@article{seiler_campbell_nixon_tsuruta_dayton_jennings_redding_lustgarten_2016, title={FEASIBILITY AND SAFETY OF CONTRAST-ENHANCED ULTRASOUND IN THE DISTAL LIMB OF SIX HORSES}, volume={57}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12333}, abstractNote={Vascular alterations play important roles in many orthopedic diseases such as osteoarthritis, tendonitis, and synovitis in both human and equine athletes. Understanding these alterations could enhance diagnosis, prognosis, and treatment. Contrast‐enhanced ultrasound (CEUS) could be a valuable method for evaluation of blood flow and perfusion of these processes in the equine distal limb, however no reports were found describing feasibility or safety of the technique. The goal of this prospective, experimental study was to describe the feasibility and safety of distal limb CEUS in a sample of six horses. For each horse, CEUS of the distal limb was performed after intravenous injections of 5 and 10 ml, as well as intra‐arterial injections of 0.5 and 1 ml contrast medium. Vital parameters were monitored and CEUS images were assessed qualitatively and quantitatively for degree of contrast enhancement. None of the horses had clinically significant changes in their vital parameters after contrast medium injection. One horse had a transient increase in respiratory rate, and several horses had mild increases of systolic blood pressure of short duration after intravenous, but not after intra‐arterial injections. Intra‐arterial injection was possible in all horses and resulted in significantly improved contrast enhancement both quantitatively (P = 0.027) and qualitatively (P = 0.019). Findings from this study indicated that CEUS is a feasible and safe diagnostic test for evaluation of the equine distal limb. Future studies are needed to assess the clinical utility of this test for horses with musculoskeletal diseases.}, number={3}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Seiler, Gabriela S. and Campbell, Nigel and Nixon, Britton and Tsuruta, James K. and Dayton, Paul A. and Jennings, Samuel and Redding, W. Rich and Lustgarten, Meghann}, year={2016}, pages={282–289} }
 @article{shrauner_blikslager_davis_campbell_law_lustgarten_prange_2017, title={Feasibility and safety of lumbosacral epiduroscopy in the standing horse}, volume={49}, ISSN={["2042-3306"]}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-84978052421&partnerID=MN8TOARS}, DOI={10.1111/evj.12591}, abstractNote={SummaryReasons for performing studyThe large size of the adult horse prevents the use of advanced imaging modalities in most areas of the axial skeleton, including the lumbosacral vertebral column. Traditional imaging techniques are frequently unable to pinpoint the underlying pathology in horses with caudal back pain. In man, lumbosacral epiduroscopy is used to diagnose and treat subjects with chronic back and leg pain. This technique may close the diagnostic gap in horses with similar clinical signs.ObjectivesTo evaluate the safety and feasibility of lumbosacral epiduroscopy in the standing adult horse.Study designDescriptive, experimental study.MethodsSeven adult horses weighing 504–578 kg were sedated and restrained in stocks in preparation for aseptic surgery. Vascular dilators of increasing size were inserted cranial to the first moveable vertebra caudal to the sacrum to facilitate a minimally invasive approach into the epidural space. A flexible video‐endoscope was introduced and advanced as far as its 60‐cm working length permitted. Pre‐, intra‐ and post‐operative plasma cortisol samples were collected, and neurological and lameness examinations were performed prior to and during the 2 weeks following the procedure. Post‐mortem examinations were conducted in 5 of the 7 horses.ResultsStanding lumbosacral epiduroscopy was well tolerated by all horses. The anatomic structures in the epidural space (dura mater, spinal nerve roots, fat and blood vessels) were followed as far cranial as the thoracolumbar region. No complications related to the procedure were noted in the 2‐week monitoring period following epiduroscopy. Small, organised haematomas were identified in the sacral epidural space during necropsy in one horse. No abnormalities were seen in the other 4 animals.ConclusionsLumbosacral epiduroscopy can be performed safely in sedated standing horses. The procedure may become a valuable diagnostic tool in horses with caudal back or hindlimb pain of unknown origin.}, number={3}, journal={EQUINE VETERINARY JOURNAL}, author={Shrauner, B. and Blikslager, A. and Davis, J. and Campbell, N. and Law, M. and Lustgarten, M. and Prange, T.}, year={2017}, month={May}, pages={322–328} }
