Scharf Alexandra, Acutt Elizabeth, Bills Kathryn, Werpy Natasha
Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Equine Diagnostic Imaging, Inc., Archer, Florida, USA.
Equine Vet J. 2025 Sep;57(5):1183-1203. doi: 10.1111/evj.14508. Epub 2025 May 2.
Deep digital flexor (DDF) tendinopathy is a significant cause of lameness and poor performance in equine athletes with substantial implications for their return to athletic performance. Magnetic resonance imaging (MRI) is increasingly integrated into the diagnostic workup of horses with foot pain and has revolutionised the diagnosis and management of these injuries. This review discusses the principles of MRI in the context of deep digital flexor tendon (DDFT) injury, comparing high-field and low-field systems and highlighting the clinical relevance of technical parameters, including field strength and sequence selection, in achieving an accurate diagnosis. This review also critically evaluates how different configurations and/or imaging features of tendon lesions may impact patient prognosis, considers the complementary role of computed tomography and ultrasonography in cases where MRI may not be feasible, and discusses emerging imaging techniques including positron emission tomography (PET)-MRI and quantitative MRI. Lastly, this review underscores the importance of serial imaging to monitor lesion progression and guide rehabilitation, while identifying knowledge gaps and proposing future research directions. Ultimately, a multidisciplinary approach incorporating advanced imaging and tailored rehabilitation is essential to improving clinical outcomes in horses with DDFT injuries.
指深屈肌腱(DDF)病变是导致马属动物运动员跛行和运动成绩不佳的重要原因,对其恢复运动能力有重大影响。磁共振成像(MRI)越来越多地被纳入对蹄部疼痛马匹的诊断检查中,并彻底改变了这些损伤的诊断和管理方式。本综述讨论了在指深屈肌腱(DDFT)损伤背景下MRI的原理,比较了高场和低场系统,并强调了技术参数(包括场强和序列选择)在实现准确诊断方面的临床相关性。本综述还批判性地评估了肌腱病变的不同形态和/或成像特征如何影响患者预后,考虑了在MRI不可行的情况下计算机断层扫描和超声检查的互补作用,并讨论了包括正电子发射断层扫描(PET)-MRI和定量MRI在内的新兴成像技术。最后,本综述强调了系列成像在监测病变进展和指导康复方面的重要性,同时指出了知识空白并提出了未来的研究方向。最终,采用包括先进成像和量身定制的康复方案的多学科方法对于改善患有DDFT损伤马匹的临床结局至关重要。