IMAGING

The hospital is equipped with the latest digital imaging technology including top of the range ultrasound machines, digital radiography, nuclear scintigraphy and standing MRI. Images from each modality are electronically stored using a PACS system, enabling direct comparison of images from different modalities on high resolution screens.

Gaynor Minshall BVSc Cert ES MRCVS oversees the imaging services, with her particular area of expertise being ultrasonography. Meredith Smith MA VetMB PhD Cert ES Dip ECVS MRCVS oversees the scintigraphy and MRI services. Interpretation of all forms of diagnostic imaging is available for both for in house and referring veterinarians.

Nia Turley BSc(Hons) manages the digital imaging services at our hospital and satellite yards. She advises international clients on techniques and equipment required in advanced diagnostic imaging techniques.

  • Services available include:
    • Digital Radiography on and off-site, including at the sales
    • Digital ultrasonography (Musculoskeletal, thoracic, abdominal, etc.)
    • Endoscopy/Videoendoscopy (Respiratory, urogenital and digestive)
    • Laparoscopy
    • Magnetic Resonance Imaging (MRI)
    • Scintigraphy

Images are available in Dicom or Jpeg format on CD or film print if required.

  • Also available:
    • Digital transfer of images, including ultrasound
    • Consultancy on digital imaging
    • Consultancy on MRI and interpretation of MR examinations
    • Consultancy on equine nuclear medicine techniques and interpretation of scintigrams
    • Consultancy on Radiation Protection issues

Every year we organise and host the BEVA course 'Diagnostic Techniques in Equine Practice'.

MAGNETIC RESONANCE IMAGING (MRI)

Standing low field MRI is available at the Newmarket Equine Hospital. The service is available on a day case basis as well as in conjunction with more detailed lameness investigation.

Magnetic resonance images are produced through interactions between a powerful magnet, a radiofrequency coil, magnetic field gradients and powerful computer software. This imaging technique is non invasive, making it very safe for both patient and personnel, and MRI is now considered to be the gold standard means of imaging the equine distal limb.

A low field Magnetic Resonance Imaging (MRI) system has been developed specifically for the equine veterinary market, enabling images of the distal limb to be acquired from horses standing under sedation. With the use of motion correction software it is currently possible to image the forelimb up to and including the carpus (knee), and the hindlimb up to and including the tarsus (hock).

In the horse, abnormalities which may be detectable using MRI include ligament and tendon injuries, bone trauma and necrosis, osseous cyst-like lesions, articular cartilage damage, subchondral and trabecular bone modelling and fractures. MRI is of particular use in imaging structures contained within the hoof capsule, as it is difficult to visualise structures contained within the hoof wall using any other imaging technique.

There is a huge quantity of information contained within a series of MR images. In order to put this information into context, a detailed knowledge of the anatomy of the region of interest is required, together with experience of the normal variations that occur. Not all abnormalities are associated with pain and lameness, and so the identification of abnormalities on MRI must be interpreted in the light of clinical findings during a full lameness investigation.

SCINTIGRAPHY

Following the installation of a new state of the art nuclear medicine suite, Newmarket Equine Hospital offers nuclear scintigraphy.

Nuclear scintigraphy (bone scanning) is an established aid for equine lameness diagnosis and usually forms part of a lameness/poor performance evaluation. It is a highly sensitive method of demonstrating bone injury in horses, often providing early diagnosis, or revealing additional lesions to those found radiographically. Because of its sensitivity, it allows for the monitoring of healing, helping to ensure that horses are returned to work at the correct time. Scintigraphy also allows imaging of sites in which radiography is difficult or contraindicated, such as the pelvis.

Various equine scintigraphic examinations can be performed such as skeletal, vascular and soft tissue studies, pulmonary and infection localisation scans. However the majority of equine patients undergo skeletal scintigraphy for the diagnosis of bone pathology, particularly to screen for stress fractures and entheseopathies. The improved diagnosis of stress fractures has been of great benefit in reducing the mortality rate from these injuries in the racehorse.

A skeletal nuclear scintigraphy examination (bone scan) involves the intravenous injection of a small amount of radiopharmaceutical (99m Tc Methylene Diphosphonate) into the horse approximately two to three hours prior to performing the examination (this time interval ensures that the bone to soft tissue ratio is at its highest and that images are optimal). The uptake of the radiopharmaceutical by bone depends upon a number of factors, the most important of which are the blood supply to each area and the rate of bone turnover. Wherever there is damage there is often increased bone turnover, and in these regions there is increased binding of the radiopharmaceutical to the skeleton. Individual scintigraphic images of the areas of interest are acquired using a camera which detects gamma rays emitted from the decay of the radionuclide over a fixed time. Images are evaluated for “hot spots” or areas of increased radiopharmaceutical uptake (IRU).

Although a safe procedure, nuclear scintigraphic examinations are only undertaken when there is specific clinical indication to do so due to the strict radiation protection regulations that have to be adhered to within the work place.