Achilles tendon: MR imaging at 1.5 T.

Abstract

Thirty magnetic resonance (MR) examinations of the Achilles tendon were performed: 20 from patients without suspected tendon abnormalities; ten from patients with suspected tendon abnormalities. The appearance of the normal Achilles tendon is hypointense and flattened. Partial tears appeared as high-signal intratendinous collections, complete acute ruptures appeared as tendinous discontinuity, and uncomplicated surgical repairs appeared as areas of tendinous continuity with inhomogeneous signal in the operative site. Chronic tendinitis appeared as a diffuse thickening of the tendon. MR imaging of the Achilles tendon at 1.5 T enabled the determination of the degree of tendinous continuity, which may help with diagnosis, treatment, and the pacing of rehabilitation.

Postoperative MR Imaging and Ultrasonography of Surgically Repaired Achilles Tendon Ruptures

“…The aver age time for return to sporting activities after the sur gical repair of an Achilles tendon rupture has been reported to vary from 6.5 (10) to 9.1 (2) months. The MR appearance of an acute Achilles tendon rupture has been described earlier (9,15,18,19,21,22), but we found only 4 case reports on the postoperative ap pearance of completely raptured Achilles tendon (12,15,18,19). The ultrasonographic (US) appear ance of Achilles tendon injuries has also been de scribed (3,6), including the swelling and oedema at the repair site during the first postoperative year.…”

Distribution of sonographically detected tendon abnormalities in patients with a clinical diagnosis of chronic Achilles tendinosis

“…1,2,7,13 MRI may be used to evaluate the Achilles tendon 31,32 ; however, high-frequency sonography has greater spatial and contrast resolution for superficial tendon structures than does MRI. In addition, cost considerations, the ready availability of sonography, and the dynamic nature of real-time examination make sonography a preferred method for the initial imaging assessment of patients with posterior heel pain.…”

Magnetic resonance imaging in chronic achilles tendinopathy

“…In tendinopathy, MRI demonstrates the diffuse or focal enlargement or thickening of the tendon and in most of the cases high signal lesions in both T1-and T2-sequences can be noticed (Quinn et al, 1987, Berquist, 1990 (Figures 11, 12 and 13). In trauma, the disruption of tendon structure is clear in total ruptures and in large partial ruptures.…”

“…The normal Achilles tendon appears as a long, thin, hypointense structure in the sagittal image, and a flattened, hypointense structure with rounded lateral and medial margins in the transaxial image (Quinn et al 1987). The normal Achilles tendon has a very low water content, which means that the tendon is hypointense -"black" -in all MRI sequences (Figures 10 and 12).…”

“…In trauma, the disruption of tendon structure is clear in total ruptures and in large partial ruptures. Smaller partial ruptures can be recognized as high intratendinous signal collections, or inhomogeneity of the signal, in both T1-and T2 weighted images (Quinn et al, 1987, Davies, 1991. The partial saturation techniques and short T1 inversion recovery sequences have been suggested to be more sensitive in detecting focal signal changes than spin echo sequences alone in the case of small alterations of tendon structure (Davies, 1991).…”