 @article{specchi_pey_ledda_lustgarten_thrall_bertolini_2015, title={COMPUTED TOMOGRAPHIC AND ULTRASONOGRAPHIC CHARACTERISTICS OF CAVERNOUS TRANSFORMATION OF THE OBSTRUCTED PORTAL VEIN IN SMALL ANIMALS}, volume={56}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12265}, abstractNote={In humans, the process of development of collateral vessels with hepatopetal flow around the portal vein in order to bypass an obstruction is called “cavernous transformation of the portal vein.” The purpose of this retrospective, cross‐sectional, multicentric study was to describe presumed cavernous transformation of the portal vein in small animals with portal vein obstruction using ultrasound and multidetector‐row computed tomography (MDCT). Databases from three different institutions were searched for patients with an imaging diagnosis of cavernous transformation of the portal vein secondary to portal vein obstruction of any cause. Images were retrieved and reanalyzed. With MDCT‐angiography, two main portoportal collateral pathways were identified: short tortuous portoportal veins around/inside the thrombus and long portoportal collaterals bypassing the site of portal obstruction. Three subtypes of the long collaterals, often coexisting, were identified. Branches of the hepatic artery where involved in collateral circulation in nine cases. Concomitant acquired portosystemic shunts were identified in six patients. With ultrasound, cavernous transformation of the portal vein was suspected in three dogs and one cat based on visualization of multiple and tortuous vascular structures corresponding to periportal collaterals. In conclusion, the current study provided descriptive MDCT and ultrasonographic characteristics of presumed cavernous transformation of the portal vein in a sample of small animals. Cavernous transformation of the portal vein could occur as a single condition or could be concurrent with acquired portosystemic shunts.}, number={5}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Specchi, Swan and Pey, Pascaline and Ledda, Gianluca and Lustgarten, Meghann and Thrall, Donald and Bertolini, Giovanna}, year={2015}, pages={511–519} }
 @article{lustgarten_redding_labens_davis_daniel_griffith_seiler_2015, title={ELASTOGRAPHIC EVALUATION OF NATURALLY OCCURING TENDON AND LIGAMENT INJURIES OF THE EQUINE DISTAL LIMB}, volume={56}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12284}, abstractNote={Compression elastography is an ultrasonographic technique that estimates tissue strain and may have utility in diagnosing and monitoring soft tissue injuries in the equine athlete. Recently, elastography has been proven to be a feasible and repeatable imaging modality for evaluating normal tendons and ligaments of the equine distal forelimb. The purposes of this prospective study were to investigate the ability of elastography to detect spontaneously occurring lesions of equine tendons and ligaments diagnosed with magnetic resonance imaging (MRI) and gray‐scale ultrasound (US) and to characterize the differences in the elastographic appearance of acute vs. chronic injuries. Fifty seven horses with a total of 65 lesions were evaluated. Images were assessed quantitatively and qualitatively. Acute lesions were found to be significantly softer (P < 0.0001) than chronic lesions (P < 0.0001) and the stiffness of lesions increased with progression of healing (P = 0.0138). A negative correlation between lesion hypoechogenicity and softness was appreciated with more hypoechoic lesions appearing softer (P = 0.0087) and more hyperechoic regions harder (P = 0.0002). A similar finding occurred with increased signal intensity on short tau inversion recovery (STIR) and proton density (PD) MRI sequences correlating with increased softness on elastography (P = 0.0164). Using US and MRI as references, commonly encountered soft tissue injuries of the equine distal limb could be detected with elastography. However, elastography was limited for detecting small, proximal injuries of the hindlimb proximal suspensory ligament. Elastographic evaluation of equine tendons and ligaments may allow better characterization of lesion chronicity and severity, and sequential examinations may optimize lesion management, rehabilitation, and return to training.}, number={6}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Lustgarten, Meghann and Redding, W. Rich and Labens, Raphael and Davis, Weston and Daniel, Thomas M. and Griffith, Emily and Seiler, Gabriela S.}, year={2015}, pages={670–679} }
