Magnetic resonance imaging of Achilles tendon xanthomas using a fat—water discrimination technique at 0.1 T

Koivunen-Niemelä, T.; Komu, Markku; Viikari, Jorma; Alanen, A.

doi:10.1016/s1076-6332(05)80192-8

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…Fat-water separation has been applied in one previous study of five patients with FH at 0.1-T that showed, like our study, increased Achilles tendon water content in patients with FH compared with two healthy patients. Unlike our study, however, an increase in tendon fat content was also shown (15). Our study showed that both fatwater separation and tendon volume parameters clearly discriminated xanthoma tendons from control tendons and, for relative water content, proved more discriminatory than did other parameters at depicting tendon change with treatment.…”

Section: Data Management and Statistical Analysiscontrasting

confidence: 80%

“…Tendon xanthomas manifest at imaging as either diffuse tendon thickening and altered tendon echogenicity or as signal intensity rather than as discrete tendon masses (2)(3)(4)(5)13,14). Fatwater separation by using MR imaging may be potentially useful for diagnosis and treatment monitoring by determining the amount of fat and water in tendon xanthomas (15). Tendon volume measurement may also potentially provide a more discriminatory measurement of tendon xanthoma size (16).…”

Section: Control Subjectsmentioning

confidence: 99%

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Achilles Tendon Xanthomas: Fat-Water Separation at Baseline and after Treatment

Griffith

Yeung

et al. 2017

Radiology

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Purpose To investigate the fat-water content of Achilles tendon xanthomas at baseline and after treatment and to compare this assessment with that of ultrasonography (US) and other magnetic resonance (MR) imaging-based parameters. Materials and Methods Forty-eight Achilles tendons with clinically apparent xanthomas in 24 patients with familial hypercholesterolemia (FH) (six men, 18 women; mean age ± standard deviation, 58 years ± 9) were compared with 20 Achilles tendons in 10 control subjects without FH (two men, eight women; mean age, 62 years ± 7). US imaging measurements (thickness, width, cross-sectional area, echogenicity) and 3.0-T MR imaging measurements (thickness, width, cross-sectional area, volume, and fat-water separation) of the Achilles tendons were obtained at baseline and in patients with FH at 3 and 6 months after treatment with probucol, a cholesterol-lowering agent. Nonparametric tests compared baseline data, whereas repeated-measures analyses assessed treatment change. Results At baseline, all US and MR imaging-based parameters were higher in xanthoma tendons compared with those in control tendons (all P < .05). The mean relative water content per unit volume was 71% higher (42.0% ± 6.7) in xanthoma tendons than in control tendons (24.5% 6 5.8; P < .001). After 6 months of cholesterol-lowering treatment, only MR imaging measurements of tendon volume (P = .007), relative fat (P = .041), and relative water content (P < .001) showed significant changes. As relative tendon fat content decreased with treatment, relative water content increased. Conclusion Most of the enlargement of Achilles tendon xanthomas is due to an increase in water content rather than fat. For depicting treatment change, relative tendon water content was the most sensitive parameter, followed by tendon volume and relative tendon fat content. RSNA, 2017 Online supplemental material is available for this article.

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Section: Data Management and Statistical Analysiscontrasting

confidence: 80%

Section: Control Subjectsmentioning

confidence: 99%

Achilles Tendon Xanthomas: Fat-Water Separation at Baseline and after Treatment

Griffith

Yeung

et al. 2017

Radiology

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“…Magnetic resonance (MR) imaging has also been used for the evaluation of ATX [51,55,60,61]. On MR the normal Achilles tendon exhibits a homogeneous low signal intensity in all pulse sequences and its anterior margin appears straight [51] (Fig.…”

Section: Detection Of Achilles Tendon Xanthomas (Table 1)mentioning

confidence: 99%

“…Although histologic confirmation is missing, these low signal intensity structures are thought to represent collagen fibres while the high signal material may represent infiltrating foam cells and the associated inflammatory response [51]. Besides classic MRI sequences, spin‐wrap MRI techniques have been used to evaluate Achilles tendon signal intensity on fat and water images [60]. In all images, normal tendons showed a very low signal intensity, approaching that of the back‐round noise.…”

Section: Detection Of Achilles Tendon Xanthomas (Table 1)mentioning

confidence: 99%

“…In all images, normal tendons showed a very low signal intensity, approaching that of the back‐round noise. In patients with FH, the signal intensity of tendons was fourfold and tenfold higher than the background noise, in fat and water images, respectively [60]. However, no matter the type of MR sequence used, MRI does not depict discrete nodules, compatible with xanthomas [55,60,61].…”

Section: Detection Of Achilles Tendon Xanthomas (Table 1)mentioning

confidence: 99%

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Pathogenesis, detection and treatment of Achilles tendon xanthomas

Tsouli

Kiortsis

Argyropoulou

et al. 2005

Eur J Clin Investigation

121

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Tendon xanthomatosis often accompanies familial hypercholesterolaemia, but it can also occur in other pathologic states. Achilles tendons are the most common sites of tendon xanthomas. Low-density lipoprotein (LDL) derived from the circulation accumulates into tendons. The next steps leading to the formation of Achilles tendon xanthomas (ATX) are the transformation of LDL into oxidized LDL (oxLDL) and the active uptake of oxLDL by macrophages within the tendons. Although physical examination may reveal Achilles tendon xanthomas (ATX), there are several imaging methods for their detection. It is worth mentioning that ultrasonography is the method of choice in everyday clinical practice. Although several treatments for Achilles tendon xanthomas (ATX) have been proposed (LDL apheresis, statins, etc.), they target mostly in the treatment of the basic metabolic disorder of lipid metabolism, which is the main cause of these lesions. In this review we describe the formation, detection, differential diagnosis and treatment of ATX as well as the relationship between tendon xanthomas and atheroma.

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MRI of the Achilles tendon—A comprehensive pictorial review. Part one

Szaro

Nilsson-Helander

Carmont

2021

European Journal of Radiology Open

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Highlights Presence of normal septation between subtendons may mimic an intrasubstance tear. MRI is superior to ultrasound in detection of partial tears. Ultrasound is as useful as MRI in detection of tendinopathy and full-thickness tears. Kager's fat pad is involved in infection more than in postoperative changes. The Achilles tendon xanthoma has a higher signal on T1- and T2-weighted sequences.

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Magnetic resonance imaging of Achilles tendon xanthomas using a fat—water discrimination technique at 0.1 T

Cited by 8 publications

References 12 publications

Achilles Tendon Xanthomas: Fat-Water Separation at Baseline and after Treatment

Achilles Tendon Xanthomas: Fat-Water Separation at Baseline and after Treatment

Pathogenesis, detection and treatment of Achilles tendon xanthomas

MRI of the Achilles tendon—A comprehensive pictorial review. Part one

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