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Topic:Magnetic Resonance Imaging

Magnetic Resonance Imaging (MRI) is a non-invasive diagnostic tool used in veterinary medicine to obtain detailed images of the internal structures of horses. It utilizes strong magnetic fields and radio waves to create cross-sectional images, allowing for the examination of soft tissues, bones, and joints without the need for radiation. MRI is particularly useful for diagnosing conditions in areas that are challenging to assess with other imaging modalities, such as the hoof, distal limb, and head. This page compiles peer-reviewed research studies and scholarly articles that explore the application, techniques, and advancements in MRI technology for equine diagnostics, as well as its role in improving the understanding of equine anatomy and pathology.
Magnetic resonance imaging and computed tomography of equine cheek teeth and adjacent structures: comparative study of image quality in horses in vivo, post-mortem and frozen-thawed.
Acta veterinaria Scandinavica    December 10, 2019   Volume 61, Issue 1 62 doi: 10.1186/s13028-019-0495-8
Röttiger C, Hellige M, Ohnesorge B, Bienert-Zeit A.The use of cadavers for radiology research methodologies involving subjective image quality evaluation of anatomical criteria is well-documented. The purpose of this method comparison study was to evaluate the image quality of dental and adjacent structures in computed tomography (CT) and high-field (3 T) magnetic resonance (MR) images in cadaveric heads, based on an objective four-point rating scale. Whilst CT is a well-established technique, MR imaging (MRI) is rarely used for equine dental diagnostics. The use of a grading system in this study allowed an objective assessment of CT and MRI a...
Standing low-field MRI of the equine proximal metacarpal/metatarsal region is considered useful for diagnosing primary bone pathology and makes a positive contribution to case management: A prospective survey study. Labens R, Schramme MC, Murray RC, Bolas N.High-field MRI of the proximal metacarpal/metatarsal region has been associated with great diagnostic potential and clinical reports of standing low-field MRI of the forelimb suggest the same. To better understand diagnostic outcomes with standing low-field MRI of the proximal suspensory region, a prospective survey study was conducted and users of a widely available system questioned on their experience, operating procedures, and interpretation of standing low-field MRI findings. Response data included scores on a modified Likert scale from which weighted ratings were calculated for statistic...
Metabolomic analysis of synovial fluid from Thoroughbred racehorses diagnosed with palmar osteochondral disease using magnetic resonance imaging.
Equine veterinary journal    November 28, 2019   Volume 52, Issue 3 384-390 doi: 10.1111/evj.13199
Graham RJTY, Anderson JR, Phelan MM, Cillan-Garcia E, Bladon BM, Taylor SE.Palmar osteochondral disease (POD) is a common cause of lameness in competition horses. Magnetic resonance imaging (MRI) is the most sensitive diagnostic modality currently available, however it may not be financially or logistically practical for routine screening of POD. There is increasing interest in the use of metabolomics for diagnosis prior to progression to irreversible damage. Objective: To determine metabolite levels in synovial fluid (SF) of horses with a clinical diagnosis of POD based on diagnostic analgesia and MRI, with the hypothesis that metabolomic profiles differ between dis...
Quantitative magnetic resonance imaging and histological hoof wall assessment of 3-year-old Quarter Horses.
Equine veterinary journal    November 7, 2019   Volume 52, Issue 3 435-440 doi: 10.1111/evj.13188
Pownder SL, Caserto BG, Bowker RM, Lin B, Potter HG, Koff MF.Few noninvasive methods are available for equine hoof wall evaluation. The highly organised wall structures and composition of proteoglycans and collagens may make this region amenable to quantitative MRI (qMRI) techniques of T1ρ and T2 mapping to identify pathology related to proteoglycan content and collagen organisation respectively. Objective: To establish normative T1ρ and T2 values of the equine hoof wall of 3-year-old Quarter Horses with histological comparison. Methods: Cadaveric anatomical study. Methods: Six cadaveric left thoracic feet from 3-year-old racing Quarter Horses with no...
An MRI study of solute transport in the intervertebral disc.
