{"id":16910,"date":"2025-10-10T14:32:27","date_gmt":"2025-10-10T13:32:27","guid":{"rendered":"https:\/\/hallmarq.net\/?p=16910"},"modified":"2025-10-15T10:56:21","modified_gmt":"2025-10-15T09:56:21","slug":"down-vs-standing-equine-mri-whats-the-difference","status":"publish","type":"post","link":"https:\/\/hallmarq.net\/us\/2025\/10\/10\/down-vs-standing-equine-mri-whats-the-difference\/","title":{"rendered":"Down vs. Standing Equine MRI: What\u2019s the Difference?"},"content":{"rendered":"\n<p>Both down and standing MRI play important roles in equine diagnostics, but they differ in image quality, patient safety, and practical considerations. Each has its own advantages depending on the clinical scenario and level of detail required for diagnosis. Chrysanthi Pitaouli walks us through the pros and cons of each modality. <\/p>\n\n<p>Just like humans who regularly turn to Magnetic Resonance Imaging (MRI) in the care and assessment of soft-tissue and bony injury, horses are frequently referred for advanced imaging such as MRI, which provides superior detail in evaluating soft tissue and osseous structures associated with lameness. In equine medicine, MRI is widely regarded as the gold standard for imaging the foot, yet its utility is not limited to the hoof. We frequently scan higher up the limb, reaching the fetlock, carpus, tarsus and stifle.<\/p>\n\n<p>As MRI gained recognition for its value in equine lameness investigation and demand increased, Hallmarq Veterinary Imaging pioneered their innovative <a href=\"https:\/\/hallmarq.net\/us\/products\/standing-equine-mri\/\" target=\"_blank\" rel=\"noreferrer noopener\">Standing Equine MRI<\/a> machine, designed specifically for the standing sedated horse. The alternative option is recumbent or \u2018down\u2019 MRI which requires the horse to be anesthetised.<\/p>\n\n<h2 class=\"wp-block-heading\">The Importance of Image Quality in MRI Imaging<\/h2>\n\n<p>In equine imaging,\u00a0magnetic field strength\u00a0is central to image quality. MRI systems may be classified:<\/p>\n\n<ul class=\"wp-block-list\" class=\"wp-block-list\">\n<li><strong>High-field <\/strong>(typically 1.5T\u20133T)<\/li>\n\n\n\n<li><strong>Low-field<\/strong>\u00a0(0.2T\u20130.3T)<\/li>\n<\/ul>\n\n<p>A higher magnetic field strength typically delivers finer image detail and greater resolution.\u00a0Recumbent or &#8216;down&#8217; MRI\u00a0can use either high-field or low-field magnets. Standing Equine MRI &#8211; developed by Hallmarq specifically for the standing, sedated horse, uses a low-field system. As the patient remains standing, the risks and costs of anesthesia are avoided. Widely regarded as the\u00a0gold standard for imaging the equine foot in standing horses, standing MRI provides excellent diagnostic value.<\/p>\n\n<p>Motion artefact has been a critical factor in achieving diagnostic image quality in standing systems. As motion correction technology continues to evolve, more recent innovations such as <a href=\"https:\/\/hallmarq.net\/us\/2025\/08\/21\/transforming-standing-equine-mri\/\" target=\"_blank\" rel=\"noreferrer noopener\">Hallmarq&#8217;s iNAV<\/a>, combined with optimized sedation protocols, deliver markedly improved image quality higher up the limb. Important research has show that, when imaging the equine foot, image quality is not affected by whether the horse is standing or recumbent, but more by the acquisition system itself [1].<\/p>\n\n<h2 class=\"wp-block-heading\">MRI and Motion Correction Technology<\/h2>\n\n<p>Image quality in standing MRI has improved dramatically over the years. Hallmarq\u2019s award-winning motion correction software automatically compensates for natural patient sway, and more recent developments have significantly reduced scan times compared to when standing MRI was first introduced. <\/p>\n\n<p>iNAV is the latest enhancement to Hallmarq&#8217;s motion correction software and uniquely designed to address one of the most persistent challenges in veterinary imaging: patient movement. <\/p>\n\n<p>In a recent case study highlighting <a rel=\"noopener noreferrer\" target=\"_blank\" href=\"https:\/\/eur02.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fhallmarq.net%2Fcase-studies%2Fabnormal-sclerosis-of-the-central-tarsal-bone%2F&amp;data=05%7C02%7CSara.horner%40Hallmarq.net%7Cb35acdea49724fab8dea08dde569aa87%7Ce3b1a6622cce4c92a4a9c9f62fdd405d%7C0%7C0%7C638918964199212199%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&amp;sdata=vAtQGHkf9r5G%2B%2F4gDT8BDg3%2FLu6eXcmqhpHNMCvBEso%3D&amp;reserved=0\">abnormal sclerosis of the central tarsal bone<\/a>, diagnostic scans of difficult to image areas were possible with iNAV, which proves particularly beneficial when imaging the fetlock, tarsus, carpus, or high suspensory. The improved detail and the clarity it delivers is invaluable for accurate assessment.