Aßmann Anton D, Sànchez-Andrade José Suàrez, Argüelles David, Bischofberger Andrea S
Equine Hospital, Vetsuisse-Faculty, University of Zürich, 8057 Zürich, Switzerland.
Clinic for Diagnostic Imaging, Vetsuisse-Faculty, University of Zürich, 8057 Zürich, Switzerland.
Animals (Basel). 2025 Jul 31;15(15):2250. doi: 10.3390/ani15152250.
Diagnosing digital flexor tendon sheath (DFTS) pathologies, particularly manica flexoria (MF) tears, can be challenging with standard imaging modalities. Standing low-field MRI tenography (MRIt) may improve the detection rate of MF tears. This study aimed to compare ultrasonography, contrast radiography, pre-contrast MRI, and MRIt to detect naturally occurring MF lesions in horses undergoing tenoscopy. Ten horses with a positive DFTS block, which underwent contrast radiography, ultrasonography, MRI, MRIt, and tenoscopy were included. Two radiologists evaluated the images and recorded whether an MF lesion was present and determined the lesion side. Sensitivity and specificity were calculated for each modality using tenoscopy as a reference. MRIt and contrast radiography detected MF lesions with the same frequency, both showing 71% sensitivity and 100% specificity. Pre-contrast MRI and ultrasonography detected MF lesions with a lower sensitivity (57%); however, the MRI (100%) demonstrated a higher specificity than ultrasonography (33%). Adding contrast in MRI changed the sensitivity from (4/7 lesions) 57% to (5/7 lesions) 71%, with a constant high specificity (100%). MRIt diagnoses MF tears with a similar sensitivity to contrast radiography, with the same specificity, but with the added benefit of lesion laterality detection. The combined advantages of the anatomical detail of the T1 sequence and the post-contrast hyperintense appearance of the fluid may help diagnose MF tears and identify intact MFs. However, this needs to be substantiated in a larger number of cases.
诊断指屈肌腱鞘（DFTS）病变，尤其是屈肌总腱鞘（MF）撕裂，采用标准成像方式具有挑战性。站立位低场MRI肌腱造影（MRIt）可能提高MF撕裂的检出率。本研究旨在比较超声检查、造影X线摄影、造影前MRI和MRIt，以检测接受关节镜检查的马匹中自然发生的MF病变。纳入10匹DFTS阻滞阳性且接受了造影X线摄影、超声检查、MRI、MRIt和关节镜检查的马匹。两名放射科医生评估图像，记录是否存在MF病变并确定病变侧。以关节镜检查为参考，计算每种检查方式的敏感性和特异性。MRIt和造影X线摄影检测到MF病变的频率相同，敏感性均为71%，特异性均为100%。造影前MRI和超声检查检测MF病变的敏感性较低（57%）；然而，MRI（100%）的特异性高于超声检查（33%）。MRI中添加造影剂后，敏感性从（4/7个病变）57%变为（5/7个病变）71%，特异性保持较高（100%）。MRIt诊断MF撕裂的敏感性与造影X线摄影相似，特异性相同，但还具有检测病变侧别的额外优势。T1序列的解剖细节和造影后液体的高信号表现相结合的优势，可能有助于诊断MF撕裂并识别完整的MF。然而，这需要在更多病例中得到证实。
