Identification of surgically-induced longitudinal lesions of the equine deep digital flexor tendon in the digital flexor tendon sheath using contrast-enhanced ultrasonography: an ex-vivo pilot study.
Abstract: Longitudinal tears in the lateral aspect of the deep digital flexor tendon are the most common causes of pain localised to the equine digital flexor tendon sheath. However conventional ultrasonographic techniques provide limited information about acute lesions. Ultrasonographic contrast agents are newly developed materials that have contributed to advancement in human diagnostic imaging. They are currently approved for intravenous use in human and animal models. In this study we described intrathecal use in the horse. This study was undertaken to evaluate the reliability of standard and angle contrast-enhanced ultrasonography to detect and characterize surgically-induced longitudinal lesions in the deep digital flexor tendons.In this pilot study surgically-induced lesions were created in the lateral aspect of the deep digital flexor tendon within the digital flexor tendon sheath in 10 isolated equine limbs to generate a replicable model for naturally occurring lesions. Another 10 specimens were sham operated. All the limbs were examined ultrasonographically before and shortly after the intrasynovial injection of an ultrasound contrast agent containing stabilised microbubbles. The images were blindly evaluated to detect the ability to identify surgically-created lesions. The deep digital flexor tendons were dissected and a series of slices were obtained. The depth of longitudinal defects identified with contrast-enhanced ultrasound scans was compared to the real extent of the lesions measured in the corresponding gross tendon sections. Results: Contrast-enhanced ultrasonography with both angle and standard approach provided a significant higher proportion of correct diagnoses compared to standard and angle contrast ultrasonography (p < 0.01). Contrast-enhanced ultrasonography reliably estimated the depth of surgically-induced longitudinal lesions in the deep digital flexor tendons. Conclusions: Contrast-enhanced ultrasound of the digital flexor tendon sheath could be an effective tool to detect intrasynovial longitudinal tears of the deep digital flexor tendon, although an in vivo study is required to confirm these results for naturally occurring lesions.
Publication Date: 2014-11-25 PubMed ID: 25421569PubMed Central: PMC4245795DOI: 10.1186/s13028-014-0078-7Google Scholar: Lookup
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- Journal Article
Summary
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The study examines the use of contrast-enhanced ultrasonography in detecting and evaluating surgically-induced tendon injuries in horses, suggesting its potential as a reliable tool for identifying naturally occurring tendon damages.
Research Purpose and Methodology
- The primary objective of this study was to assess the effectiveness of standard and angle contrast-enhanced ultrasonography in detecting and characterising longitudinal injuries on the deep digital flexor tendons in horses.
- To establish a reliable model for study, the researchers created artificial lesions in the deep digital flexor tendon of 10 isolated horse limbs. The creation of lesions simulated natural injuries, enabling the team to examine the ultrasonography’s inspection capability.
- Another set of 10 specimens were subjected to sham operations, used as controls for comparison purposes.
- Following intrasynovial injection of an ultrasound contrast agent stabilising microbubbles, all limbs were examined pre and post-procedure.
- Images from these procedures were evaluated blindly, focusing on their capacity to identify the artificially induced injuries.
Study Findings
- The study results show that both angle and standard contrast-enhanced ultrasonography provided a significantly higher proportion of correct diagnoses in comparison to non-contrast-enhanced methods, indicating the success of this technique in recognising the artificially induced tendon injuries.
- In addition, the method was found to be reliable in estimating the depth of the induced lesions when compared to the actual size observed in the dissected tendon sections.
- However, the practical value of these results in diagnosing real life cases of tendon injuries can only be confirmed by in vivo studies i.e. experiments conducted on whole, living organisms.
Conclusion
- The research concludes that contrast-enhanced ultrasound of the digital flexor tendon sheath holds great promise in detecting intrasynovial longitudinal tears of the deep digital flexor tendon in horses. This technique could potentially bring about significant enhancements in diagnosing and subsequently, treating tendon injury in equines.
Cite This Article
APA
Bertuglia A, Mollo G, Bullone M, Riccio B.
(2014).
Identification of surgically-induced longitudinal lesions of the equine deep digital flexor tendon in the digital flexor tendon sheath using contrast-enhanced ultrasonography: an ex-vivo pilot study.
Acta Vet Scand, 56(1), 78.
https://doi.org/10.1186/s13028-014-0078-7 Publication
Researcher Affiliations
- Dipartimento di Science Veterinarie, Università degli Studi di Torino, via Leonardo da Vinci 44, Grugliasco, 10095, TO, Italy. andrea.bertuglia@unito.it.
MeSH Terms
- Animals
- Contrast Media
- Forelimb / diagnostic imaging
- Forelimb / injuries
- Forelimb / surgery
- Hindlimb / diagnostic imaging
- Hindlimb / injuries
- Hindlimb / surgery
- Horses / injuries
- Pilot Projects
- Random Allocation
- Reproducibility of Results
- Tendon Injuries / diagnostic imaging
- Tendon Injuries / surgery
- Ultrasonography / veterinary
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