<\/p>\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"405\" height=\"454\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2025\/04\/Grosbois-2-T2FSE-iNAV.jpg\" alt=\"Transverse image of the left tarsus T2 FSE taken with standing MRI\" class=\"wp-image-15838\" style=\"aspect-ratio:1;object-fit:cover\" srcset=\"https:\/\/hallmarq.net\/app\/uploads\/2025\/04\/Grosbois-2-T2FSE-iNAV.jpg 405w, https:\/\/hallmarq.net\/app\/uploads\/2025\/04\/Grosbois-2-T2FSE-iNAV-268x300.jpg 268w\" sizes=\"auto, (max-width: 405px) 100vw, 405px\" \/><figcaption class=\"wp-element-caption\"><em>Transverse image of the left tarsus\u00a0T2 FSE with iNAV motion correction<\/em><\/figcaption><\/figure>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"406\" height=\"432\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2025\/04\/Grosbois-3-STIR-FSE-iNAV.jpg\" alt=\"Transverse image of the left tarsus STIR FSE taken with standing MRI\" class=\"wp-image-15839\" style=\"aspect-ratio:1;object-fit:cover\" srcset=\"https:\/\/hallmarq.net\/app\/uploads\/2025\/04\/Grosbois-3-STIR-FSE-iNAV.jpg 406w, https:\/\/hallmarq.net\/app\/uploads\/2025\/04\/Grosbois-3-STIR-FSE-iNAV-282x300.jpg 282w\" sizes=\"auto, (max-width: 406px) 100vw, 406px\" \/><figcaption class=\"wp-element-caption\"><em>Transverse image of the left tarsus\u00a0STIR FSE with iNAV motion correction<\/em><\/figcaption><\/figure>\n<\/div><\/div>\n<\/div>\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Standing MRI has considerably improved our assessment of lameness cases. In addition, the introduction of iNAV allows us to obtain images of exceptional diagnostic quality even for difficult areas, such as the tarsal region. In the present case, the fracture line and the area of bone oedema-like signal are clearly defined with minimal motion artifacts, which would not have been possible otherwise.&#8221;<\/p>\n\n\n\n<p><\/p>\n<cite>Dr Claudia Fraschetto DMV, DECVSMR, ISELP Cert,&nbsp;Clinique de Grosbois, France.<\/cite><\/blockquote>\n\n<p>Although certain fine details may only be visible on high-field systems, studies confirm that the vast majority of everyday lameness-related conditions can be effectively diagnosed with low-field standing MRI [1-6]. Moreover, standing MRI has proven invaluable beyond the foot and fetlock, providing crucial diagnostic information regarding pathology affecting the\u00a0<a href=\"https:\/\/hallmarq.net\/us\/case-studies\/assessment-of-chronic-avulsion-fracture-of-the-proximal-suspensory-origin\/\" target=\"_blank\" rel=\"noreferrer noopener\">proximal suspensory region<\/a>, carpus, and tarsus\u00a0[7].<\/p>\n\n<h2 class=\"wp-block-heading\">What&#8217;s the Risk of MRI Imaging?<\/h2>\n\n<p>Down MRI requires the horse to undergo general anesthesia (GA) before image acquisition. Once anesthetized, the recumbent horse is positioned for scanning, with the distal limbs placed into the machine\u2019s tubular core. High-field MRI cannot be performed on awake horses, as even the smallest movement creates motion artefact that renders the images non-diagnostic, leaving general anesthesia as the only option. <\/p>\n\n<p>Standing low-field MRI produces the same image resolution as recumbent low-field MRI without relying on general anesthesia (GA) to reduce motion artefact. <\/p>\n\n<p>Despite the proficiency of practice staff in administering anesthesia and obtaining detailed images, many owners remain skeptical regarding the potential risks associated with down MRI.<\/p>\n\n<h2 class=\"wp-block-heading\">Reducing the Risk to the Patient <\/h2>\n\n<p>General anesthesia always carries risk, even in healthy horses. A large retrospective study reported that around\u00a0one in 100 horses experience a peri-anesthetic complication\u00a0[8]. In more recent research\u00a0looking specifically at MRI, the risks are equally clear:\u00a0Manning &amp; Sampson (2025)\u00a0found that peri-anesthetic complications occurred in a substantial number of cases during high-field MRI, reinforcing the challenges of performing these procedures under general anesthesia. Similarly,\u00a0Morgan et al. (2024)\u00a0identified both the incidence and risk factors for complications associated with anesthesia for elective MRI, underlining that even in controlled, elective settings, adverse events remain a genuine concern. For owners and trainers of elite sport horses, this risk versus benefit calculation is a difficult one and, for many, it is simply not worth taking.