MRI recovery of the Achilles tendon after percutaneous tenotomy in older children

Abstract Background An observational study was conducted to evaluate the recovery of older children with relapsed congenital clubfoot who underwent an Achilles tenotomy for the second time as part of the Ponseti treatment. Methods Thirteen patients (19 feet) with congenital clubfoot underwent Achilles tenotomy where magnetic resonance images of the severed tendons were taken after 1, 3, and 6 weeks post-procedure. The participants were categorized into older children who underwent tenotomy for the first time (group A: mean, 4.9±1.8, and range, 2.8–7 years old) and older children who underwent tenotomy for a second time (group B: mean, 4.9±1.5, and range, 3–6.8 years old). The area of high signal intensity between the severed tendons on MRI scans was computed using Python programming language and compared with clinical assessment. Results Three weeks after Achilles tenotomy, groups A and B had clinically intact tendons in 9 out of 11 and 2 out of 8 feet, respectively, according to both clinical and MRI assessment. From week 1 to week 3 post-tenotomy, computational analysis showed that the mean high signal intensity area of group A decreased by 88.5±15.2%, which was significantly different (P .048 < .05) than the percent reduction of high signal intensity area of group B (69.0±24.9%). Conclusion Children who underwent Achilles tenotomy for the second time showed slower tendon recovery on the third week post-procedure. A possible reason for slower healing times may be due to the location of tenotomy in being further away from the musculotendinous junction where extrinsic healing mechanisms take place.

Download Full-text

A Case of Vasospastic Angina in the Detection of a High Signal Intensity Area by using Balanced SSFP with Inversion Recovery

International Journal of Radiology & Radiation Therapy ◽

10.15406/ijrrt.2017.03.00079 ◽

2017 ◽

Vol 3 (6) ◽

Author(s):

Kazue Matsumoto

Keyword(s):

Signal Intensity ◽

High Signal Intensity ◽

Inversion Recovery ◽

Vasospastic Angina ◽

High Signal ◽

Balanced Ssfp ◽

High Signal Intensity Area

Download Full-text

Long-term surgical outcome and risk factors in patients with cervical myelopathy and a change in signal intensity of intramedullary spinal cord on magnetic resonance imaging

Journal of Neurosurgery Spine ◽

10.3171/2009.5.spine08940 ◽

2010 ◽

Vol 12 (1) ◽

pp. 59-65 ◽

Cited By ~ 75

Author(s):

Mitsuru Yagi ◽

Ken Ninomiya ◽

Michiya Kihara ◽

Yukio Horiuchi

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Signal Intensity ◽

High Signal Intensity ◽

High Signal ◽

Recovery Ratio ◽

Mr Images ◽

The Mean ◽

High Signal Intensity Area

Object The goal of this study was to determine the long-term clinical significance of and the risk factors for intramedullary signal intensity change on MR images in patients with cervical compression myelopathy (CCM), an entity most commonly seen with cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament (OPLL). Methods One hundred seventy-four patients with CCM but without cervical disc herniation, severe OPLL (in which the cervical canal is < 10 mm due to OPLL), or severe kyphotic deformity (> 15° of cervical kyphosis) who underwent surgery were initially selected. One hundred eight of these patients were followed for > 36 months, and the 71 patients who agreed to MR imaging examinations both pre- and postsurgery were enrolled in the study (the mean follow-up duration was 60.6 months). All patients underwent cervical laminoplasty. The authors used the Japanese Orthopaedic Association (JOA) score and recovery ratio for evaluation of pre- and postoperative outcomes. The multifactorial effects of variables such as age, sex, a history of smoking, diabetes mellitus, duration of symptoms, postoperative expansion of the high signal intensity area of the spinal cord on MR imaging, sagittal arrangement of the cervical spine, presence of ventral spinal cord compression, and presence of an unstable cervical spine were studied. Results Change in intramedullary signal intensity was observed in 50 of the 71 patients preoperatively. The pre- and postoperative JOA scores and the recovery ratio were significantly lower in the patients with signal intensity change. The mean JOA score of the upper extremities was also significantly lower in these patients. Twenty-one patients showed hypointensity in their T1-weighted images, and a nonsignificant correlation was observed between intensity in the T1-weighted image and the mean JOA score and recovery ratio. The risk factors for signal intensity change were instability of the cervical spine (OR 8.255, p = 0.037) and ventral spinal cord compression (OR 5.502, p < 0.01). Among these patients, 16 had postoperative expansion of the high signal intensity area of the spinal cord. The mean JOA score and the recovery ratio at the final follow-up were significantly lower in these patients. The risk factor for postoperative expansion of the high signal intensity area was instability of the cervical spine (OR 5.509, p = 0.022). No significant correlation was observed between signal intensity on T1-weighted MR images and postoperative expansion of the intramedullary high signal intensity area on T2-weighted MR images. Conclusions Long-term clinical outcome was significantly worse in patients with intramedullary signal intensity changes on MR images. The risk factors were instability of the cervical spine and severe ventral spinal compression. The long-term clinical outcome was also significantly worse in patients with postoperative expansion of the high signal intensity area. The fact that cervical instability was a risk factor for the postoperative expansion of the high signal intensity indicates that this high signal intensity area occurred, not only from necrosis secondary to ischemia of the anterior spinal artery, but also from the repeated minor traumas inflicted on the spinal cord from an unstable cervical spine. The long-term neurological outcome found in the preliminary study of patients with CCM who had cervical instability and intramedullary signal intensity changes on MR images suggests that surgical treatment should include posterior fixation along with cervical laminoplasty or anterior spinal fusion.