Magma (New York, N.Y.)    October 4, 2019   Volume 33, Issue 2 299-307 doi: 10.1007/s10334-019-00781-z
Palfrey RM, Summers IR, Winlove CP.Quantitative magnetic resonance imaging was used to determine partition coefficients and characteristic time constants for diffusion of MRI contrast agents in disc tissue. Methods: Twenty-two excised equine intervertebral discs were exposed to a range of contrast agents: six to manganese chloride, eight to Magnevist (gadopentetate dimeglumine) and eight to Gadovist (gadobutrol), and uptake into the disc was quantified in T-weighted images. Results: Diffusion for all contrast agents was approximately 25% faster in the nucleus than in the outer annulus; disc-average time constants ranged from (2...
Equine Stereotaxtic Population Average Brain Atlas With Neuroanatomic Correlation.
Frontiers in neuroanatomy    October 3, 2019   Volume 13 89 doi: 10.3389/fnana.2019.00089
Johnson PJ, Janvier V, Luh WM, FitzMaurice M, Southard T, Barry EF.There is growing interest in the horse for behavioral, neuroanatomic and neuroscientific research due to its large and complex brain, cognitive abilities and long lifespan making it neurologically interesting and a potential large animal model for several neuropsychological diseases. Magnetic resonance imaging (MRI) is a powerful neuroscientific research tool that can be performed , with adapted equine facilities, or in the research setting. The brain atlas is a fundamental resource for neuroimaging research, and have been created for a multitude animal models, however, none currently exist f...
Transient pelvic limb neuropathy following proximal metatarsal and tarsal magnetic resonance imaging in seven horses.
Equine veterinary journal    October 1, 2019   Volume 52, Issue 3 359-363 doi: 10.1111/evj.13181
Moreno KL, Scallan EM, Friedeck WO, Simon BT.Pelvic limb neuropathy is a rare post-anaesthetic complication. In the authors' experiences, the incidence of post-anaesthesia neuropathy is increased following MRI of the proximal metatarsus and tarsal regions when compared with previously reported incidences of post-anaesthetic neuropathy. Objective: This study reports the incidence, diagnosis, treatment and outcome of seven horses with post-anaesthesia neuropathy following proximal metatarsal and tarsal MRI. Methods: Retrospective case series. Methods: Case record review of horses receiving general anaesthesia for MRI between 1 January 2012...
Determination of magnetic motor evoked potential latency time cutoff values for detection of spinal cord dysfunction in horses.
Journal of veterinary internal medicine    September 6, 2019   Volume 33, Issue 5 2312-2318 doi: 10.1111/jvim.15576
Rijckaert J, Pardon B, Saey V, Raes E, Van Ham L, Ducatelle R, van Loon G, Deprez P.Transcranial magnetic stimulation (TMS) and recording of magnetic motor evoked potentials (MMEP) can detect neurological dysfunction in horses but cutoff values based on confirmed spinal cord dysfunction are lacking. Objective: To determine latency time cutoff for neurological dysfunction. Methods: Five control horses and 17 horses with proprioceptive ataxia. Methods: Case-control study with receiver operating characteristic curve analysis, based on diagnostic imaging, TMS, and histopathological findings. Horses were included if all 3 examinations were performed. Results: Diagnostic imaging an...
Finite Element Modelling Simulated Meniscus Translocation and Deformation during Locomotion of the Equine Stifle.
Animals : an open access journal from MDPI    July 31, 2019   Volume 9, Issue 8 502 doi: 10.3390/ani9080502
Zellmann P, Ribitsch I, Handschuh S, Peham C.We developed a finite element model (FEM) of the equine stifle joint to identify pressure peaks and simulate translocation and deformation of the menisci. A series of sectional magnetic resonance images (1.5 T) of the stifle joint of a 23 year old Shetland pony gelding served as basis for image segmentation. Based on the 3D polygon models of femur, tibia, articular cartilages, menisci, collateral ligaments and the meniscotibial ligaments, an FEM model was generated. Tissue material properties were assigned based on data from human (Open knee(s) project) and bovine femoro-tibial joint available...
Equine cervical intervertebral disc degeneration is associated with location and MRI features. Veraa S, Bergmann W, Wijnberg ID, Back W, Vernooij H, Nielen M, van den Belt AM.Morphology of the equine cervical intervertebral disc is different from that in humans and small companion animals and published imaging data are scarcely available. The objectives of this exploratory, methods comparison study were (a) to describe MRI features of macroscopically nondegenerated and degenerated intervertebral discs (b) to test associations between spinal location and macroscopic degeneration or MRI-detected annular protrusion and between MRI-detected annular protrusion and macroscopic degeneration, and (c) to define MRI sequences for characterizing equine cervical intervertebral...