<\/p>\n\n<p>When investigating lameness, the choice of imaging modality depends on balancing the level of diagnostic detail required with the risk to the patient.\u00a0MRI is usually considered after lameness examination, diagnostic nerve blocks, and initial imaging with radiography and ultrasound suggest pathology that cannot be fully characterized with these techniques.\u00a0Standing MRI, requiring only mild sedation, often represents the\u00a0safest and most practical first step, providing detailed information for most distal limb conditions. In cases where the standing study does not fully explain the clinical signs, or when extremely fine anatomical detail is needed,\u00a0referral for high-field MRI under general anesthesia may still be warranted.<\/p>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"683\" src=\"https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-1024x683.jpg\" alt=\"Hallmarq's Standing Equine MRI is carried out without the need for general anesthesia that 'down' MRI would require.\" class=\"wp-image-13392\" srcset=\"https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-1024x683.jpg 1024w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-300x200.jpg 300w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-768x512.jpg 768w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-1536x1025.jpg 1536w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-500x333.jpg 500w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-1000x667.jpg 1000w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-1500x1000.jpg 1500w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-540x360.jpg 540w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill-1080x720.jpg 1080w, https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241030-HM-PT-6W1A0751-Enhanced-NROakhill.jpg 1619w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Hallmarq&#8217;s Standing Equine MRI is carried out without the need for general anesthesia.<\/figcaption><\/figure>\n\n<h2 class=\"wp-block-heading\">Cost Implications of MRI Scans<\/h2>\n\n<p>Down MRI undoubtedly places a larger demand on practice staff. Highly skilled personnel are needed to administer anesthesia, and several people are required to ensure the safe positioning of the horse in the magnet. The patient will need constant monitoring for the duration of the scan process. These additional costs are, of course, passed on to the horse owner.<\/p>\n\n<p>In comparison, standing MRI can be operated by just two staff &#8211; one qualified by Hallmarq to operate the machine and one to manage the patient. Since standing MRI does not require general anesthesia, image acquisition is complete in a matter of hours as opposed to the lengthier procedure that down MRI demands. The practice and horse owner benefit from associated cost savings and most veterinarians can <a href=\"https:\/\/hallmarq.net\/2021\/06\/15\/how-do-they-do-it\/\">see more patients in less time<\/a>, thus generating more revenue.<\/p>\n\n<p>For the veterinary practice, Standing Equine MRI costs less to install, requires less space and needs less shielding than high-field MRI. The stronger the magnet, the more care is needed in planning the surrounding area to minimize interference with image quality. <\/p>\n\n<p>Down MRI requires a large, dedicated room taking up valuable clinic space. In comparison, Hallmarq\u2019s Standing Equine MRI can be delivered in a self-contained modular room and dropped into place for quick and easy setup. The patient is simply walked into the magnet, a hoof coil attached to the relevant limb and scanning can start. Overall, it&#8217;s a much less labor- intensive process than that required by down MRI.<\/p>\n\n<h2 class=\"wp-block-heading\">Down vs. Standing Equine MRI: What&#8217;s the Answer?<\/h2>\n\n<p>As with all clinical decisions, there is no single answer that fits every case. The key consideration is the\u00a0level of detail required for diagnosis. Evidence suggests that\u00a0field strength and the acquisition system itself are more critical determinants of image quality than whether a horse is scanned standing or recumbent\u00a0[1]. Ultimately, the question becomes whether a\u00a0high-field system is necessary to capture the finest anatomical detail, or whether a\u00a0low-field standing system provides sufficient information to make the diagnosis safely and effectively.