Crombé Amandine, Dallaudière Benjamin, Bohand Marie-Camille, Fournier Claire, Spinnato Paolo, Poursac Nicolas, Carl Michael, Poujol Julie, Hauger Olivier
Department of Musculoskeletal Imaging, Pellegrin University Hospital CHU Bordeaux, 33076 Bordeaux, France.
SARCOTARGET Team, Inserm, UMR1312, BRIC, Bordeaux Institute of Oncology, University of Bordeaux, 33076 Bordeaux, France.
J Clin Med. 2025 Jul 24;14(15):5251. doi: 10.3390/jcm14155251.
: Accurate visualization of the Achilles tendon enthesis is critical for distinguishing mechanical, degenerative, and inflammatory pathologies. Although ultrasonography is the first-line modality for suspected enthesis disease, recent technical advances may expand the role of magnetic resonance imaging (MRI). This study evaluated the utility of ultra-short echo time (UTE) and zero echo time (ZTE) sequences versus proton density-weighted imaging (PD-WI) for depicting the enthesis organ in healthy volunteers. In this institutional review board (IRB)-approved prospective single-center study, 50 asymptomatic adult volunteers underwent 3-Tesla hindfoot MRI with fat-suppressed PD-WI, UTE, and ZTE between 2018 and 2023. Four radiologists assessed image quality, signal-to-noise ratio, visibility, and abnormal high signal intensities (SIs) of the periost, sesamoid, and enthesis fibrocartilages (PCa, SCa, and ECa, respectively). Statistical tests included Chi-square, McNemar, paired Wilcoxon, and Benjamini-Hochberg adjustments for multiple comparisons. : The median age was 36 years (range: 20-51); 58% women were included. PD-WI and ZTE sequences were always available while UTE was unavailable in 24% of patients. PD-WI consistently failed to concomitantly visualize all fibrocartilages. ZTE and UTE visualized all fibrocartilages in 72% and 92.1% of volunteers, respectively, with significant differences favoring ZTE and UTE over PD-WI ( < 0.0001) and UTE over ZTE ( = 0.027). Inter-rater agreement exceeded 80% except for SCa on ZTE (68%, 95%CI: 53.2-80.1). Abnormal SCa findings in asymptomatic patients were more frequent with UTE (23.7%) and ZTE (34%) than with PD-WI (2%) ( = 0.0045). : At 3-Tesla, UTE and ZTE sequences reliably depict the enthesis organ of the Achilles tendon, outperforming PD-WI. However, the high sensitivity of these sequences also presents challenges in interpretation.
准确显示跟腱附着点对于鉴别机械性、退行性和炎性病变至关重要。尽管超声检查是疑似附着点疾病的一线检查方法，但最近的技术进展可能会扩大磁共振成像（MRI）的作用。本研究评估了超短回波时间（UTE）和零回波时间（ZTE）序列与质子密度加权成像（PD-WI）在描绘健康志愿者附着点器官方面的效用。在这项经机构审查委员会（IRB）批准的前瞻性单中心研究中，50名无症状成年志愿者在2018年至2023年期间接受了3特斯拉后足MRI检查，包括脂肪抑制PD-WI、UTE和ZTE序列。四名放射科医生评估了骨膜、籽骨和附着点纤维软骨（分别为PCa、SCa和ECa）的图像质量、信噪比、可视性和异常高信号强度（SI）。统计检验包括卡方检验、McNemar检验、配对Wilcoxon检验以及用于多重比较的Benjamini-Hochberg校正。中位年龄为36岁（范围：20 - 51岁）；纳入了58%的女性。PD-WI和ZTE序列总是可用，而UTE在24%的患者中不可用。PD-WI始终无法同时显示所有纤维软骨。ZTE和UTE分别在72%和92.1%的志愿者中显示了所有纤维软骨，与PD-WI相比，ZTE和UTE具有显著差异（<0.0001），与ZTE相比，UTE也具有显著差异（=0.027）。除了ZTE上的SCa（68%，95%CI：53.2 - 80.1）外，观察者间一致性超过80%。无症状患者中，UTE（23.7%）和ZTE（34%）比PD-WI（2%）更频繁地发现SCa异常（=0.0045）。在3特斯拉时，UTE和ZTE序列能可靠地描绘跟腱的附着点器官，优于PD-WI。然而，这些序列的高敏感性在解读方面也带来了挑战。
