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- Shalabi, A, et al.
(författare)
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Dynamic contrast-enhanced mr imaging and histopathology in chronic achilles tendinosis. A longitudinal MR study of 15 patients
- 2002
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 43:2, s. 198-206
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the value of dynamic contrast-enhanced MR imaging (DEMRI) and its correlation to symptoms and histopathology in chronic Achilles tendinosis. Material and Methods: Fifteen patients with severe symptoms underwent DEMRI preoperatively and 2 years postoperatively. US-guided core biopsies of tendinosis tissue were obtained preoperatively and the specimens were analyzed using a semiquantitative protocol. DEMRI was evaluated by calculating the area under curve (AUC) of signal alteration and the static MR by a semiquantitative grading scale. A questionnaire and clinical examination evaluated the clinical outcome. Results: Early contrast enhancement (first 72 s) was seen in DEMRI at tendon lesions of the symptomatic Achilles tendons with a significant difference to asymptomatic contralateral tendon that revealed no or mild enhancement. Increased severity of tendon pathology (including fiber structure abnormality, increased vascularity, rounding of nuclei and increased amount of glycosaminoglycans) was correlated to both dynamic and static signal enhancement. Two years following surgical treatment, the signal alterations showed regression of early contrast enhancement (AUC decreased from 9 preoperatively to 2 postoperatively). The clinical outcome was as follows: 8 patients excellent, 4 good, 2 fair and 1 poor. Conclusion: Patients with chronic painful achillodynia showed an early contrast-agent enhancement corresponding to the tendon lesion. Increased enhancement correlated to increased severity of tendon histopathology and patient symptoms. Two years after surgical treatment the contrast-agent enhancement decreased.
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| 3. |
- Shalabi, A, et al.
(författare)
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MR evaluation of chronic Achilles tendinosis. A longitudinal study of 15 patients preoperatively and two years postoperatively
- 2001
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 42:3, s. 269-276
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate surgically treated patients with chronic Achilles tendinosis by MR. Material and Methods: Gd-contrast-enhanced (CME) T1-, precontrast T1-, PD- and T2-weighted images were obtained preoperatively and 2 years following surgical treatment on 15 middle-aged patients with severe symptoms of chronic Achilles tendinosis. MR evaluation included the depiction of intratendinous signal alterations and their volume, and also measurement of tendon diameter. A questionnaire and clinical examination evaluated the clinical outcome. Results: The most sensitive sequence to depict an intratendinous lesion was the CME T1-WI. There was marked regress of the estimated volume of the intratendinous signal alteration from a median of 1.2 cm3 preoperatively to 0.0 cm3 postoperatively on CME T1-WI. CME T1-WI showed a regress in intratendinous signal abnormality from 13 out of 15 patients preoperatively to 4 of 15 patients 2 years postoperatively. The a.p. dimension was 9 mm at both MR occasions. The clinical outcome was excellent in 8, good in 5, fair in 1 and poor in 1 patient. Conclusion: Surgical treatment of chronic Achilles tendinosis and its healing resulted in a decrease or elimination of the intratendinous signal alteration correlating to an improved clinical outcome 2 years postoperatively.
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