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Home / Equine Research Bank / Equine Vet J / Longitudinal tendon healing assessed with multi-modality adv...
Equine veterinary journal2021; doi: 10.1111/evj.13478

Longitudinal tendon healing assessed with multi-modality advanced imaging and tissue analysis.

Abstract: The range of diagnostic modalities available to evaluate superficial digital flexor tendon (SDFT) injury includes magnetic resonance imaging (MRI), computed tomography (CT) and ultrasonography (US). Direct, comprehensive comparison of multi-modality imaging characteristics to end-point data has not previously been performed using a model of tendinopathy but is required to obtain a better understanding of each modality's diagnostic capabilities. Objective: To compare CT, MRI and US evaluation to outcome measures for histologic, biochemical and biomechanical parameters using an equine surgical model of tendinopathy. Methods: Controlled experiment. Methods: Lesions were surgically created in both forelimb SDFTs of eight horses and imaged using MRI, CT and US at seven time points over 12 months. Imaging characteristics were then correlated to end point histologic, biochemical and biomechanical data using lasso regression. Longitudinal lesion size was compared between imaging modalities. Results: Lesion to tendon isoattenuation on CT evaluation correlated with the greatest levels of aggrecan deposition. A significant correlation between cellular density and percentage of tendon involvement on the T2-weighted sequence and signal intensity on the proton density fat saturated (PD FS) sequence was appreciated at the 12-month time point (P = .006, P = .02 respectively). There was no significant correlation between end-point data and US or contrast imaging characteristics. Cross sectional area lesion to tendon measurements were significantly largest on CT evaluation, followed by MRI and then US (P < .001). Conclusions: Experimentally induced tendon injury with singular end-point data correlation. Conclusions: Lesion isoattenuation on CT evaluation suggested scar tissue deposition, while T2-weighted hyperintensity indicated hypercellular tendinopathy even in chronic stages of healing. Non contrast-enhanced MRI and CT evaluation correlated most closely to cellular characteristics of surgically damaged tendons assessed over a twelve month study period. Ultrasonographic evaluation underestimates true lesional size and should be interpreted with caution.
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Publication Date: 2021-06-08 PubMed ID: 34101888DOI: 10.1111/evj.13478Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research compared the effectiveness of different imaging techniques (CT, MRI, and Ultrasound) to evaluate superficial digital flexor tendon (SDFT) injuries in horses. The research found that CT and MRI were more closely correlated to cellular characteristics of damaged tendons over a year-long study period. Ultrasound, which often underestimated the size of the injury, should therefore be used with caution.

Research Methodology

  • The researchers conducted a controlled experiment on eight horses, creating lesions in both forelimb SDFTs.
  • The lesions were imaged using MRI, CT, and ultrasound at seven different time points over a 12-month period.
  • The researchers used lasso regression to correlate the imaging characteristics to end point histologic, biochemical, and biomechanical data.
  • The researchers compared the longitudinal lesion size between different imaging modalities.

Findings

  • The researchers found that on CT evaluation, lesion to tendon isoattenuation correlated with the highest levels of aggrecan deposition, suggesting that it was capable of detecting scar tissue deposition.
  • There was a significant correlation between cellular density and percentage of tendon involvement on the T2-weighted sequence. The signal intensity on the proton density fat saturated (PD FS) sequence was also notable at the 12-month point.
  • According to the research, there was no significant correlation between the end-point data and ultrasound or contrast imaging characteristics. This implies that ultrasound may not provide sufficient data when assessing tendon injuries.
  • They also discovered that the cross-sectional area of the lesion was significantly larger when evaluated using CT, followed by MRI and then ultrasound. This suggests that ultrasound could under-estimate the actual extent of the injury.

Conclusions

  • This study showed that non contrast-enhanced CT and MRI evaluations closely corresponded to the cellular characteristics of surgically damaged tendons assessed over the year-long study period.
  • The researchers concluded that ultrasound evaluation underestimates the true lesion size and should therefore be interpreted with caution. This underestimation may lead to an incorrect diagnosis or treatment plan, highlighting the importance of using CT or MRI when evaluating tendon injuries.

Cite This Article

APA
Johnson SA, Valdés-Martínez A, Turk PJ, Wayne McIlwraith C, Barrett MF, McGilvray KC, Frisbie DD. (2021). Longitudinal tendon healing assessed with multi-modality advanced imaging and tissue analysis. Equine Vet J. https://doi.org/10.1111/evj.13478

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Johnson, Sherry A
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Orthopaedic Research Center at the C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, CO, USA.
Valdés-Martínez, Alejandro
  • Veterinary Imaging Consultants, Inc, Denver, CO, USA.
Turk, Philip J
  • Atrium Health, Center for Outcomes Research and Evaluation, Charlotte, NC, USA.
Wayne McIlwraith, Cyril
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Orthopaedic Research Center at the C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, CO, USA.
Barrett, Myra F
  • Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
McGilvray, Kirk C
  • Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA.
Frisbie, David D
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Orthopaedic Research Center at the C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, CO, USA.

Grant Funding

  • Department of Clinical Sciences, Orthopaedic Research Center, Colorado State University.

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Citations

This article has been cited 3 times.
  1. Doll CU, Bohner M, Berner D, Buettner K, Horstmeier C, Winter K, Burk J. Approaches to standardising the magnetic resonance image analysis of equine tendon lesions.. Vet Rec Open 2023 Jun;10(1):e257.
    doi: 10.1002/vro2.57pubmed: 36846276google scholar: lookup
  2. Zhang G, Zhou X, Hu S, Jin Y, Qiu Z. Large animal models for the study of tendinopathy.. Front Cell Dev Biol 2022;10:1031638.
    doi: 10.3389/fcell.2022.1031638pubmed: 36393858google scholar: lookup
  3. Doll CU, von Pueckler K, Offhaus J, Berner D, Burk J. Characterization of Equine Chronic Tendon Lesions in Low- and High-Field Magnetic Resonance Imaging.. Vet Sci 2022 Jun 15;9(6).
    doi: 10.3390/vetsci9060297pubmed: 35737349google scholar: lookup
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