Holowinski Maureen E, Solano Mauricio, Maranda Louise, García-López José M
Tufts Cummings School of Veterinary Medicine, North Grafton, MA 01536, USA.
Vet Radiol Ultrasound. 2012 Sep-Oct;53(5):566-72. doi: 10.1111/j.1740-8261.2012.01954.x. Epub 2012 Jun 25.
Adhesions occur in the navicular bursa between the deep digital flexor tendon (DDFT) and other structures. Our objectives were to describe the appearance of navicular bursa adhesions on high-field magnetic resonance (MR) images, to compare these findings to findings at navicular bursoscopy, and to determine the prevalence of lesions in the remainder of the podotrochlear apparatus. Sixteen forelimbs from 14 horses that underwent MR imaging and navicular bursoscopy were evaluated. Adhesions were considered type 1 when characterized by a discontinuity in the navicular bursa fluid signal between two structures, type 2 when the navicular bursa fluid signal was disrupted and ill-defined tissue was present between two structures, and type 3 when the fluid signal was disrupted and well-defined tissue was present between two structures. Twenty-six adhesions were suspected on MR images and nineteen were visualized at surgery. The positive predictive value was 50% for type 1 adhesions, 67% for type 2 adhesions, and 100% for type 3 adhesions. Additional lesions were detected in the navicular bursa in 15 limbs, the DDFT in 13, the navicular bone in 15, the collateral sesamoidean ligaments in 9, and the distal sesamoidean impar ligament in 8. A discontinuity in the navicular bursa fluid signal with well-defined tissue between two structures detected on high-field MR images is diagnostic for a navicular bursa adhesion. Additional lesions in the podotrochlear apparatus are common in horses with navicular bursa adhesions.
粘连发生于指深屈肌腱（DDFT）与其他结构之间的舟状黏液囊内。我们的目的是描述高场磁共振（MR）图像上舟状黏液囊粘连的表现，将这些发现与舟状黏液囊镜检查结果进行比较，并确定跗关节装置其余部分病变的发生率。对14匹马的16个前肢进行了MR成像和舟状黏液囊镜检查评估。当两个结构之间的舟状黏液囊液信号不连续时，粘连被认为是1型；当舟状黏液囊液信号中断且两个结构之间存在边界不清的组织时，为2型；当液信号中断且两个结构之间存在边界清晰的组织时，为3型。MR图像上疑似26处粘连，手术中观察到19处。1型粘连的阳性预测值为50%，2型粘连为67%，3型粘连为100%。在15个肢体的舟状黏液囊中检测到其他病变，13个在指深屈肌腱，15个在舟状骨，9个在籽骨侧韧带，8个在远籽骨间韧带。在高场MR图像上检测到两个结构之间的舟状黏液囊液信号中断且有边界清晰的组织，可诊断为舟状黏液囊粘连。跗关节装置中的其他病变在患有舟状黏液囊粘连的马匹中很常见。
