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Magnetic resonance imaging of Achilles tendon xanthomas using a fat-water discrimination technique at 0.1 T
T Koivunen-Niemelä1, M Komu, J Viikari
1Department of Diagnostic Radiology, University of Turku, Finland.
Rationale And Objectives:
Tendon xanthomas are atherosclerotic plaque like collections of lipids that develop with age in the Achilles tendons of patients having familial hypercholesterolemia (FH). We tested a fat-water discrimination technique for imaging Achilles tendon xanthomatosis.
Methods:
We used the spin-warp imaging technique optimized for low-field magnetic resonance (MR) imaging to obtain separate fat and water images of the Achilles tendon. Seven patients with FH, two patients with normal tendons, and three patients with other tendon pathology were studied.
Results:
Normal tendons showed an intensity near or equal to that of the noisy background in all images. Compared with the background, the intensity of the FH tendons was approximately fivefold greater in magnitude images, fourfold in fat images, and 10-fold in water images.
Conclusion:
The method sensitively detected even subtle xanthomatosis in young patients, but differentiation of xanthomas from other pathologic lesions was possible with this method only when the tendons were significantly thickened.