Clinical efficacy of clodronic acid in horses diagnosed with navicular syndrome: A field study using objective and subjective lameness evaluation.
Research in veterinary science    July 19, 2019   Volume 125 298-304 doi: 10.1016/j.rvsc.2019.07.018
Argüelles D, Saitua A, de Medina AS, Muñoz JA, Muñoz A.Navicular syndrome, a common cause of equine forelimb lameness, is associated with pathological changes in the navicular bone. Consequently, administration of bisphosphonates (BPs) has been advocated in order to modify the rate of bone turnover. The present study aimed to assess the clinical efficacy of intramuscularly administered clodronic acid for the treatment of 11 horses with clinical and radiographic findings compatible with navicular syndrome. Magnetic resonance imaging was performed in 5 of the 11 horses. The animals were treated with an intramuscular dose of clodronic acid of 765 m...
Investigation of changes in bone density and chemical composition associated with bone marrow oedema-type appearances in magnetic resonance images of the equine forelimb.
BMC musculoskeletal disorders    July 15, 2019   Volume 20, Issue 1 330 doi: 10.1186/s12891-019-2693-y
Heales CJ, Summers IR, Fulford J, Knapp KM, Winlove CP.The aetiology of bone marrow oedema-like abnormalities (BMOA) seen on magnetic resonance imaging (MRI) is as yet not fully understood. The current study aimed to investigate the potential of projection radiography and Raman microspectroscopy to provide information regarding the underlying physiological changes associated with BMOA in equine bone samples. Methods: MRI was used to assess 65 limbs from 43 horses. A subset of 13 limbs provided 25 samples, 8 with BMOA present and 17 as controls; these were examined with projection radiography to assess bone mineral density and Raman spectroscopy to...
Magnetic resonance dacryocystography in the horse: A feasibility study.
Veterinary ophthalmology    July 15, 2019   Volume 23, Issue 1 129-134 doi: 10.1111/vop.12697
Manso-Díaz G, García-López JM, López-Sanromán J, Taeymans O.To provide a comprehensive anatomical description of the normal equine nasolacrimal duct using magnetic resonance imaging, and to develop a practical protocol for performing magnetic resonance dacryocystography (MRD) in horses. Methods: The heads of ten fresh horse cadavers with no history of sinonasal or ophthalmologic disorders were used for this study. Methods: An MRD technique was developed in this study, which consisted of two parts. In the first part, olive oil and gadolinium were compared as contrast medium, using five horses. Two concentrations of gadolinium were used: 0.25 mmol/mL an...
Outcome of arthroscopic debridement of cartilage injury in the equine distal interphalangeal joint.
The Canadian veterinary journal = La revue veterinaire canadienne    July 10, 2019   Volume 60, Issue 7 731-736 
Warnock WR, Marsh CA, Hand DR.The purpose of this study was to report long-term outcome following arthroscopic debridement of articular cartilage lesions of the distal interphalangeal joint, diagnosed with high-field magnetic resonance imaging. Diagnosis was based on the results of diagnostic anesthesia, magnetic resonance imaging (MRI), and arthroscopy. Ten horses underwent arthroscopic evaluation for cartilage injury and received various intra-articular therapies after surgery. Three of ten horses had lesions that were surgically inaccessible. Four horses became sound and returned to their preoperative level of athletici...
Evaluation of a Novel Bone Substitute Injection Technique for Potential Treatment of Impact Injury to the Equine Palmar Metacarpal Condyle.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    July 6, 2019   Volume 32, Issue 6 447-453 doi: 10.1055/s-0039-1692984
Rice HC, Brokken MT, Hostnik ET, Bertone AL. The aim of this study was to evaluate the injection of a bone substitute material (BSM) into an impact lesion in the palmar condyle of the third metacarpal bone. Methods:  This was an controlled study performed on six horses. Methods:  Medial metacarpal condyles were exposed via arthrotomy and a compressive lesion created in anaesthetized horses using 80 psi (27.6 MPa) onto the articular surface ( = 12). Paired limbs were randomly selected as a control or for extra-articular injection of BSM towards the subchondral bone near the compressive lesion. Parameters of the surgical tech...
