Koivunen-Niemelä T, Alanen A, Viikari J
Department of Diagnostic Radiology, University of Turku, Finland.
J Intern Med. 1993 Oct;234(4):401-5. doi: 10.1111/j.1365-2796.1993.tb00762.x.
Tendon xanthomas cause thickening of the tendon and are an important sign in monogenic familial hypercholesterolaemia (FH). The aim of our study was to investigate the usefulness of achilles tendon sonography in detecting FH patients. Special attention was paid to structural abnormalities of the achilles tendon.
A clinical study with methodological testing.
Patients suspected of having FH were sent to the out-patient Department of Medicine from other departments of Turku University Central Hospital and from primary care units. The patients were studied by high-frequency ultrasound before more exact typing of the lipid disorder. An additional study of normolipidaemic volunteers and a phantom study were also carried out.
Forty FH patients, 51 non-FH hypercholesterolaemia patients and 41 normolipidaemic volunteers were included in the study. MAIN OUTCOME OF MEASURES: The thickness of the tendon was measured and the tendon structure and its echogenicity were recorded.
Twenty-five out of 40 (63%) FH patients had distinctly thickened tendons (men more than 10 mm, women more than 9 mm). Thirty-six (90%) had a typical structural alteration of low or mixed echogenicity of the tendon. Three non-FH patients were found to have xanthomas on sonography.
We conclude that ultrasonography is a sensitive method of detecting xanthomas that reveals the altered tendon structure even in xanthomatous tendons of normal thickness.
肌腱黄色瘤会导致肌腱增厚，是单基因家族性高胆固醇血症（FH）的重要体征。我们研究的目的是调查跟腱超声检查在检测FH患者中的作用。特别关注跟腱的结构异常情况。
一项带有方法学测试的临床研究。
疑似患有FH的患者从图尔库大学中心医院的其他科室以及基层医疗单位被送至内科门诊。在对脂质紊乱进行更精确分型之前，先通过高频超声对患者进行研究。还对血脂正常的志愿者进行了额外研究以及进行了模型研究。
40例FH患者、51例非FH高胆固醇血症患者和41例血脂正常的志愿者被纳入研究。测量指标的主要结果：测量肌腱厚度，并记录肌腱结构及其回声性。
40例FH患者中有25例（63%）肌腱明显增厚（男性超过10毫米，女性超过9毫米）。36例（90%）有典型的肌腱结构改变，表现为低回声或混合回声。在超声检查中发现3例非FH患者有黄色瘤。
我们得出结论，超声检查是检测黄色瘤的一种敏感方法，即使在厚度正常的含黄色瘤肌腱中也能显示出改变的肌腱结构。
