MRI propels lameness diagnosis - DVM
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MRI propels lameness diagnosis


Canine with a likely acquired portosystemic shunt.
"There is a whole realm of diagnosis I would never consider making before — potentially painful injuries, which were essentially next to impossible to diagnose without MRI," says Jake Hersman, DVM, of Animal Imaging in Irving, Texas. "With MRI, it has been rewarding noting various soft-tissue injuries, such as deep flexor tendon or collateral ligament injuries, that have changed the way we handle some of these horses. We could get some very good indications that a horse had a collateral ligament (tear) or possibly other injuries, but we never were certain. There are also a whole lot of changes in the navicular bone itself that we see with MRI that we couldn't with regular films."


This proton density transverse section through the right-hind foot just proximal to the navicular bone shows a dorsal- to plantar-directed tear in the medial lobe of the deep digital flexor tendon, shown by a high signal intensity defect (arrow) within the normally low signal intensity deep digital flexor tendon (black).
Animal Imaging uses a 1.0-Tesla high-field magnet, which requires general anesthesia. The actual imaging time for a unilateral sequence is about 45 minutes, and a bilateral sequence requires about twice as long. With the system used at Animal Imaging, images can be sent to radiologists — typically Washington State University clinician Pat Gavin, DVM, PhD, Dipl. ACVR — for review, as well as other consulting colleagues, as soon as they are acquired. Generally, MRI fees run between $1,000-1,600 and are considered reasonable compared to exploratory surgery that used to be required to diagnose some causes of equine lameness, sources say.

This proton density transverse section through the left-front pastern shows desmitis of the lateral branch of the oblique distal sesamoidean ligament, shown by increased signal intensity centrally (white) in the enlarged ligament (arrows).
"When a horse is referred to our facility for imaging, the procedure is performed, and the horse is sent back to the referring veterinarian for treatment as long as the referring veterinarian has the means necessary to treat the horse," Zubrod explains. If not, the patient is treated in-house after consulting with the referring veterinarian. Following imaging, they will send a report and images to the owner and referring veterinarian that describes the abnormalities found on the MRI and outlines the recommended treatment or treatments. This eliminates the need for a veterinarian to know how to read an MRI in order to refer a patient for this imaging modality.

"I think that referring veterinarians need to know which cases would benefit from an MRI and recommend MRI to the client," Zubrod says. "Getting a definitive diagnosis is the best thing for the patient, and we should not make the decision for the client as to whether an MRI is economically feasible for them. As veterinarians, we should be offering the client the best diagnostics and treatment available, and let them make the decisions whether or not to utilize these techniques."


Source: DVM360 MAGAZINE,
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