MR imaging of overuse injuries of the Achilles tendon
MR imaging of overuse injuries of the Achilles tendon
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DOI：
10.2214/ajr.175.1.1750251
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发表时间：
2000-07-01
影响因子：
5
通讯作者：
Tirman, PFJ
中科院分区：
文献类型：
--
作者：
Karjalainen, PT;Soila, K;Tirman, PFJ
目标。本研究旨在阐明和分类在高分辨率磁共振成像中发现的有症状的成人运动患者跟腱的异常。用1.5T磁铁对100例患者118个跟腱疼痛进行成像。对肌腱、腱周组织、肌腱止点和肌腱连接处进行磁共振成像检查。28例患者接受了手术，13例采集了组织病理标本。在MR成像后进行了平均3.4年的长期随访。结果：在118例疼痛的跟腱中，111例发现了异常，这些异常发生在肌腱(n=90)、周围结构或两者都有。54条肌腱的肌腱内信号增强，最好是在轴向高分辨率T1加权梯度回波磁共振成像上发现。组织病理学检查证实肌腱结构异常。在21个经手术证实的肌腱病病灶中，有20个在磁共振成像上被发现。在附着点水平，15%的研究发现肌腱有变化，19%的跟骨后囊有变化，8%的跟骨骨髓有变化。腱周围软组织异常率为67%。结论：跟腱和腱周围结构的病变具有相似的临床表现，MR成像可以发现并表征这些变化。与单纯的临床检查相比，使用磁共振成像可以做出更具体的诊断和预后。
OBJECTIVE. This study was conducted to illustrate and classify the abnormalities found on high-resolution MR imaging of symptomatic Achilles tendons in athletic adult patients.SUBJECTS AND METHODS. One hundred patients with 118 painful Achilles tendons were imaged with a 1.5-T magnet. The tendon, peritendinous tissues, tendon insertion, and musculotendinous junction were examined on MR imaging. Twenty-eight patients underwent surgery, and histopathologic samples were taken in 13. Long-term follow-up was performed, on average, 3.4 years after MR imaging.RESULTS. Of 118 painful Achilles tendons, abnormalities were detected in 111, These were in the tendon (n = 90), surrounding structures, or both. Fifty-four tendons had a focal area of increased intratendinous signal, best detected on axial high-resolution T1-weighted gradient-echo MR imaging. Histopathology confirmed abnormal tendon structure. Of the 21 surgically proven foci of tendinosis, 20 were revealed on MR imaging. At the: level of the insertion, changes were found in the tendon in 15%, in the retrocalcaneal bursa in 19%, and in the calcaneal bone marrow in 8% of the studies. Abnormalities in peritendinous soft tissues were detected in 67%,. More than one type of abnormality was found in 64% of the studies.CONCLUSION. Lesions in the Achilles tendon and in the peritendinous structures can have similar clinical presentation, MR imaging detects and characterizes these changes. A more specific diagnosis and prognosis can be made with the use of MR imaging than with clinical examination alone.