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