Comparison of magnetic resonance imaging with standing cervical radiographs for evaluation of vertebral canal stenosis in equine cervical stenotic myelopathy.

REASONS FOR PERFORMING STUDY: The sensitivity and specificity of lateral cervical radiographs to evaluate horses suspected of cervical stenotic myelopathy (CSM) are limited by the assessment being restricted to the sagittal plane. OBJECTIVE: To determine whether magnetic resonance imaging (MRI) allows for a more accurate identification of stenosis than lateral cervical radiographs in horses with CSM. STUDY DESIGN: Case control study. METHODS: Nineteen Thoroughbred horses with CSM (17 males, 2 females, age 6-50 months) were compared to 9 control Thoroughbreds (6 males, 3 females, age 9-67 months). Ante mortem, the subjects had neurological examinations and standing cervical radiographs with sagittal ratios calculated from C3 to C7. Intact cervical column MRI scans and histological examinations of the spinal cord were performed post mortem. Morphometric parameters were measured on the vertebral canal, spinal cord and intervertebral foramen. RESULTS: Radiographic cervical canal height measurements categorised by standard minimal sagittal diameter intravertebral and intervertebral ratios produced several false positive and false negative determinations of canal stenosis as defined by spinal cord histopathology. Post mortem MRI measurements of canal area and cord canal area ratio more accurately predicted sites of cord compression in CSM cases. No differences in spinal cord measurements were observed when comparing CSM to control horses, but each of the vertebral canal parameters achieved significance at multiple sites. CONCLUSIONS: Vertebral canal area and cord canal area ratio are better parameters to predict the location of cervical canal stenosis compared to only the sagittal plane of canal height. Additional visual planes and measurements obtained by MRI, specifically vertebral canal area and the cord canal area ratio, will provide a more accurate method to identify regions of canal stenosis than lateral cervical radiographs. The development of MRI or computed tomography equipment capable of evaluating the cervical column of mature horses may substantially enhance evaluation of CSM patients. The Summary is available in Chinese - see Supporting information.

First record of dicephalia in a bull shark Carcharhinus leucas (Chondrichthyes: Carcharhinidae) foetus from the Gulf of Mexico, U.S.A.

The first recorded incidence of dicephalia in a bull shark Carcharhinus leucas is reported from a foetus collected by a fisherman in the Gulf of Mexico near Florida, U.S.A. External examination, Radiography and magnetic resonance imaging revealed a case of monosomic dicephalia where the axial skeleton and internal organs were found to divide into parallel systems anterior to the pectoral girdle resulting in two well-developed heads.

Computed tomographic findings in the pituitary gland and brain of horses with pituitary pars intermedia dysfunction.

BACKGROUND: Pituitary pars intermedia dysfunction (PPID) is the most common endocrinologic disorder of aged horses. HYPOTHESIS/OBJECTIVES: Pituitary glands of PPID-affected horses are larger than those of aged horses without signs of PPID, and the size difference can be detected using computed tomography (CT) imaging. ANIMALS: Eight horses with clinical signs of PPID and supportive endocrinologic test results and 3 aged control (PPID-negative) horses. METHODS: Computed tomography examination of the brain and pituitary gland was performed twice in 10 of the 11 horses, approximately 6 months apart. Six PPID-affected horses were treated with pergolide for 6 months between CT scans. The second CT scan was followed by euthanasia and pathologic examination of 6 PPID-affected horses (4 treated horses). RESULTS: On initial examination, pituitary glands of PPID-affected horses were larger in height (P < .01) and width (P < .01) than controls, but the difference in length was not significant (P = .06). After 6 months of pergolide treatment of PPID-affected horses, pituitary gland length increased (P < .05), but height and width were not different from pretreatment values. There was no difference between pituitary gland measurements made at the terminal CT scans and necropsy. Furthermore, pituitary gland volume calculated from the measurements was highly correlated to pituitary gland weight. Additional CT findings were bilaterally symmetrical mineralization in the thalamus and cholesterol granulomas adjacent to the lateral and fourth ventricles. CONCLUSIONS AND CLINICAL IMPORTANCE: CT is a useful imaging modality to determine pituitary gland size of PPID-affected horses,and CT measurements are similar to gross pathologic measurements.

Meniscal translocation and deformation throughout the range of motion of the equine stifle joint: an in vitro cadaveric study.

