A Revolution in Ultrasound
For Tendon Tissue Assessment studies we make use of the technology of The Ultrasound Tissue Characterisation (UTC). UTC scanner technology can differentiate between different fibre types within the tendon. This allows assessment of percentages of healthy aligned fibres, the degree of scar tissue, the severity of a lesion and the effect on the tendon of the current exercise level, all in one scan.
The system consists of both hardware and software for quantitative evaluation of tendon structural integrity.
Ultrasonographic tissue characterisation is driven by a precision instrument that automatically moves a high-frequency ultrasonographic probe along the long axis of the tendon, collecting 600 transverse images at regular intervals of 0.2 mm.
These images are stored in real-time for later processing by compounding contiguous transverse images into a 3D ultrasonographic data-block that can be used for:
- Tomographic visualisation of the entire tendon in one view.
- Ultrasound tissue characterisation and quantification of the architecture and integrity of the tendon or ligament matrix.
- Accurate calculation of lesion size.
Regions of interest within the 3D ultrasonographic data-block are visualised in the transverse, sagittal and coronal views, as well as in a 3D rendered coronal view.
The ultrasonographic tissue characterisation algorithms are applied to quantify the echo patterns in contiguous images and the integrity of the collagenous matrix can be assessed.
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The scanner will detect and display 4 different fibre types/patterns:
- Green: healthy flexible fibres
- Blue: less flexible and less organised fibres. These are present during healing, but also excessive in scar tissue
- Red: fibres that are separated as present in lesions and overstrain
- Black: complete lack of fibre structure/fluid
It is the percentages of these different fibres types in areas in the tendon that allows accurate assessment of the extent of damage, the quality of healing and to establish the optimal exercise the tendon can handle in order to achieve optimal results.
No other technology can offer this amount of information regarding tendon fibre composition.
Based on the above, the UTC scanner has become world-renowned for its ability to:
- Carry out an assessment of the load effect of training and exercise levels on the tendon leading to early detection of tendon weakening and injury.
- Regular scans will allow monitoring of tendons and will make decisions about the ability to perform possible.
- Assessment and staging of healing of injuries leading to customised and guided rehabilitation for the horse.
Not only does a UTC scan allow us to tailor a rehab programme exactly to your horse’s injury, but it can also determine the effects of exercise levels on fibre structure in the tendon. This allows us to be proactive in managing the tendons before possible tendon strain and rupture.
The above example shows how difficult it is to assess scarred tissue in the tendon using ultrasound only. It is only after using UTC technology that the large scared (type II, Blue fibres) area is clearly visible. This horse was planned to go back into training but the fact that there is already “tearing” at the scar (red fibres dotted around the scar) indicates this horse is clearly not ready for training.
Above is an example of healing patterns as shown by UTC; the top image shows complete rupture with blue and red fibres (check ligament), the middle image is a month later with much more green fibres and the bottom image is after 3 months of combined use of UTC, Equestride boot, ArcEquine and shockwave showing complete healing.