Standing MRI for surgical planning of equine fracture repair.
Veterinary surgery : VS    July 3, 2019   Volume 48, Issue 8 1372-1381 doi: 10.1111/vsu.13272
Genton M, Vila T, Olive J, Rossignol F.To report the feasibility of standing MRI (sMRI) and document the value of sMRI in surgical planning for surgical repair of limb fractures in the horse. Methods: Retrospective case series. Methods: Thirty-one horses with preoperative sMRI. Methods: Medical records were reviewed for fracture type, application of a polyester cast, sMRI sequences performed, technical variables, and image quality. Fracture geometry and concomitant lesions were compared between sMRI and radiography. The relative value of sMRI with regard to surgical planning was classified as minor (sMRI did not provide additional ...
Suspensory Branch Desmitis in a Horse: Ultrasonography, Computed Tomography, Magnetic Resonance Imaging, and Gross Postmortem Findings.
Journal of equine veterinary science    July 3, 2019   Volume 80 49-55 doi: 10.1016/j.jevs.2019.06.008
Elemmawy YM, Senna NA, Abu-Seida AM, Youssef AF.Injury of suspensory ligament (SL) branch is a frequently diagnosed problem in horses of different ages and disciplines. This case reports for the first time the ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) findings in a 10-year-old draught horse with traumatic chronic SL branch desmitis of 8 months duration. The horse had a grade 3 of 5 left hindlimb lameness with a moderately hot, painful, and diffuse swelling from the tarsus till the hoof. Ultrasonography, both SL branches appeared as enlarged hyperechogenic structures with poor demarcation of their margins a...
T2* and quantitative susceptibility mapping in an equine model of post-traumatic osteoarthritis: assessment of mechanical and structural properties of articular cartilage.
Osteoarthritis and cartilage    July 2, 2019   Volume 27, Issue 10 1481-1490 doi: 10.1016/j.joca.2019.06.009
Nykänen O, Sarin JK, Ketola JH, Leskinen H, Te Moller NCR, Tiitu V, Mancini IAD, Visser J, Brommer H, van Weeren PR, Malda J, Töyräs J, Nissi MJ.To investigate the potential of quantitative susceptibility mapping (QSM) and T2* relaxation time mapping to determine mechanical and structural properties of articular cartilage via univariate and multivariate analysis. Samples were obtained from a cartilage repair study, in which surgically induced full-thickness chondral defects in the stifle joints of seven Shetland ponies caused post-traumatic osteoarthritis (14 samples). Control samples were collected from non-operated joints of three animals (6 samples). Magnetic resonance imaging (MRI) was performed at 9.4 T, using a 3-D multi-echo gr...
Heterogeneity among traumatic spinal cord injuries at the thoracolumbar junction: helping select patients for clinical trials.
Spinal cord    June 25, 2019   Volume 57, Issue 11 972-978 doi: 10.1038/s41393-019-0317-x
Liu SJ, Wang Q, Tang HH, Bai JZ, Wang FY, Lv Z, Chen SZ, Liu JS, Hong Y, Zhang JW.Retrospective analysis. Methods: China Rehabilitation Research Center, Beijing, China. Objective: A retrospective study that documents the modalities and clarifies the heterogeneity among spinal cord injuries (SCIs) caused by trauma to the thoracolumbar vertebral junction. Methods: X-ray and MRI imaging, neurological records, and the urodynamics results of 190 patients were reviewed and used to categorize different SCI modalities. First, injuries were divided into complete and incomplete injuries using the International Standard for Neurological Classification of Spinal Cord Injury. Next, the ...
Incomplete fracture of the talus secondary to maladaptive stress remodeling in a horse.
Journal of the American Veterinary Medical Association    June 14, 2019   Volume 255, Issue 1 102-108 doi: 10.2460/javma.255.1.102
Katzman SA, Spriet MP, Beck BR, Barrett MF, Hendrickson DA.A 6-year-old Quarter Horse gelding used for barrel racing was evaluated for acute onset of non-weight-bearing lameness of the left hind limb following strenuous exercise. Nuclear scintigraphic imaging revealed focal increased radiopharmaceutical uptake centrally within the left talus. Subsequent standard radiographic and ultrasonographic examinations of the tarsus failed to identify the cause of the increased radiopharmaceutical uptake; however, the lameness was definitively localized to the tarsocrural joint by intra-articular anesthesia. Subsequent MRI sequences of the left tarsus revealed a...
