Durrington P N, Adams J E, Beastall M D
Atherosclerosis. 1982 Dec;45(3):345-58. doi: 10.1016/0021-9150(82)90235-0.
The Achilles tendons of 43 men and women were examined by conventional radiography and by computed tomography (CT). Eleven subjects were normolipidaemic and 32 had familial hypercholesterolaemia, of whom 19 were considered to have polygenic hypercholesterolaemia and 13 monogenic. Achilles tendon xanthomata were identifiable by both radiography and CT. In assessing the size of xanthomata, CT had advantages since the junction between muscle and tendon was easily identified and all the dimensions and the cross-sectional area of the tendon could be measured. The area of Achilles tendons was closely correlated with body height in normolipidaemic men and women and patients with polygenic hypercholesterolaemia. In monogenic hypercholesterolaemia this relationship was lost. The tendons of the normolipidaemic group and of patients with polygenic hypercholesterolaemia were indistinguishable, whereas those of patients with monogenic hypercholesterolaemia were significantly larger. Neither the maximum nor the average CT attenuation values of the tendons differed significantly between the 3 groups. Of the patients with monogenic hypercholesterolaemia, those whose Achilles tendons were less than 200 mm2 in area had received treatment longer than those with larger tendons. CT shows promise as a means of assessing the therapeutic response of patients with monogenic familial hypercholesterolaemia.
对43名男性和女性的跟腱进行了传统X线摄影和计算机断层扫描（CT）检查。11名受试者血脂正常，32名患有家族性高胆固醇血症，其中19名被认为患有多基因高胆固醇血症，13名患有单基因高胆固醇血症。跟腱黄瘤在X线摄影和CT检查中均可识别。在评估黄瘤大小时，CT具有优势，因为肌肉与肌腱的连接处易于识别，并且可以测量肌腱的所有尺寸和横截面积。在血脂正常的男性和女性以及多基因高胆固醇血症患者中，跟腱面积与身高密切相关。在单基因高胆固醇血症中，这种关系消失了。血脂正常组和多基因高胆固醇血症患者的肌腱无法区分，而单基因高胆固醇血症患者的肌腱明显更大。三组之间肌腱的最大CT衰减值和平均CT衰减值均无显著差异。在单基因高胆固醇血症患者中，跟腱面积小于200平方毫米的患者接受治疗的时间比肌腱面积较大的患者更长。CT有望成为评估单基因家族性高胆固醇血症患者治疗反应的一种手段。
