Bude R O, Adler R S, Bassett D R, Ikeda D M, Rubin J M
Department of Radiology, University of Michigan Medical Center, Taubman Center, Ann Arbor 48109-0326.
Radiology. 1993 Aug;188(2):567-71. doi: 10.1148/radiology.188.2.8327717.
Prospective sonographic evaluation of 44 Achilles tendons in 22 patients with heterozygous familial hypercholesterolemia (FH) was performed with linear-array transducers with high frequency and high resolution. Intratendinous hypoechoic regions believed to represent xanthomas, ranging from single hypoechoic nodules to diffusely enlarged tendons that were heterogeneously hypoechoic, were seen in 40 of the 44 tendons (91%) and 21 of the 22 patients (95%). In addition, focal xanthomas were seen in two of three patients whose Achilles tendons were either normal or questionably abnormal at palpation. The direct visualization of xanthomas in most of these patients contrasts with findings from previously published studies, in which sonographically detected involvement was based on secondary tendon enlargement alone. The improved sonographic visualization of tendon xanthomas in FH, rather than the secondary tendon enlargement caused by them, therefore, suggests a new role for ultrasound in the early diagnosis and follow-up of these cases.
使用高频高分辨率线性阵列换能器对22例杂合子家族性高胆固醇血症（FH）患者的44条跟腱进行前瞻性超声评估。在44条跟腱中的40条（91%）以及22例患者中的21例（95%）中，发现了被认为代表黄瘤的肌腱内低回声区域，范围从单个低回声结节到弥漫性增大且呈不均匀低回声的肌腱。此外，在三名跟腱触诊正常或可疑异常的患者中，有两名发现了局灶性黄瘤。这些患者中大多数黄瘤的直接可视化与先前发表的研究结果形成对比，在先前的研究中，超声检测到的受累仅基于肌腱的继发性增大。因此，FH患者肌腱黄瘤超声可视化的改善，而非由它们引起的继发性肌腱增大，提示了超声在这些病例早期诊断和随访中的新作用。
