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Longitudinal tendon healing assessed with multi-modality advanced imaging and tissue analysis.
Sherry A Johnson1, Alejandro Valdés-Martínez2, Philip J Turk3
1Department 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.
Computed tomography (CT) and magnetic resonance imaging (MRI) best correlate with cellular changes in equine superficial digital flexor tendon (SDFT) injuries. Ultrasonography (US) underestimates lesion size and should be used cautiously.
Area of Science:
- Veterinary Imaging
- Equine Tendinopathy Research
- Biomechanical Analysis
Background:
- Superficial digital flexor tendon (SDFT) injuries are common in horses.
- Diagnostic imaging modalities like MRI, CT, and US are used for evaluation.
- A direct comparison of these modalities against endpoint data for tendinopathy is lacking.
Purpose of the Study:
- To compare CT, MRI, and US evaluations against histologic, biochemical, and biomechanical outcome measures.
- To assess diagnostic capabilities of different imaging modalities in an equine tendinopathy model.
Main Methods:
- Surgically created SDFT lesions in eight horses.
- Serial imaging using MRI, CT, and US over 12 months.
- Correlation of imaging characteristics with endpoint histologic, biochemical, and biomechanical data via lasso regression.
Main Results:
- CT isoattenuation correlated with aggrecan deposition.
- T2-weighted MRI and PD FS sequences correlated with cellular density and tendon involvement.
- No significant correlation found between US/contrast imaging and endpoint data.
- Lesion size was largest on CT, followed by MRI, then US.
Conclusions:
- CT isoattenuation suggests scar tissue, while T2 hyperintensity indicates hypercellularity in chronic tendinopathy.
- Non-contrast MRI and CT correlate closely with cellular characteristics of surgically induced tendon damage.
- US underestimates lesion size and requires cautious interpretation.
