Quantitative T2* With Ultrashort Time-to-Echo MRI Differentiates Tendonitis Severity in Lateral Epicondylitis

Area of Science:

• Musculoskeletal imaging
• Radiology
• Orthopedics

Background:

• Lateral epicondylitis (LE), or tennis elbow, causes significant elbow mobility issues due to extensor carpi radialis brevis (ECRB) tendon degeneration.
• Conventional MRI provides qualitative assessments of LE, limiting objective evaluation of tendon pathology.

Purpose of the Study:

• To evaluate if quantitative T2*-mapping using ultrashort time-to-echo (UTE) MRI can differentiate LE severity grades.
• To assess the correlation between UTE T2* values and conventional MRI findings in LE patients.

Main Methods:

• Prospective, cross-sectional study involving 30 patients with elbow pain.
• UTE T2* MRI and conventional proton-density MRI were acquired at 3 T.
• ECRB tendon segmentation was performed to obtain mean T2* and proton-density values, correlated with radiologic LE grades (0-3).

Main Results:

• Mean T2* values were significantly higher in partially torn tendons (15.3 ms) compared to normal/degenerated tendons (7.70 ms, P < 0.01) and degenerated tendons (8.32 ms, P = 0.04).
• A moderate correlation (r = 0.624, P < 0.01) was observed between T2* and proton-density values.

Conclusions:

• Quantitative T2* UTE MRI effectively differentiates LE tendon severity grades.
• T2* mapping may enhance conventional MRI by providing increased sensitivity to tendon changes, aiding in objective treatment and return-to-play decisions.