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Contrast-Enhanced Magic-Angle MR Imaging of the Achilles Tendon

¹ All authors: Imaging Sciences Department, The Robert Steiner Magnetic Resonance Unit, MRC Clinical Sciences Centre, Imperial College Faculty of Medicine, Hammersmith Hospital, Du Cane Rd., London W12 0HS, England.

View larger version (114K): [in a new window]   Fig. 1A. —57-year-old male control volunteer. Spin-echo MR image (TR/TE, 1500/16) at 0° shows no signal in tendon (arrow).

View larger version (113K): [in a new window]   Fig. 1B. —57-year-old male control volunteer. Spin-echo MR image (1500/16) at 55° shows obvious signal intensity in tendon (arrow).

View larger version (17K): [in a new window]   Fig. 2A. —Six male control volunteers between 27 and 45 years old. Plots of T1 against time in Achilles tendon show decrease in T1 over 40 min-1.5 hr followed by return to normal values over 1-22 hr. Large error bars seen in these measurements reflect tissue heterogeneity in region of interest rather than intrinsic uncertainty in T1, which is shown by clear trends seen in data.

View larger version (16K): [in a new window]   Fig. 2B. —Six male control volunteers between 27 and 45 years old. Plots of T1 against time in Achilles tendon show decrease in T1 over 40 min—1.5 hr followed by return to normal values over 1-22 hr. Large error bars seen in these measurements reflect tissue heterogeneity in region of interest rather than intrinsic uncertainty in T1, which is shown by clear trends seen in data.

View larger version (110K): [in a new window]   Fig. 3A. —57-year-old man with chronic tendinopathy. Inversion recovery MR images (TR/TE, 1500/16; inversion time, 300 msec) before (A), 5 min after (B), 1 hr after (C), and 7 hr after (D) administration of IV gadodiamide. Early enhancement is seen adjacent to myotendinous junction and more centrally in B (arrows). This enhancement diffuses more widely in C (arrows) and occupies most of tendon in D (arrows).

View larger version (108K): [in a new window]   Fig. 3B. —57-year-old man with chronic tendinopathy. Inversion recovery MR images (TR/TE, 1500/16; inversion time, 300 msec) before (A), 5 min after (B), 1 hr after (C), and 7 hr after (D) administration of IV gadodiamide. Early enhancement is seen adjacent to myotendinous junction and more centrally in B (arrows). This enhancement diffuses more widely in C (arrows) and occupies most of tendon in D (arrows).

View larger version (111K): [in a new window]   Fig. 3C. —57-year-old man with chronic tendinopathy. Inversion recovery MR images (TR/TE, 1500/16; inversion time, 300 msec) before (A), 5 min after (B), 1 hr after (C), and 7 hr after (D) administration of IV gadodiamide. Early enhancement is seen adjacent to myotendinous junction and more centrally in B (arrows). This enhancement diffuses more widely in C (arrows) and occupies most of tendon in D (arrows).

View larger version (104K): [in a new window]   Fig. 3D. —57-yeard-old man with chronic tendinopathy. Inversion recovery MR images (TR/TE, 1500/16; inversion time, 300 msec) before (A), 5 min after (B), 1 hr after (C), and 7 hr after (D) administration of IV gadodiamide. Early enhancement is seen adjacent to myotendinous junction and more centrally in B (arrows). This enhancement diffuses more widely in C (arrows) and occupies most of tendon in D (arrows).

View larger version (14K): [in a new window]   Fig. 3E. —57-year-old man with chronic tendinopathy. Plot of T1 versus time shows myotendinous junction (region 1) and central area (region 2). Myotendinous junction shows early uptake, whereas central area shows delayed and lower uptake. Unenhanced inversion recovery sequence has low signal not because of short T2 of tendon but because its inversion time is close to null point.

View larger version (105K): [in a new window]   Fig. 4A. —34-year-old woman with previous tendon rupture. Inversion recovery sequence (TR/TE, 1500/16; inversion time, 300 msec) at 55° is shown before IV gadodiamide was administered.

View larger version (109K): [in a new window]   Fig. 4B. —34-year-old woman with previous tendon rupture. Inversion recovery sequence (1500/16; inversion time, 300 msec) at 55° is shown after IV gadodiamide was administered. Note widespread enhancement in thickened tendon (arrows).

View larger version (99K): [in a new window]   Fig. 4C. —34-year-old woman with previous tendon rupture. Inversion recovery sequence (1500/16; inversion time, 300 msec) at 0° is shown after IV gadodiamide was administered. This enhancement is not apparent with tendon orientated at 0°.

View larger version (11K): [in a new window]   Fig. 4D. —34-year-old woman with previous tendon rupture. Plot of T1 versus time in contrast-enhancing area shows rapid uptake and elimination of contrast material in abnormal region.

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