MR evaluation of chronic achilles tendinosis - A longitudinal study of 15 patients preoperatively and two years postoperatively

Purpose: To evaluate surgically treated patients with chronic Achilles tend inosis by MR. Material and Methods: Gd-contrast-enhanced (CME) T1-, precontrast T1-, PD- and T2-weighted images were obtained preoperatively and 2 years following s urgical treatment on 15 middle-aged patients with severe symptoms of chroni c Achilles tendinosis. MR evaluation included the depiction of intratendino us signal alterations and their volume, and also measurement of tendon diam eter. A questionnaire and clinical examination evaluated the clinical outco me. Results: The most sensitive sequence to depict an intratendinous lesion was the CME T1-WI. There was marked regress of the estimated volume of the int ratendinous signal alteration from a median of 1.2 cm(3) preoperatively to 0.0 cm(3) postoperatively on CME T1-WI. CME T1-WI showed a regress in intra tendinous signal abnormality from 13 out of 15 patients preoperatively to 4 of 15 patients 2 years postoperatively. The a.p. dimension was 9 mm at bot h MR occasions. The clinical outcome was excellent in 8, good in 5, fair in 1 and poor in 1 patient. Conclusion: Surgical treatment of chronic Achilles tendinosis and its heali ng resulted in a decrease or elimination of the intratendinous signal alter ation correlating to an improved clinical outcome 2 years postoperatively.