Surgical correction of a meningoencephalocele in a thoroughbred filly.
Veterinary surgery : VS    May 28, 2019   Volume 48, Issue 8 1483-1489 doi: 10.1111/vsu.13240
Buck AM, Hunt RJ.To describe the surgical correction of a closed meningoencephalocele in a thoroughbred filly. Methods: Case report. Methods: One thoroughbred filly, 1.5 months old at the time of surgery. Methods: A meningoencephalocele was identified at birth and diagnosed with radiography and MRI. The abnormal tissue was excised and submitted for histopathology, the dura was closed, and the defect in the skull was corrected with a titanium mesh. Results: Histopathology confirmed the presence of neural parenchyma consisting of neurons and glial cells. The filly remained without neurologic deficits 7 month...
A Thoroughbred racehorse with a unicortical palmar lateral condylar fracture returned to training 14 days after surgery: a hypothesis on the role of a single bone screw on crack propagation.
Journal of equine science    April 3, 2019   Volume 30, Issue 1 7-12 doi: 10.1294/jes.30.7
Brown HR, Peloso JG, Werner WC, Mecholsky JJ, Cohen ND, Vogler JB.A 2-year-old Thoroughbred racehorse had LF lameness that began post high-speed exercise and persisted for two days before the horse once again became sound. Diagnostic analgesia localized the lameness to the LF distal metacarpus, and a standing MRI identified a unicortical condylar fracture. A single 5.5 mm cortical screw was placed in lag fashion. The horse began hand walking at 14 days, racetrack jogging at 30 days, and racing at 5 months after the day of surgery. Placement of a single lag screw ahead of the tip of the crack in unicortical condylar fracture may be useful for reducing the rec...
Neuroanatomy of the equine brain as revealed by high-field (3Tesla) magnetic-resonance-imaging.
PloS one    April 1, 2019   Volume 14, Issue 4 e0213814 doi: 10.1371/journal.pone.0213814
Schmidt MJ, Knemeyer C, Heinsen H.In this study, the morphology of the horse brain (Equus caballus) is decribed in detail using high field MRI. The study includes sagittal, dorsal, and transverse T2-weighted images at 0.25 mm resolution at 3 Tesla and 3D models of the brain presenting the external morphology of the brain. Representative gallocyanin stained histological slides of the same brain are presented. The images represent a useful tool for MR image interpretation in horses and may serve as a starting point for further research aiming at in vivo analysis in this species.
Standing magnetic resonance imaging of distal phalanx fractures in 6 cases of Thoroughbred racehorse.
The Journal of veterinary medical science    March 21, 2019   Volume 81, Issue 5 689-693 doi: 10.1292/jvms.18-0183
Mizobe F, Nomura M, Kanai K, Ishikawa Y, Yamada K.Six Thoroughbred racehorses with palmar process fractures of the distal phalanx were evaluated with standing magnetic resonance imaging (sMRI). In all the cases, the fractures were detectable on T1-weighted images and fat-suppressed images. Furthermore, multi-planar reconstruction images were useful for assessing the articular involvement of the fractures. Follow-up sMRI was obtainable in 3 cases, which revealed that the area of high signal intensity on fat-suppressed images decreased over time as symptoms improved. Our findings support the use of sMRI for the detailed evaluation of distal pha...
Use of non-contrast-enhanced computed tomography to identify deep digital flexor tendinopathy in horses with lameness: 28 cases (2014-2016).
Journal of the American Veterinary Medical Association    March 20, 2019   Volume 254, Issue 7 852-858 doi: 10.2460/javma.254.7.852
Jones ARE, Ragle CA, Mattoon JS, Sanz MG.To describe the use of non-contrast-enhanced CT to identify deep digital flexor (DDF) tendinopathy in horses with lameness attributed to pain in regions distal to the metatarsophalangeal or metacarpophalangeal joints. Methods: Retrospective case series. Methods: 28 client-owned horses. Methods: Medical records were searched to identify horses that underwent non-contrast-enhanced CT with or without high-field MRI as part of an evaluation for lameness localized to areas distal to the metacarpophalangeal or metatarsophalangeal joint in ≥ 1 limb. Horses were included in the study if they had ≥...
