Background: Chronic Achilles tendinosis is a common problem. When evaluating and comparing different\r\ntherapies there is a need for reliable imaging methods. Our aim was to evaluate if chronic Achilles tendinosis\r\naffects the dynamic contrast-enhancement in the tendon and its surroundings and if short-term eccentric\r\ncalf-muscle training normalizes the dynamic contrast-enhancement.\r\nMethods: 20 patients with chronic Achilles tendinopathy were included. Median duration of symptoms was\r\n31 months (range 6 to 120 months). Both Achilles tendons were examined with dynamic contrast enhanced MRI\r\nbefore and after a 12- week exercise programme of eccentric calf-muscle training. The dynamic MRI was evaluated\r\nin tendon, vessel and in fat ventrally of tendon. Area under the curve (AUC), time to peak of signal, signal increase\r\nper second (SI/s) and increase in signal between start and peak as a percentage (SI%) was calculated. Pain and\r\nperformance were evaluated using a questionnaire.\r\nResults: In the fat ventrally of the tendon, dynamic contrast enhancement was significantly higher in the\r\nsymptomatic leg compared to the contralateral non-symptomatic leg before but not after treatment. Despite\r\ndecreased pain and improved performance there was no significant change of dynamic contrast enhancement in\r\nsymptomatic tendons after treatment.\r\nConclusion: In Achilles tendinosis there is an increased contrast enhancement in the fat ventrally of the tendon.\r\nThe lack of correlation with symptoms and the lack of significant changes in tendon contrast enhancement\r\nparameters do however indicate that dynamic enhanced MRI is currently not a useful method to evaluate chronic\r\nAchilles tendinosis.
Loading....