Abstract
We studied a xanthomatous Achilles tendon and a normal Achilles tendon with the proton magnetic resonance imaging (MRI) and spectroscopy (MRS) at 1.5 T in a standard head coil. TheT2 maps and the localized proton spectra of the Achilles tendon were reconstructed. The normal tendon revealed no MR signal, whereas the xanthomatous tendon image consisted of variable signal intensities, for which the value ofT2 was significantly shorter (p=0.0002) than that of adipose tissue. The proton spectrum of this tendon xanthoma showed an increased water peak and unsaturated olefinic group intensity compared with the spectrum of the normal Achilles tendon area. The complex cholesterol molecule itself cannot be proven directly in a xanthomatous tendon, but its presence can be revealed with the help of the increased methyl and methylene groups of the fatty acids of the cholesteryl esters. This and other typical features describedin vitro for atheromatous tissue can be detectedin vivo in xanthomas.
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