Standing cone-beam computed tomographic digital flexor tendon sheath contrast tenography in 18 horses

IF 0.8 4区农林科学 Q3 VETERINARY SCIENCES

Equine Veterinary Education Pub Date : 2025-03-17 DOI:10.1111/eve.14141

O. Fletcher, R. Agass, J. Dixon

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引用次数: 0

Abstract

Background

Limited data exist on the benefits of using standing cone-beam computed tomography (CBCT) contrast tenography before tenoscopy of the digital flexor tendon sheath (DFTS).

Objectives

To document DFTS pathologies in a sample population and compare CBCT contrast tenography and radiographic tenography with tenoscopic or post-mortem findings.

Study design

This prospective study compared CBCT contrast tenographic findings with final tenoscopic diagnoses. Radiographic tenogram studies were retrospectively reviewed to assess agreement with CBCT and tenoscopic findings.

Methods

Between May 2022 and September 2023, 18 horses with DFTS-related lameness underwent radiographic contrast tenography, followed by standing CBCT and subsequently underwent tenoscopic or post-mortem examination. A retrospective, blinded assessment of radiographic tenograms was performed. No additional invasive procedures or adverse events occurred.

Results

Pathologies included deep digital flexor (DDF) tendinopathy (4 cases), manica flexoria (MF) tears (3), palmar/plantar annular ligament (PAL) constriction (6), superficial digital flexor (SDF) tendinopathy (4) and straight sesamoidean ligament (SSL) enthesopathy (1). CBCT detected all DDF tendinopathies and correctly identified two of three MF tears. CBCT accurately identified two of four SDF lesions and six of seven cases afflicted only by PAL constriction. SSL enthesopathy was detected on CBCT and post-mortem. No pathology was detected radiographically but was not detected by CBCT. Misclassified cases on CBCT were similarly misclassified radiographically. CBCT detected a DDF tendinopathy, SDF tendinopathy and SSL enthesopathy that were not acknowledged on radiographic tenography. Inversely, a radiographically suspected MF tear was not considered present on CBCT, and the MF was confirmed to be normal at tenoscopy.

Main limitations

Small sample size, subjective interpretation of CBCT and tenoscopic findings, and lack of ultrasound comparison.

Conclusions

Standing CBCT contrast tenography shows promise in identifying DFTS pathologies, especially in cob-type horses, potentially improving surgical planning and reducing costs. Further studies are needed to validate these findings.

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18匹马站立式锥形束计算机断层数字屈肌腱鞘造影

背景：在指屈肌腱鞘（DFTS）腱鞘检查前使用站立式锥形束计算机断层扫描（CBCT）造影术的益处数据有限。目的记录样本人群的DFTS病理，并将CBCT造影和x线摄影与腱鞘镜或尸检结果进行比较。研究设计：这项前瞻性研究比较了CBCT对比造影结果和最终的腱鞘镜诊断。回顾性回顾x线摄影研究，以评估与CBCT和腱鞘镜检查结果的一致性。方法在2022年5月至2023年9月期间，对18匹患有dfts相关性跛行的马进行了放射造影，随后进行了站立CBCT检查，随后进行了肌腱镜检查或死后检查。对x线摄影进行回顾性盲法评估。无其他侵入性手术或不良事件发生。结果病理包括深指屈肌（DDF）肌腱病（4例）、拇屈肌（MF）撕裂（3例）、掌/足底环韧带（PAL）收缩（6例）、浅指屈肌（SDF）肌腱病（4例）和直海马韧带（SSL）腱鞘病（1例）。CBCT检测到所有DDF肌腱病变，并正确识别了三个MF撕裂中的两个。CBCT准确地识别了4个SDF病变中的2个，7个病例中的6个仅受PAL收缩的影响。在CBCT和尸检中检测到SSL末期病变。影像学未发现病理，但CBCT未发现病理。CBCT上错误分类的病例在放射学上也同样错误分类。CBCT检测到影像学未发现的DDF肌腱病、SDF肌腱病和SSL肌腱病。相反，影像学上怀疑的MF撕裂在CBCT上没有被认为存在，并且在腱鞘镜下证实MF是正常的。主要局限性：样本量小，主观解读CBCT和肌腱镜检查结果，缺乏超声比较。结论：站立式CBCT造影在识别DFTS病变，特别是cob型马，有可能改善手术计划并降低费用。需要进一步的研究来验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Equine Veterinary Education 农林科学-兽医学

CiteScore

2.40

自引率

22.20%

发文量

132

审稿时长

18-36 weeks

期刊介绍： Equine Veterinary Education (EVE) is the official journal of post-graduate education of both the British Equine Veterinary Association (BEVA) and the American Association of Equine Practitioners (AAEP). Equine Veterinary Education is a monthly, peer-reviewed, subscription-based journal, integrating clinical research papers, review articles and case reports from international sources, covering all aspects of medicine and surgery relating to equids. These papers facilitate the dissemination and implementation of new ideas and techniques relating to clinical veterinary practice, with the ultimate aim of promoting best practice. New developments are placed in perspective, encompassing new concepts and peer commentary. The target audience is veterinarians primarily engaged in the practise of equine medicine and surgery. The educational value of a submitted article is one of the most important criteria that are assessed when deciding whether to accept it for publication. Articles do not necessarily need to contain original or novel information but we welcome submission of this material. The educational value of an article may relate to articles published with it (e.g. a Case Report may not have direct educational value but an associated Clinical Commentary or Review Article published alongside it will enhance the educational value).