Aarsvold S, Solano M, Garcia-Lopez J
Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, USA.
Equine Vet J. 2018 Sep;50(5):649-657. doi: 10.1111/evj.12818. Epub 2018 Feb 28.
Systemic administration of gadolinium contrast medium is common in small animals to increase lesion conspicuity and determine vascularisation of lesions identified with magnetic resonance imaging (MRI); however, the large volume required for systemic administration limits its use in horses.
The purpose of this study was to assess the feasibility of administering a low dose of contrast medium via venous regional limb perfusion.
Prospective clinical study.
Distal limbs of 26 horses (one limb per horse) were imaged with MRI before and after administration of 5 mL of gadopentetate dimeglumine (Magnevist ) diluted with 5 mL of physiological saline via a palmar/plantar digital vein with a tourniquet in place at the level of the mid aspect of the third metacarpal/metatarsal bone. Commonly assessed structures of the equine distal limb were examined for normal and abnormal contrast enhancement.
Twenty-five of 26 horses had adequate contrast enhancement of their distal limb. The lack of adequate contrast enhancement in one limb was likely associated with failure of the tourniquet. No adverse reactions were identified in any horse. One hundred thirty-two lesions were detected, of which, 69 contrast enhanced. Twelve lesions were detected exclusively following contrast enhancement.
Case numbers and lesion variability yielded insufficient data to perform statistical analyses. Histopathology was not performed on sound horses to determine if the imaged structures were normal.
Regional limb perfusion is a feasible method to administer gadolinium contrast material to the equine distal limb for MRI. The enhancement pattern of the equine distal limb in sound horses is described. Contrast enhanced MRI of the distal equine limb helps to further characterise lesions identified with precontrast images, including adhesions and deep digital flexor tendinopathy. Contrast enhanced MRI also aids in identification of additional lesions, such as neovascularisation.
在小动物中,全身注射钆对比剂很常见,用于增强病变的显影并确定磁共振成像(MRI)所发现病变的血管化情况;然而,全身注射所需的大剂量限制了其在马身上的应用。
本研究的目的是评估通过静脉区域肢体灌注给予低剂量对比剂的可行性。
前瞻性临床研究。
对26匹马的远端肢体(每匹马一个肢体)在通过掌/跖指静脉注射5 mL钆喷酸葡胺(马根维显)并用止血带在第三掌骨/跖骨中部水平处扎住,该钆喷酸葡胺用5 mL生理盐水稀释前后进行MRI成像。检查马远端肢体常见的评估结构,观察正常和异常的对比增强情况。
26匹马中有25匹其远端肢体有足够的对比增强。一个肢体对比增强不足可能与止血带使用失败有关。未在任何一匹马中发现不良反应。共检测到132个病变,其中69个有对比增强。12个病变仅在对比增强后被检测到。
病例数量和病变变异性产生的数据不足,无法进行统计分析。未对健康马匹进行组织病理学检查以确定成像结构是否正常。
区域肢体灌注是向马远端肢体注射钆对比剂以进行MRI检查的一种可行方法。描述了健康马匹远端肢体的增强模式。马远端肢体的对比增强MRI有助于进一步明确对比前图像所发现病变的特征,包括粘连和指深屈肌腱病。对比增强MRI也有助于识别其他病变,如新生血管形成。