Magnetic Resonance T-2* Is Increased In Patients With Early-Stage Achilles And Patellar Tendinopathy

Background T-2* mapping has proven useful in tendon research and may have the ability to detect subtle changes at an early stage of tendinopathy.Purpose To investigate the difference in T-2* between patients with early tendinopathy and healthy controls, and to investigate the relationship between T-2* and clinical outcomes, tendon size, and mechanical properties.Study Type Prospective cross-sectional.Subjects Sixty-five patients with early tendinopathy and 25 healthy controls.Field Strength/Sequence Three Tesla, ultrashort time to echo magnetic resonance imaging.Assessment Tendon T-2* was quantified using a monoexponential fitting algorithm. Clinical symptoms were evaluated using the Victorian Institute of Sports Assessment-Achilles/Patella (VISA-A/VISA-P). In vivo mechanical properties were measured using an ultrasound-based method that determined force and deformation simultaneously in tendons of patellar tendinopathy patients.Statistical Tests A generalized linear model adjusted for age was applied to investigate the difference between patients and controls. In the two patient groups, linear regressions were applied to investigate the association between T-2* and tendon size, clinical outcomes, and biomechanical properties.Results There was a significant difference in T-2* between patients and healthy controls (204.8 [95% CI: 44.5-365.0] mu sec, P < 0.05). There was a positive correlation between tendon size and T-2* for both Achilles (r = 0.72; P < 0.05) and patellar tendons (r = 0.53; P < 0.05). There was no significant correlation between VISA-A and T-2* (r = -0.2; P = 0.17) or VISA-P and T-2* (r = -0.5; P = 0.0504). Lastly, there was a negative correlation between modulus and T-2* (r = -0.51; P < 0.05).Data Conclusions T-2* mapping can detect subtle structural changes that translate to altered mechanical properties in early-phase tendinopathy. However, T-2* did not correlate with clinical scores in patients with early-phase Achilles and patellar tendinopathy. Thus, T-2* mapping may serve as a tool for early detection of structural changes in tendinopathy but does not necessarily describe the clinical severity of disease.Level of Evidence 1Technical Efficacy Stage 2