 @article{lustgarten_redding_schnabel_prange_seiler_2016, title={Navigational ultrasound imaging: A novel imaging tool for aiding interventional therapies of equine musculoskeletal injuries}, volume={48}, ISSN={["2042-3306"]}, DOI={10.1111/evj.12410}, abstractNote={SummaryReasons for performing studyNavigational ultrasound imaging, also known as fusion imaging, is a novel technology that allows real‐time ultrasound imaging to be correlated with a previously acquired computed tomography (CT) or magnetic resonance imaging (MRI) study. It has been used in man to aid interventional therapies and has been shown to be valuable for sampling and assessing lesions diagnosed with MRI or CT that are equivocal on ultrasonography. To date, there are no reports of the use of this modality in veterinary medicine.ObjectivesTo assess whether navigational ultrasound imaging can be used to assist commonly performed interventional therapies for the treatment of equine musculoskeletal injuries diagnosed with MRI and determine the appropriateness of regional anatomical landmarks as registration sites.Study designRetrospective, descriptive clinical study.MethodsHorses with musculoskeletal injuries of the distal limb diagnosed with MRI scheduled for ultrasound‐guided interventional therapies were evaluated (n = 17 horses with a total of 29 lesions). Anatomical landmarks used for image registration for the navigational procedure were documented. Accuracy of lesion location and success of the procedure were assessed subjectively and described using a grading scale.ResultsAll procedures were accurately registered using regional anatomical landmarks and considered successful based on our criteria. Anatomical landmarks were described for each lesion type. The addition of navigational imaging was considered to greatly aid the procedures in 59% of cases and added information to the remainder of the procedures. The technique was considered to improve the precision of these interventional procedures.ConclusionsNavigational ultrasound imaging is a complementary imaging modality that can be used for the treatment of equine soft tissue musculoskeletal injuries diagnosed with MRI.}, number={2}, journal={EQUINE VETERINARY JOURNAL}, author={Lustgarten, M. and Redding, W. R. and Schnabel, L. V. and Prange, T. and Seiler, G. S.}, year={2016}, month={Mar}, pages={195–200} }
 @article{lustgarten_redding_labens_morgan_davis_seiler_2014, title={ELASTOGRAPHIC CHARACTERISTICS OF THE METACARPAL TENDONS IN HORSES WITHOUT CLINICAL EVIDENCE OF TENDON INJURY}, volume={55}, ISSN={["1740-8261"]}, DOI={10.1111/vru.12104}, abstractNote={Tendon and ligament injuries are common causes of impaired performance in equine athletes. Gray‐scale ultrasonography is the current standard method for diagnosing and monitoring these injuries, however this modality only provides morphologic information. Elastography is an ultrasound technique that allows detection and measurement of tissue strain, and may provide valuable mechanical information about equine tendon and ligament injuries. The purpose of this study was to determine the feasibility, reproducibility, and repeatability of elastography; and to describe elastographic characteristics of metacarpal tendons in sound horses. Nineteen legs for 17 clinically sound horses without evidence of musculoskeletal pathology were included. Elastographic images of the superficial and deep digital flexor tendons and the branches of the suspensory ligament (tendon of the interosseous muscle) were described quantitatively and qualitatively. There was no statistically significant difference between operators (P = 0.86) nor within operators (P = 0.93). For qualitative assessments, reproducibility (0.46) was moderate and repeatability (0.78) was good. Similar to human Achilles tendons, equine tendons were classified as predominantly hard using elastography. There was no statistically significant difference in stiffness of the flexor tendons (P = 0.96). No significant difference in stiffness was found with altered leg position during standing (P = 0.84) and while nonweight bearing (P = 0.61). The flexor tendons were softer when imaged in longitudinal versus transverse planes (P < 0.01) however, the suspensory branches were not (P = 0.67). Findings supported future clinical application of elastography as a noninvasive “stall‐side” imaging modality for evaluation of the tendons and ligaments of the distal forelimb in horses.}, number={1}, journal={VETERINARY RADIOLOGY & ULTRASOUND}, author={Lustgarten, Meghann and Redding, W. Rich and Labens, Raphael and Morgan, Michel and Davis, Weston and Seiler, Gabriela S.}, year={2014}, month={Jan}, pages={92–101} }
 @article{newman_lustgarten_berman_vivrette_redding_2014, title={Surgical treatment of synovial osteochondromatosis in the middle carpal joint of a pony}, volume={26}, ISSN={["2042-3292"]}, DOI={10.1111/eve.12093}, abstractNote={SummaryA 9‐year‐old Paint pony gelding presented for signs of left carpal swelling of 1–2 weeks' duration. Radiographic, ultrasonographic and arthroscopic evaluation of the left carpus was consistent with synovial osteochondromatosis. This presumptive clinical diagnosis was confirmed histopathologically. Arthroscopic removal of the osteochondral bodies resulted in resolution of the carpal effusion and return to previous athletic activity by 4.5 months post operatively. Arthroscopic removal of osteochondral bodies is the treatment of choice in cases of suspected synovial osteochondromatosis.}, number={8}, journal={EQUINE VETERINARY EDUCATION}, author={Newman, J. C. and Lustgarten, M. and Berman, K. G. and Vivrette, S. and Redding, W. R.}, year={2014}, month={Aug}, pages={395–399} }