<\/p>\n\n<p>High-field systems can deliver finer anatomical detail, but for the majority of everyday lameness cases, low-field MRI &#8211; particularly Hallmarq\u2019s standing system &#8211; provides the necessary diagnostic information safely and effectively. When combined with the advantages of avoiding general anesthesia and reducing overall costs, standing MRI represents a practical and sensible first step in most equine lameness investigations.<\/p>\n\n<h6 class=\"wp-block-heading\">References<\/h6>\n\n<ul class=\"wp-block-list\" class=\"wp-block-list\">\n<li style=\"font-size:12px\">[1] Byrne, C.A., Marshall, J.F., Voute, L.C. (2020) Clinical magnetic resonance image quality of the equine foot is significantly influenced by acquisition system. Equine Vet J. 00, pp 1\u2013 12<\/li>\n\n\n\n<li style=\"font-size:12px\">[2] Powell, S.E., 2012. Low\u2010field standing magnetic resonance imaging findings of the metacarpo\/metatarsophalangeal joint of racing Thoroughbreds with lameness localised to the region: a retrospective study of 131 horses.\u00a0Equine veterinary journal,\u00a044(2), pp.169-177.<\/li>\n\n\n\n<li style=\"font-size:12px\">[3] Murray, R.C., Mair, T.S., Sherlock, C.E. and Blunden, A.S., 2009. Comparison of high\u2010field and low\u2010field magnetic resonance images of cadaver limbs of horses.\u00a0Veterinary Record,\u00a0165(10), pp.281-288.<\/li>\n\n\n\n<li style=\"font-size:12px\">[4] Werpy, N.M., 2007. Magnetic resonance imaging of the equine patient: a comparison of high-and low-field systems.\u00a0Clinical techniques in equine practice,\u00a06(1), pp.37-45.<\/li>\n\n\n\n<li style=\"font-size:12px\">[5] Porter, E.G. and Werpy, N.M., 2014. New concepts in standing advanced diagnostic equine imaging.\u00a0Veterinary Clinics: Equine Practice,\u00a030(1), pp.239-268.<\/li>\n\n\n\n<li style=\"font-size:12px\">[6] Sherlock, C.E., Mair, T.S., Ireland, J. and Blunden, T., 2015. Do low field magnetic resonance imaging abnormalities correlate with macroscopical and histological changes within the equine deep digital flexor tendon?.\u00a0Research in veterinary science,\u00a098, pp.92-97.<\/li>\n\n\n\n<li style=\"font-size:12px\">[7] Labens, R., Schramme, M.C., Murray, R.C. and Bolas, N., 2020. Standing low\u2010field MRI of the equine proximal metacarpal\/metatarsal region is considered useful for diagnosing primary bone pathology and makes a positive contribution to case management: a prospective survey study.\u00a0Veterinary Radiology &amp; Ultrasound,\u00a061(2), pp.197-205.<\/li>\n\n\n\n<li style=\"font-size:12px\">[8] Dugdale A.H., Obhrai. J., Cripps P.J. (2016) Twenty years later: a single-centre, repeat retrospective analysis of equine perioperative mortality and investigation of recovery quality. Vet Anaesth Analg. 43, (2), 171-8<\/li>\n\n\n\n<li style=\"font-size:12px\">[9] Manning, H. and Sampson, S., 2025. Peri\u2010anaesthetic complications in 1798 equids undergoing high\u2010field elective orthopaedic MRI at a tertiary referral hospital.\u00a0Equine Veterinary Journal,\u00a057(3), pp.666-673.<\/li>\n\n\n\n<li style=\"font-size:12px\">[10] Morgan, J.M., Aceto, H., Manzi, T. and Davidson, E.J., 2024. Incidence and risk factors for complications associated with equine general anaesthesia for elective magnetic resonance imaging.\u00a0Equine Veterinary Journal,\u00a056(5), pp.944-951.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>While both &#8216;down&#8217; are standing equine MRI are viable diagnostic options, there are crucial differences between the two. Here\u2019s what you need to know.<\/p>\n","protected":false},"author":2,"featured_media":13385,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[70,71],"class_list":["post-16910","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-equine-us","category-mri-us"],"featured_image_src":"https:\/\/hallmarq.net\/app\/uploads\/2024\/12\/20241029-HM-PT-6W1A0484-Enhanced-NROakhill.jpg","author_info":{"display_name":"Sara Horner","author_link":"https:\/\/hallmarq.net\/us\/author\/sara\/"},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Down vs. Standing Equine MRI - Hallmarq Veterinary Imaging<\/title>\n<meta name=\"description\" content=\"While both &#039;down&#039; and standing equine MRI 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