Ultrashort echo time T2^∗ values decrease in tendons with application of static tensile loads

In early stages of tendon disease, mechanical properties may become altered prior to changes in morphological anatomy. Ultrashort echo time (UTE) magnetic resonance imaging (MRI) can be used to directly detect signal from tissues with very short T2 values, including unique viscoelastic tissues such as tendons. The purpose of this study was to use UTE sequences to measure T2^∗, T1 and magnetization transfer ratio (MTR) variations of tendon samples under static tensile loads. Six human peroneal tendons were imaged before and under static loading using UTE sequences on a clinical 3T MRI scanner. Tendons were divided into two static tensile loading groups: group A that underwent one-step loading (15N) and group B that underwent two-step loading (15 and 30N). The T2^∗, T1 and MTR variations were investigated in two selected section regions of interest (ROIs), including whole and core sections. Mean T2^∗ values for the first step of loading (groups A and B) in both whole section and core section ROIs were significantly decreased by 13±7% (P=0.028) and 16±5% (P=0.017), respectively. For the second loading step (group B), there was a consistent, but non-significant reduction in T2^∗ value by 9±2% (P=0.059) and 7±5% (P=0.121) for whole and core sections, respectively. Mean T1 did not show any consistent changes for either loading steps (P>0.05). Mean MTR increased slightly, but not significantly for both loading steps (P>0.05). Significant differences were found only in T2^∗ values of tendons by static tensile load application. Therefore, T2^∗ monitoring during loading is suggested for quantitative investigation of the tendons biomechanics.