Aims and objectives
Tendinopathy is a common tendon injury that can cause morbidity and disability [1].It is a mechanical,
biochemical,
degenerative and overuse disease. It is associated with degeneration and disorganization of the collagen structure with a reduction of elasticity and with an increase in mucoid,
proteoglycan and water content [2].
An accurate and reliable assessment of tendon status is critical to provide early diagnosis and to implement conservative treatments ( such as PRP,
Needling,
etc).
Magnetic resonance imaging (MRI) and ultrasound (US) are the most commonly used...
Methods and materials
We evaluated 17 patients (9 males,
8 females,
mean age 34.6 years,
range 26-52) with clinical and instrumental (US/MRI) evidence of degenerative tendon disease: 8 patients with Achilles tendinopathy and 9 patients with sopraspinatus tendinopathy.
Patients with recent trauma or previous surgery were excluded.
All patients were submitted to 3T MRI examination using standard morphological and T2 mapping sequences,
and ultrasound examination using compression elastography.
For T2 mapping evaluation,
we used a multiecho sequence.
Using a dedicated software, T2 color-scale rapresentation for qualitative analysis was...
Results
The intra-observer agreement resulted from “good” to “excellent” for all the parameters.
The inter-observer agreement was excellent according to Cohen k analysis (0.84) for the evaluation of the grade of degeneration and good (0.79) for the degenerative process localization.
Highest concordance (>0.81) was found for detection of severe tendinosis in the mid Achilles tendon and in the supraspinatus crescent area (Fig.8,
Fig.9); lowest agreement values were found at the musculotendinous junctions and at the insertional area for both tendons.
Results are summarized in Table 1...
Conclusion
Several studies demonstrated the capability of T2 mapping to detect early biochemical abnormalities that occur in case of tendinopathy[2][8].
Concerning elastosonography,
published data showed the uselfuness of this tecnique for detecting the intratendinous and peritendinous alterations,
considering the mechanical properties of tissues[3][5][9].
In our study,
T2 mapping values,
an MR imaging surrogate of collagen pathology,
was highly correlated with SE maps,
an ultrasound surrogate of decreased elasticity.
The association between T2 and SE in localization and grading,
a measurable consequence of tendon degeneration,
further supports...
References
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