Pownder Sarah L, Hayashi Kei, Lin Bin Q, Meyers Kathleen N, Caserto Brian G, Breighner Ryan E, Potter Hollis G, Koff Matthew F
MRI Laboratory, Hospital for Special Surgery, New York, NY, USA.
Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
Quant Imaging Med Surg. 2021 Apr;11(4):1234-1246. doi: 10.21037/qims-20-684.
Previous studies have utilized ultrashort echo (UTE) magnetic resonance imaging (MRI), and derived T2* maps, to evaluate structures with highly ordered collagen structures such as tendon. T2* maps may provide a noninvasive means to assess tendon damage and healing. This pilot study evaluated the longitudinal relationship of an induced mechanical strain on the patellar tendon with corresponding UTE T2* metrics, histologic and biomechanical evaluation at two post-operative time points.
A total of 27 patellar tendons in male Beagles were surgically subjected to stretching by a small diameter (SmD) or a large diameter (LgD) diameter rod to induce damage due to strain, and evaluated at 4- and 8-week intervals using quantitative MRI (qMRI), biomechanical testing, and histology. A separate set of 16 limbs were used as controls.
The tendons experienced a 67% and 17% prolongation of short T2* values as compared to controls at 4 and 8 weeks post-operatively, respectively. Histologic analysis displayed a trend of increased collagen disruption at 4 weeks followed by presence of greater organization at 8 weeks. Biomechanical evaluation found a reduction of tendon modulus and failure strain at both time points, and an increase in cross-sectional area at 4 weeks as compared to controls.
These findings display tendon healing in response to an imposed strain and present the utility of qMRI to evaluate longitudinal differences of patellar tendon T2* values in a model of induced subclinical tendon damage. The qMRI technique of UTE provides a means to non-invasively evaluate the healing process of a mechanically damaged tendon.
以往的研究利用超短回波(UTE)磁共振成像(MRI)以及由此得出的T2图,来评估具有高度有序胶原结构的组织,如肌腱。T2图可能提供一种非侵入性手段来评估肌腱损伤和愈合情况。这项初步研究评估了诱导的机械应变对髌腱的影响与相应的UTE T2*指标、术后两个时间点的组织学和生物力学评估之间的纵向关系。
对27只雄性比格犬的髌腱进行手术,用小直径(SmD)或大直径(LgD)杆进行拉伸,以诱导应变损伤,并在术后4周和8周间隔使用定量MRI(qMRI)、生物力学测试和组织学进行评估。另外16只肢体作为对照组。
与对照组相比,术后4周和8周时,肌腱的短T2*值分别延长了67%和17%。组织学分析显示,4周时胶原破坏增加,随后8周时组织结构更有序。生物力学评估发现,两个时间点的肌腱模量和破坏应变均降低,与对照组相比,4周时横截面积增加。
这些发现显示了肌腱对施加应变的愈合反应,并展示了qMRI在评估亚临床肌腱损伤模型中髌腱T纵向差异的实用性。UTE的qMRI技术提供了一种非侵入性评估机械损伤肌腱愈合过程的方法。