REASON FOR PERFORMING STUDY: By study of the translocation and deformation of equine menisci throughout the range of motion, it may be possible to identify potential mechanical factors in the pathogenesis of injury to the cranial horn of the medial meniscus. OBJECTIVE: To quantitatively document meniscal translocation and deformation using radiographic and MR imaging, and to evaluate for potential variation between the medial and lateral menisci. METHODS: Radiographic markers were embedded in the periphery of the menisci in 6 cadaver stifles. Proximal-distal radiographs were taken at 15° intervals ranging from full flexion (30°) to full extension (160°). Magnetic resonance imaging sequences of 3 additional cadaver stifles were obtained in axial and sagittal planes at the predetermined stifle angles. RESULTS: A significantly greater overall mean cranial-caudal translocation (1.6 times) of the lateral meniscus relative to the medial was seen from full extension to full flexion (P = 0.002). The cranial horn of the medial meniscus was the least mobile of the 4 horns, yet a significant cranial displacement relative to the cranial horn of the lateral meniscus was seen in the terminal 10° of extension. MRI images revealed a significantly greater axial compressive strain in the cranial horn of the medial meniscus relative to the cranial horn of the lateral meniscus in the terminal 10° of extension (P = 0.017). CONCLUSION: The equine menisci exhibit a cranial-caudal translocation over the tibia throughout the range of motion. While the cranial horn of the medial meniscus is the least mobile of the 4 horns, it undergoes significant cranial translocation and axial compression in the terminal 10° of extension. POTENTIAL RELEVANCE: Hyperextension of the stifle may place the cranial horn of the medial meniscus at risk of injury and thus explain the higher prevalence of meniscal tears at this location.

Use of ultrasound to evaluate outcome following colic surgery for equine large colon volvulus.

REASONS FOR PERFORMING STUDY: The post operative response of the large colon wall after a surgically corrected large colon volvulus (LCV) has not been investigated. OBJECTIVES: To use transabdominal ultrasound to monitor the post operative change in large colon wall thickness following surgical correction of LCV. HYPOTHESIS: A prolonged period to colon wall involution is correlated with an increased rate of post operative morbidity and mortality. METHODS: A prospective clinical study including horses that presented to the North Carolina State University Veterinary Teaching Hospital for colic between September 2006 and March, 2008, had surgically diagnosed and corrected LCV (at least 360 degrees ) without resection and recovered from anaesthesia. Ultrasound of the ventral large colon was performed at the time of anaesthetic recovery and every 6-8 h until the colon wall returned to normal thickness (< or = 5 mm). Outcome was evaluated using a one-way ANOVA to compare average time to colon wall involution between: 1) survivors and nonsurvivors; and 2) horses that developed multiple organ dysfunction syndrome (MODS) during the post operative period and those that recovered without evidence of MODS. RESULTS: Sixteen horses that recovered without evidence of MODS had a significantly shorter period to colon wall involution (< or = 5 mm) compared to those diagnosed with MODS (mean +/- s.e. 19.6 h +/- 2.5 and 39.7 h +/- 6.7 respectively, P = 0.006). There was no significant difference in mean period to colon wall involution between survivors and nonsurvivors (26.2 +/- 4.9 and 33.2 +/- 7.8 h, respectively). CONCLUSIONS: A shorter time to colon wall involution was associated with decreased post operative morbidity in horses presented for surgical correction of large colon volvulus without resection. POTENTIAL RELEVANCE: Ultrasonographic monitoring of colon wall involution after surgical correction of LCV may aid in identifying those cases at risk of MODS. Further investigation of colon wall involution time using a larger number of horses is warranted.

Diagnosis of laryngeal dysplasia in five horses using magnetic resonance imaging and ultrasonography.

REASONS FOR PERFORMING STUDY: Laryngeal dysplasia due to suspected maldevelopment of the fourth branchial arch has been reported previously in the horse and has been associated with rostral displacement of the palatopharyngeal arch and/or right laryngeal dysfunction. These studies all described the endoscopic and/or anatomical post mortem identification of the disease, but ultrasonography or magnetic resonance imaging (MRI) of this disease have not been described. HYPOTHESIS: MRI and ultrasound findings accurately reflect the anatomical features of presumptive fourth branchial arch abnormality and allow accurate ante mortem diagnosis of this condition and, therefore, appropriate management. METHODS: Between February 2008 and January 2009, all horses examined at Rood and Riddle Equine Hospital diagnosed with rostral displacement of the palatopharyngeal arch and/or right laryngeal dysfunction using upper airway endoscopy (n=5) underwent ultrasonography and MRI of the laryngeal region. RESULTS: All 5 horses that met the inclusion criteria were identified and all underwent laryngeal MRI and ultrasound examinations. Features consistent with laryngeal dysplasia, including lack of the cricothyroid articulation, dorsal extension of the thyroid cartilage lamina, and absence or hypoplasia of the cricopharyngeus muscle, were seen in all cases using both types of imaging. CONCLUSIONS AND POTENTIAL RELEVANCE: MRI and ultrasonography permit definitive premortem diagnosis of laryngeal dysplasia. Upper airway abnormalities identified using endoscopy can be more fully characterised using MRI and ultrasonography allowing more appropriate recommendations to be made. Preoperative imaging may also prevent inappropriate surgical intervention.

