In Achilles tendinopathy, the neovascularization, detected by contrast-enhanced ultrasound (CEUS), is abundant but not related to symptoms

Marchi, Armanda De; Pozza, Simona; Cenna, E.; Cavallo, Franco; Gays, Giorgia; Simbula, Luca; Petro, Paola De; Massè, Alessandro; Massazza, Giuseppe

doi:10.1007/s00167-017-4710-8

Cited by 30 publications

(37 citation statements)

References 29 publications

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“…Low baseline blood flow and blood velocity in healthy Achilles tendon makes CDUS and PDUS evaluation difficult . Contrast‐enhanced US improves the visualization of neovascularization in the Achilles tendon midportion, but its applicability in healthy controls is not well established . Note that the interpretation of US‐based measurements is subjective.…”

mentioning

confidence: 99%

“…6,12,13 Contrast-enhanced US improves the visualization of neovascularization in the Achilles tendon midportion, but its applicability in healthy controls is not well established. 14 Note that the interpretation of US-based measurements is subjective. Thus, there is a high clinical urgency to develop robust, noninvasive, and quantitative techniques to assess intratendinous microcirculation, ie, blood volume and blood flow, in human Achilles tendon.…”

mentioning

confidence: 99%

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Intravoxel incoherent motion (IVIM) imaging in human achilles tendon

Wengler

Fukuda

Tank

et al. 2018

Magnetic Resonance Imaging

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confidence: 99%

mentioning

confidence: 99%

Intravoxel incoherent motion (IVIM) imaging in human achilles tendon

Wengler

Fukuda

Tank

et al. 2018

Magnetic Resonance Imaging

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“…Additionally, Genovese et al 34 and De Marchi et al 35 were able to demonstrate the superiority of DCE‐US in detection of neovessels and neovascularization compared to power Doppler US in tendon tissues. Due to the overall strong correlation in this study, we can assume that DCE‐US and DCE‐MRI are feasible methods for assessment of neovascularization during tendon regeneration, whereas DCE‐US may more accurately identify changes in microperfusion over time.…”

Section: Discussionmentioning

confidence: 97%

Posttraumatic Perfusion Analysis of Quadriceps, Patellar, and Achilles Tendon Regeneration With Dynamic Contrast‐Enhanced Ultrasound and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

Fischer

Miska

Jung

et al. 2020

J of Ultrasound Medicine

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Objectives The healing process of tendons after surgical treatment of tendon ruptures mainly depends on the perfusion of the tendon and its surrounding tissue. Dynamic contrast‐enhanced ultrasound (DCE‐US) and dynamic contrast‐enhanced MRI (DCE‐MRI) can provide additional information about the local microperfusion. In this pilot study, the feasibility of these techniques to assess the vascularization during tendon regeneration was evaluated. Methods Between 2013 and 2015, 23 patients with surgical treatment of traumatic rupture of quadriceps, patellar, and Achilles tendons were involved. All patients received clinical follow‐up examinations at 6, 12, and at least 52 weeks postoperatively. Dynamic contrast‐enhanced US and DCE‐MRI examinations were performed 6 and 12 weeks postoperatively. Dynamic contrast‐enhanced US perfusion was quantified by the parameters peak enhancement, wash‐in area under the curve, rise time, and initial area under the curve. Correlations between these parameters were examined via the Spearman rank correlation. The clinical and functional outcomes were assessed via the Lysholm Knee Score and Knee and Osteoarthritis Outcome Score at 12 and 52 weeks postoperatively. Results Fourteen patients with quadriceps (n = 8), patellar (n = 4) and Achilles (n = 2) tendon ruptures with complete follow‐up were available. The microperfusion could be successful assessed. We could detect a strong correlation of DCE‐US (peak enhancement) parameters with DCE‐MRI (initial area under the curve) parameters after 6 and 12 weeks. Conclusions In this pilot study, DCE‐US was able to visualize the microperfusion of healing tendons with a strong correlation with DCE‐MRI. Our initial results are in favor of DCE‐US as a potential quantitative imaging tool for evaluating the vascularization in tendon regeneration as a complementary method.

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“…A study using an in vivo murine model showed that this supporting neovasculature originates by sprouting larger host tissue‐derived blood vessels that run parallel to peripheral nerves . This is a significant insight in the context of tendinopathy where neovascularization appears as ingrowths from the surrounding paratendon . The angiogenic proliferation required to support adipose tissue expansion appears to be mediated by VEGF, with VEGF‐A believed to play the most important role.…”

Section: Tendinopathymentioning

confidence: 99%

Cheiroarthropathy and tendinopathy in diabetes

et al. 2019

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Joint problems commonly occur in people with diabetes. Cheiroarthropathy affects the hands and results in painless limited finger joint extension, appearing to be associated with longer diabetes duration and the presence of microvascular complications. The prevalence of cheiroarthropathy seems to be falling, perhaps as a result of improvements in glycaemic management. Non‐enzymatic glycation of collagen results in abnormally crosslinked protein resistant to degradation with subsequent increased build‐up of collagen in joints. The management of cheiroarthropathy is predominantly conservative, with occupational and hand therapy at the forefront. Tendinopathy is more common in people with diabetes than those without, and is associated with obesity and insulin resistance. As with cheiroarthropathy, the exact causative mechanism of tendinopathy in diabetes is not known, but may be linked to inflammation, apoptosis and increased vascularity of affected tendons, driven by hyperinsulinaemia. Local fat pads have also been suggested to play a role in the pathogenesis of tendinopathy.

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In Achilles tendinopathy, the neovascularization, detected by contrast-enhanced ultrasound (CEUS), is abundant but not related to symptoms

Abstract: II.

Cited by 30 publications

References 29 publications

Intravoxel incoherent motion (IVIM) imaging in human achilles tendon

Intravoxel incoherent motion (IVIM) imaging in human achilles tendon

Posttraumatic Perfusion Analysis of Quadriceps, Patellar, and Achilles Tendon Regeneration With Dynamic Contrast‐Enhanced Ultrasound and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

Cheiroarthropathy and tendinopathy in diabetes

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