ARFI Elastography in Detecting Elasticity Changes in Equine Tendons

VRU 63(6): 790-797

June 30, 2023

  • Background: Tendinopathies are injuries often seen in sport horses and are responsible for the retirement of many of these animals. The presumptive diagnosis of tendonitis is based on clinical examination, but this is limited in defining the structure and severity of the lesion.

  • Study: This study aimed to describe the applicability of both qualitative and quantitative ARFI elastography in the identification of stiffness changes in equine SDFT with induced injury during the healing process, as well as adjacent structures.

  • Method: Eight healthy horses were selected. Preinjury B mode and ARFI evaluations were performed bilaterally in the palmar metacarpal region. Injury was induced only on the left forelimb by a single injection of collagenase in SDFT. Evaluations were performed at eight timepoints: one before injury and seven after injury.

  • Results: Injured SDFTs presented mainly cool colors (soft) from T1 to T3, and from T4, there was an increase in warm colors (hard), close to the appearance of tendons of G1. In the first four timepoints, there was a decrease in stiffness compared to G1. On T1 and T2, a cutoff value <6.21 m/s to determine tendinopathy of the SDFT was established.

  • Conclusions: Findings from this study indicated that ARFI elastography allows qualitative and quantitative verification of stiffness changes during the healing process/chronicity of the SDFT with induced injury in its different zones, as well as in the adjacent tissues, contributing to the understanding of the pathophysiology of this disease and providing a noninvasive diagnosis.

Elastographic evaluation in transverse view of the equine superficial digital flexor tendon (same as in Figure 1, delimited by the orange blocks) before (A) and after (B-H) injury induction at the 3A zone with the patient standing. Note the significant shear wave velocity (SWV) average decrease and the predominance of cool colors on the first two evaluations (B and C). A, Normal superficial digital flexor tendon at T0, with a mean shear wave velocity of 6.22 m/s. B, At T1, 72 h after injury induction, the mean SWV was 3.85 m/s. C) At T2, 15 days after injury induction, the mean shear wave velocity was 4.01 m/s. D, At T3, 30 days after injury induction, the mean shear wave velocity was 7.07 m/s. E, At T4, 45 days after injury induction, the mean SWV was 7.39 m/s. F, At T5, 60 days after injury induction, the mean shear wave velocity was 8.92 m/s. G, At T6, 75 days after injury induction, the mean SWV was 5.77 m/s. H, At T7, 90 days after injury induction, the mean SWV was 6.07 m/s. L, lateral. Elastographic setting: 10 m/s scale

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