Aström M, Gentz C F, Nilsson P, Rausing A, Sjöberg S, Westlin N
Department of Orthopaedics, Malmö University Hospital, Sweden.
Skeletal Radiol. 1996 Oct;25(7):615-20. doi: 10.1007/s002560050146.
To compare information gained by ultrasonography and magnetic resonance imaging (MRI) in chronic achilles tendinopathy with regard to the nature and severity of the lesion.
Imaging of both achilles tendons with ultrasonography and MRI was performed prior to unilateral surgery. Operative findings and histological biopsies together served as a reference.
Twenty-seven patients (22 men, 5 women; mean age 44 years; 21 athletes) suffering from chronic achilles tendinopathy participated in the study. Eighteen patients had unilateral and 9 had bilateral symptoms.
Surgical findings included 4 partial ruptures, 21 degenerative lesions and 2 macroscopically normal cases. Microscopy revealed tendinosis (degeneration) in all tendon biopsies, including cases with a partial rupture, but only slight changes in the paratendinous tissues (paratenon). Ultrasonography was positive in 21 of 26 and MRI in 26 of 27 cases. Severe intratendinous abnormalities and a sagittal tendon diameter > 10 mm suggested a partial rupture. In tendons with a false negative result histopathological changes were mild and a tendency towards a better clinical outcome was noted in the sonographic cases. Assessment of the paratenon was unreliable with both methods. Ultrasonography and MRI give similar information and may have their greatest potential as prognostic instruments.
比较超声检查和磁共振成像（MRI）在慢性跟腱病中所获得的关于病变性质和严重程度的信息。
在单侧手术前，对双侧跟腱进行超声检查和MRI成像。手术所见和组织活检共同作为参考。
27例患有慢性跟腱病的患者（22例男性，5例女性；平均年龄44岁；21例运动员）参与了本研究。18例患者有单侧症状，9例有双侧症状。
手术发现包括4例部分断裂、21例退行性病变和2例大体正常的病例。显微镜检查显示，所有肌腱活检标本均有肌腱病（退变），包括部分断裂的病例，但腱旁组织（腱周组织）仅有轻微改变。超声检查在26例中有21例阳性，MRI在27例中有26例阳性。严重的肌腱内异常和矢状面肌腱直径>10 mm提示部分断裂。在组织病理学改变较轻且超声检查病例临床预后较好的肌腱中，出现了假阴性结果。两种方法对腱周组织的评估均不可靠。超声检查和MRI提供了相似的信息，并且作为预后工具可能具有最大的潜力。