Self-Assembling Intrauterine Device (Upod) Modulation of the Reproductive Cycle in Mares.
Journal of equine veterinary science    March 13, 2019   Volume 83 102690 doi: 10.1016/j.jevs.2019.02.009
Gradil CM, Uricchio CK, Schwarz A.The present study evaluated a novel intrauterine device for its effect on estrus suppression. The self-assembling intrauterine device (Upod) consists of three 12 mm × 26 mm elliptically shaped units each with a magnetic core and coated with a polymer (total weight 22.5 g). Each magnetic unit is inserted independently from the other. Once inside the uterus, these magnetic elliptical units self-assemble and adapt the lower energy "ring" conformation. In mares, the devices can be inserted at any stage of the estrous cycle without the need for multiple exams. Shatter-proof grade material is u...
Analysis of magnetization transfer (MT) influence on quantitative mapping of T2 relaxation time.
Magnetic resonance in medicine    March 12, 2019   Volume 82, Issue 1 145-158 doi: 10.1002/mrm.27704
Radunsky D, Blumenfeld-Katzir T, Volovyk O, Tal A, Barazany D, Tsarfaty G, Ben-Eliezer N.Multi-echo spin-echo (MESE) protocol is the most effective tool for mapping T relaxation in vivo. Still, MESE extensive use of radiofrequency pulses causes magnetization transfer (MT)-related bias of the water signal, instigated by the presence of macromolecules (MMP). Here, we analyze the effects of MT on MESE signal, alongside their impact on quantitative T measurements. Study used 3 models: in vitro urea phantom, ex vivo horse brain, and in vivo human brain. MT ratio (MTR) was measured between single-SE and MESE protocols under different scan settings including varying echo train lengths, n...
Artifact Induced by a Transponder During In Vivo Magnetic Resonance Imaging on Horse Brain.
Journal of equine veterinary science    March 6, 2019   Volume 77 63-67 doi: 10.1016/j.jevs.2019.02.025
Ella A, Gomot G, Lévy I, Dominici C, Adriaensen H, Reigner F, Keller M, Guillaume D.Magnetic resonance imaging (MRI) is now widely used in equine veterinary practice. However, the mandatory European legislation regarding horse identification imposes the implantation of a transponder within the fatty tissue of the neck cervical ligament. While performing brain MRI for scientific purposes in ponies, we faced artifacts produced by such transponder and reported here this problem. Indeed, pony mares were anesthetized for 2 hours and placed, bedded on their back, in a 3T MRI scanner. A four-element flexible antenna positioned around the head was used. Three MRI sequences were perfo...
Bone marrow oedema-type signal in the proximal phalanx of Thoroughbred racehorses.
The Journal of veterinary medical science    March 4, 2019   Volume 81, Issue 4 593-597 doi: 10.1292/jvms.18-0530
Mizobe F, Nomura M, Ueno T, Yamada K.This study focused on 8 Thoroughbred racehorses showing bone marrow oedema-type signal in the proximal sagittal groove of the proximal phalanx, with the aim of understanding its clinical significance. Standing magnetic resonance imaging played an important role in assessing osseous abnormalities that were not radiographically identifiable. Further, a histopathological result from one of the cases showed there was oedema surrounding adipose tissues with increase in density of trabecular scaffolding. This may indicate presence of osseous injury within the area of decreased elasticity due to subc...
Enhanced ultrasonographic imaging of the equine distal limb using saline injection of the digital flexor tendon sheath: A cadaver study.
Veterinary journal (London, England : 1997)    February 23, 2019   Volume 247 26-31 doi: 10.1016/j.tvjl.2019.02.007
Daniel AJ, Leise BS, Selberg KT, Barrett MF.Injuries to the structures within the digital flexor tendon sheath (DFTS) can lead to lameness with a variable degree of effusion in horses. In some cases, effusion is absent or minimal, and this may be related to the chronicity and type of injury, or veterinary interventions. The purpose of this study was to determine if saline injection into the DFTS would improve ultrasonographic and magnetic resonance imaging of the distal limb without introducing artifact. Nine normal equine cadaver forelimbs were collected. Non-weight-bearing ultrasonographic and magnetic resonance imaging (MRI) examinat...
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