Accuracy of open magnetic resonance imaging for guiding injection of the equine deep digital flexor tendon within the hoof.

The study discusses the use of open magnetic resonance imaging (MRI) to accurately guide injections into the deep digital flexor tendon found within the hoof of horses. The paper suggests that the use of this method can potentially improve the effectiveness of treatments involving biologic therapeutics.

Introduction

• The research primarily focuses on investigating the accuracy of using open low-field MRI to guide injections in the deep digital flexor tendon (DDFT) of horses that suffer from hoof pain due to lesions or injuries.
• Horses often get lesions in their DDFT, and these lesions are usually diagnosed using MRI. In order to enhance the healing process, biologic therapeutics are often injected directly into the tendon. However, carrying out this procedure accurately is challenging.
• Despite the challenges, it’s important because inaccurate or ineffective injections may not yield the desired therapeutic results and could potentially aggravate the condition.

Methodology

• The researchers used ten cadaver limbs positioned in an open, low-field MRI unit to test their hypothesis.
• They used a titanium needle for injections, guided by T1-weighted transverse images that were captured simultaneously during the process.
• Each DDFT lobe was assigned to have a proximal (adjacent to the proximal aspect of the navicular bursa) or distal (next to the navicular bone) injection. They injected colored dye as a marker to trace the procedure’s accuracy.

Results and Conclusion

• The result of the study showed an 85% success rate for injections as evaluated on gross section, with a 70% success rate for proximal injections and 100% for distal ones.
• On evaluating the success of the injections through MRI, they found that the rate was 65% overall, with a 60% success rate for proximal injections and 70% for distal ones.
• Importantly, there was no significant difference in the success rates of injecting the medial versus lateral lobe, indicating that both could be targeted effectively using this method.
• However, the study’s main limitation was that the experiment was conducted only on cadaver limbs with normal tendons, which may not accurately represent the conditions in a live horse with DDFT lesions.
• The authors concluded the research by affirming that using open low-field MRI to guide injections in the DDFT within the hoof of horses is a feasible method.