MR imaging of the Achilles tendon: evaluation of criteria for the differentiation of asymptomatic and symptomatic tendons

• Published in: RöFo : Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebende Verfahren Vol. 183; no. 7; p. 631
• Main Authors: Weber, C, Wedegärtner, U, Maas, L C, Buchert, R, Adam, G, Maas, R
• Format: Journal Article
• Language: German
• Published: Germany 01-07-2011
• Subjects: Achilles Tendon - injuries; Achilles Tendon - pathology; Adolescent; Adult; Aged; Aged, 80 and over; Child; Diagnosis, Differential; Female; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Magnetic Resonance Imaging - methods; Male; Middle Aged; Reference Values; Rupture; Sensitivity and Specificity; Tendinopathy - diagnosis; Tendinopathy - etiology; Tendinopathy - pathology; Young Adult
• ISSN: 1438-9010
• DOI: 10.1055/s-0029-1246088

The purpose of this study was to develop quantitative and qualitative MRI criteria to differentiate between healthy and pathological Achilles tendons.
364 Achilles tendons were examined on a 1.5 T MRI scanner. 264 patients had Achilles tendon complaints, 100 asymptomatic Achilles tendons served as a control. T 1-weighted, T 2-weighted and a STIR sequence were performed in sagittal and axial orientation. Images were evaluated in consensus by two radiologists. Quantitative and qualitative criteria were assessed. A Mann-Whitney-U-Test and a regression analysis were used for statistical analysis.
There were statistically significant differences between the patients with disorders and the control group concerning the depth (12.0 mm and 6.3 mm, p < 0.001) and length (83.2 mm and 45.9 mm, p < 0.001) of the tendon, the area of the tendon cross section (1.60 mm (2) and 061 mm (2), p < 0.001), as well as the length of the bursa retrocalcanea (8.3 mm and 5.3 mm, p < 0.001). There was a sensitivity of 97 % and a specificity of 91 % using a formula including the 3 criteria: tendon depth (A4), length of bursa (A5) and area of tendon (F).
The measurement of the Achilles tendon and the binary-logistic regression analysis allow differentiation between normal and pathological Achilles tendons.