Abstract

Objective: The purpose of this study was to compare T1 and T2 relaxation times of normal and pathologic Achilles Tendon (AT) in order to evaluate the ability of these methods to detect early Achilles tendon tendinosis. Materials and Methods: Forty-eight subjects were included in this study. Twenty-two subjects were classified as normal group and twenty-six subjects as patient group with tendinosis. MR examination was performed by 3 Tesla scanner using a 12 channel head coil. For relaxation times quantification, we used a sagittal 3D FLASH variable flip angle gradient echo UTE sequence (3D VFA-GE UTE) for T1 mapping and a sagittal Multi Echo Spin Echo sequence (MESE) for T2 mapping. Relaxation times were quantified using two different algorithms written in MATLAB. P value < 0.05 was considered statistically significant. Results: Our results showed a statistically significant difference in T1 and T2 values for the normal group compared to the patient group (p<0.05). Mean values of T1 and T2 were 571.69 ms and 24.16 ms for the normal group and 818.10 ms and 32.43 ms for the patient group, respectively. Results reported no correlation (r=0.193) for T1 mapping and a positive significant moderate correlation (r=0.542, p=0.000) for T2 mapping between the normal and patient groups. T1 and T2 showed no correlation in the normal group (r= 0.091, p=0.489) and a positive significant weak correlation in the patient group (r=0.263, p=0.048). Conclusion: We concluded that T1 and T2 relaxation times are relatively sensitive to diagnosis degenerative changes in the AT and T1 is more sensitive to AT tendinosis compared to T2.

Highlights

  • Injuries of the Achilles Tendon (AT) are painful and can seriously hamper the activities of daily life

  • Our results showed a statistically significant difference in T1 and T2 values for the normal group compared to the patient group (p

  • We concluded that T1 and T2 relaxation times are relatively sensitive to diagnosis degenerative changes in the AT and T1 is more sensitive to AT tendinosis compared to T2

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Summary

Introduction

Injuries of the Achilles Tendon (AT) are painful and can seriously hamper the activities of daily life. They may arise because of a variety of degenerative changes in the tendon composition including an increase in stiffness of the interfascicular matrix, an increase in collagen cross-linking and a reduction in collagen fibril crimp angle [1 - 3]. Relaxations Times such as T1 and T2 are sensitive to alteration or disruption of the Extracellular Matrix (ECM). Quantitative assessment of AT injuries using biochemical sensitive MRI techniques presents the best opportunity to diagnose early microscopic degenerative changes of AT and follow-up of patients after treatment. We studied the biochemical changes in the components of AT using parametric MRI techniques. The goal was to measure and compare T1 and T2 relaxation times

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