Department of Radiology, University of California, San Diego, California, USA.
Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
NMR Biomed. 2024 Jan;37(1):e5040. doi: 10.1002/nbm.5040. Epub 2023 Sep 23.
The purpose of this study is to investigate the use of ultrashort echo time (UTE) magnetic resonance imaging (MRI) techniques (T1 and magnetization transfer [MT] modeling) for imaging of the Achilles tendons and entheses in patients with psoriatic arthritis (PsA) compared with asymptomatic volunteers. The heels of twenty-six PsA patients (age 59 ± 15 years, 41% female) and twenty-seven asymptomatic volunteers (age 33 ± 11 years, 47% female) were scanned in the sagittal plane with UTE-T1 and UTE-MT modeling sequences on a 3-T clinical scanner. UTE-T1 and macromolecular proton fraction (MMF; the main outcome of MT modeling) were calculated in the tensile portions of the Achilles tendon and at the enthesis (close to the calcaneus bone). Mann-Whitney-U tests were used to examine statistically significant differences between the two cohorts. UTE-T1 in the entheses was significantly higher for the PsA group compared with the asymptomatic group (967 ± 145 vs. 872 ± 133 ms, p < 0.01). UTE-T1 in the tendons was also significantly higher for the PsA group (950 ± 145 vs. 850 ± 138 ms, p < 0.01). MMF in the entheses was significantly lower in the PsA group compared with the asymptomatic group (15% ± 3% vs. 18% ± 3%, p < 0.01). MMF in the tendons was also significantly lower in the PsA group compared with the asymptomatic group (17% ± 4% vs. 20% ± 5%, p < 0.01). Percentage differences in MMF between the asymptomatic and PsA groups (-16.6% and -15.0% for the enthesis and tendon, respectively) were higher than the T1 differences (10.8% and 11.7% for the enthesis and tendon, respectively). The results suggest higher T1 and lower MMF in the Achilles tendons and entheses in PsA patients compared with the asymptomatic group. This study highlights the potential of UTE-T1 and UTE-MT modeling for quantitative evaluation of entheses and tendons in PsA patients.
本研究旨在探讨超短回波时间（UTE）磁共振成像（MRI）技术（T1 和磁化传递[MT]建模）在成像银屑病关节炎（PsA）患者的跟腱和附着点与无症状志愿者相比的应用。26 例 PsA 患者（年龄 59±15 岁，41%为女性）和 27 名无症状志愿者（年龄 33±11 岁，47%为女性）的脚跟在矢状面进行了 UTE-T1 和 UTE-MT 建模序列扫描，使用 3-T 临床扫描仪。在跟腱的拉伸部分和附着处（靠近跟骨）计算 UTE-T1 和大分子质子分数（MT 建模的主要结果）。使用曼-惠特尼 U 检验检验两组间的统计学差异。与无症状组相比，PsA 组的附着处 UTE-T1 显著升高（967±145 与 872±133 ms，p<0.01）。跟腱 UTE-T1 也显著升高（950±145 与 850±138 ms，p<0.01）。附着处的 MT 建模的大分子质子分数（MMF）在 PsA 组显著低于无症状组（15%±3%与 18%±3%，p<0.01）。跟腱的 MMF 也显著低于无症状组（17%±4%与 20%±5%，p<0.01）。无症状组和 PsA 组之间的大分子质子分数（MMF）百分比差异（附着处和跟腱分别为-16.6%和-15.0%）高于 T1 差异（附着处和跟腱分别为 10.8%和 11.7%）。结果表明，与无症状组相比，PsA 患者的跟腱和附着处的 T1 升高，大分子质子分数（MMF）降低。本研究强调了 UTE-T1 和 UTE-MT 建模在定量评估 PsA 患者附着处和跟腱中的潜在应用。