Development of equine upper airway fluid mechanics model for Thoroughbred racehorses.

REASON FOR PERFORMING STUDY: Computational fluid dynamics (CFD) models provide the means to evaluate airflow in the upper airways without requiring in vivo experiments. HYPOTHESIS: The physiological conditions of a Thoroughbred racehorse's upper airway during exercise could be simulated. METHODS: Computed tomography scanned images of a 3-year-old intact male Thoroughbred racehorse cadaver were used to simulate in vivo geometry. Airway pressure traces from a live Thoroughbred horse, during exercise was used to set the boundary condition. Fluid-flow equations were solved for turbulent flow in the airway during inspiratory and expiratory phases. The wall pressure turbulent kinetic energy and velocity distributions were studied at different cross-sections along the airway. This provided insight into the general flow pattern and helped identify regions susceptible to dynamic collapse. RESULTS: The airflow velocity and static tracheal pressure were comparable to data of horses exercising on a high-speed treadmill reported in recent literature. The cross-sectional area of the fully dilated rima glottidis was 7% greater than the trachea. During inspiration, the area of highest turbulence (i.e. kinetic energy) was in the larynx, the rostral aspect of the nasopharynx was subjected to the most negative wall pressure and the highest airflow velocity is more caudal on the ventral aspect of the nasopharynx (i.e. the soft palate). During exhalation, the area of highest turbulence was in the rostral and mid-nasopharynx, the maximum positive pressure was observed at the caudal aspect of the soft palate and the highest airflow velocity at the front of the nasopharynx. CONCLUSIONS AND CLINICAL RELEVANCE: In the equine upper airway collapsible area, the floor of the rostral aspect of the nasopharynx is subjected to the most significant collapsing pressure with high average turbulent kinetic during inhalation, which may lead to palatal instability and explain the high prevalence of dorsal displacement of the soft palate (DDSP) in racehorses. Maximal abduction of the arytenoid cartilage may not be needed for optimal performance, since the trachea cross-sectional area is 7% smaller than the rima glottidis.

Implications of different degrees of arytenoid cartilage abduction on equine upper airway characteristics.

REASON FOR PERFORMING STUDY: The necessary degree of arytenoid cartilage abduction (ACA) to restore airway patency at maximal exercise has not been determined. OBJECTIVES: Use computational fluid dynamics modelling to measure the effects of different degrees of ACA on upper airway characteristics of horses during exercise. HYPOTHESIS: Maximal ACA by laryngoplasty is necessary to restore normal peak airflow and pressure in Thoroughbred racehorses with laryngeal hemiplegia. METHODS: The upper airway was modeled with the left arytenoid in 3 different positions: maximal abduction; 88% cross-sectional area of the rima glottis; and 75% cross-sectional area of the rima glottis. The right arytenoid cartilage was maximally abducted. Two models were assumed: Model 1: no compensation of airway pressures; and Model 2: airway pressure compensation occurs to maintain peak airflow. The cross-sectional pressure and velocity distributions for turbulent flow were studied at peak flow and at different positions along the airway. RESULTS: Model 1: In the absence of a change in driving pressure, 12 and 25% reductions in cross-sectional area of the larynx resulted in 4.11 and 5.65% reductions in peak airflow and 3.68 and 5.64% in tidal volume, respectively, with mild changes in wall pressure. Model 2: To maintain peak flow, a 6.27% increase in driving tracheal pressure was required to compensate for a cross-sectional reduction of 12% and a 13.63% increase in driving tracheal pressure was needed for a cross-sectional area reduction of 25%. This increase in negative driving pressure resulted in regions with low intraluminal and wall pressures, depending on the degree of airway diameter reduction. CONCLUSION: Assuming no increase in driving pressure, the decrease in left ACA reduced airflow and tidal volume. With increasing driving pressure, a decrease in left ACA changed the wall pressure profile, subjecting the submaximally abducted arytenoid cartilage and adjacent areas to airway collapse. CLINICAL RELEVANCE: The surgical target of ACA resulting in 88 % of maximal cross-sectional area seems to be appropriate.

Computed tomography dacryocystography evaluation of the nasolacrimal apparatus.

Computed tomography-dacryocystography (CT-DCG) was used to evaluate the nasolacrimal system in four patients (three dogs and one horse) that were admitted for evaluation of chronic epiphora, facial swelling, or facial trauma. The four patients are reviewed and the technique for performing CT-DCG is described. Additionally, the indications for this procedure are discussed. CT-DCG is advantageous because cross-sectional imaging provides superior resolution of the nasolacrimal apparatus and the relatively long, small-diameter, bony nasolacrimal canal in most veterinary patients.