Dyson S, Murray R, Schramme M, Branch M
Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU.
Equine Vet J. 2003 Jan;35(1):18-26. doi: 10.2746/042516403775467531.
Foot pain is a common cause of equine lameness and there have been significant limitations of the methods available for the diagnosis of the causes of foot pain (radiography, nuclear scintigraphy and ultrasonography). Until recently, magnetic resonance imaging (MRI) in the horse has been limited to examination of cadaver limbs.
Our purpose was to 1) describe MRI of the foot in live horses, 2) describe MRI findings in horses with foot pain in which a definitive diagnosis could not be established by alternative means and 3) correlate MRI findings with other methods of clinical investigation.
The feet of 15 horses with unilateral (12) or bilateral (3), forelimb (14) or hindlimb (1) lameness associated with foot pain of previously ill-defined origin were examined using MRI. The horses were examined in right lateral recumbency under general anaesthesia, with the feet positioned in the isocentre of a flared end 1.5 Tesla GE Signa Echospeed magnet. Images were obtained in sagittal, transverse and dorsal planes using 3-dimensional (3D) T2* gradient echo (GRE), spoiled gradient echo, fat-saturated 3D T2* GRE and short inversion recovery sequences. Image acquisition took approximately 1 h.
Abnormalities of the distal interphalangeal joint (DIP) cartilage and/or subchondral bone, periarticular osteophyte formation, distension of the DIP joint capsule with or without synovial proliferation, distension of the navicular bursa with or without evidence of chronic inflammation, surface and core lesions in the deep digital flexor tendon, abnormal signal within the navicular bone, evidence of mineralised fragments in the distal sesamoidean impar ligament, irregular outline of and signal in the medial cortex of the distal phalanx, and an abnormal signal on the dorsal aspect of the distal phalanx consistent with laminitis were identified.
MRI permits the diagnosis of a variety of lesions involving different structures within the foot that cannot be diagnosed using other means, thus enhancing our knowledge of the causes of foot pain.
With further experience it is likely that lesions involving other structures will also be identified. Long-term follow-up data is required to determine the prognosis for the injuries described.
足部疼痛是马跛行的常见原因,而用于诊断足部疼痛病因的现有方法(放射摄影、核闪烁扫描和超声检查)存在显著局限性。直到最近,马的磁共振成像(MRI)还仅限于对尸体肢体进行检查。
我们的目的是:1)描述活马足部的MRI表现;2)描述在无法通过其他方法确诊的足部疼痛马匹中的MRI检查结果;3)将MRI检查结果与其他临床检查方法进行关联。
对15匹因足部疼痛导致单侧(12匹)或双侧(3匹)、前肢(14匹)或后肢(1匹)跛行且病因不明的马的足部进行MRI检查。在全身麻醉下将马右侧卧保定,足部置于1.5特斯拉GE Signa Echospeed开放式磁体的等中心。使用三维(3D)T2梯度回波(GRE)、扰相梯度回波、脂肪抑制3D T2 GRE和短反转恢复序列在矢状面、横断面和背侧平面获取图像。图像采集大约需要1小时。
发现远侧指间关节(DIP)软骨和/或软骨下骨异常;关节周围骨赘形成;DIP关节囊扩张伴或不伴滑膜增生;舟状黏液囊扩张伴或不伴慢性炎症迹象;指深屈肌腱表面和核心病变;舟状骨内信号异常;远籽骨间韧带内有矿化碎片迹象;远节趾骨内侧皮质轮廓和信号不规则;远节趾骨背侧出现与蹄叶炎一致的异常信号。
MRI能够诊断多种累及足部不同结构的病变,而这些病变无法通过其他方法诊断,从而增进了我们对足部疼痛病因的了解。
随着经验的积累,可能会发现累及其他结构的病变。需要长期随访数据来确定所述损伤的预后情况。