Download Full-text

Intravascular papillary endothelial hyperplasia of the digit: MRI features with histological correlation

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412453541 ◽

2012 ◽

Vol 38 (3) ◽

pp. 306-312 ◽

Cited By ~ 6

Author(s):

Y. Kitagawa ◽

K. Tamai ◽

Y. Kim ◽

M. Hayashi ◽

A. Makino ◽

...

Keyword(s):

Signal Intensity ◽

High Signal Intensity ◽

Pure Form ◽

High Signal ◽

Intravascular Papillary Endothelial Hyperplasia ◽

Mri Features ◽

Endothelial Proliferation ◽

Papillary Endothelial Hyperplasia ◽

High Signal Intensity Area ◽

T2 Weighted Images

To clarify the magnetic resonance (MR) features of the pure form of intravascular papillary endothelial hyperplasia, MR images (MRIs) from five patients were retrospectively reviewed and compared with histological findings. The images showed a heterogeneous, iso- to slightly high signal intensity mass on T1-weighted images and a mass with a central heterogeneous, iso- to slightly high signal intensity area completely or incompletely surrounded by peripheral high signal intensity areas on T2-weighted images. Heterogeneous enhancement was observed after gadolinium administration. Histological studies indicated that the central heterogeneous area on T2-weighted images corresponded to thrombi (organized and/or hyalinized) and/or papillary endothelial proliferation, and also that the peripheral high signal intensity area corresponded to vascular blood space and/or papillary endothelial proliferation. The pure form of intravascular papillary endothelial hyperplasia showed relatively characteristic features on MRIs.

Download Full-text

SERIAL MAGNETIC RESONANCE IMAGING OF ANTERIOR CRUCIATE LIGAMENT GRAFTS AFTER RECONSTRUCTION

Journal of Musculoskeletal Research ◽

10.1142/s0218957700000057 ◽

2000 ◽

Vol 04 (01) ◽

pp. 31-37 ◽

Cited By ~ 1

Author(s):

Yoshihito Nakayama ◽

Yasumasa Shirai ◽

Tetsuya Narita ◽

Atsushi Mori ◽

Kaoru Kobayashi ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Signal Intensity ◽

Cruciate Ligament ◽

High Signal ◽

Intermediate Type ◽

Signal Type ◽

Group A ◽

Anterior Cruciate ◽

Group B ◽

Signal Band

We investigated the serial changes in MR appearance of anterior cruciate ligament (ACL) grafts after reconstruction, and looked for a correlation between MRI and clinical results. Fifty-four patients underwent serial MRI examinations at 5, 11 and 24 months after arthroscopically-assisted ACL reconstruction. The MR appearance of the graft was categorized into three types depending on the signal intensity and continuity of the ligament: low signal type, intermediate type and high signal type. For the low signal type, a homogeneous low signal band with continuity was visualized over the entire course; for the intermediate type, the signal intensity increased and low signal band was visualized only in part of the graft; and for the high signal type, the graft was not identified through the joint cavity due to markedly increased signal. Forty-three of the 54 patients retained normal low signal type during the first two years of reconstruction. They were classified as Group A. Four of the remaining 11 patients showed intermediate type at five months and altered to high signal type after 12 months. The remaining seven patients showed high signal type at five months and persisted with the same MR type until 24 months. These 11 patients with increased signal intensity were classified as Group B. The mean injured-to-uninjured differences of KT-2000 arthrometer measurements were significantly greater in Group B than that in Group A. Moreover, the percentage of cases with a difference of 5 mm or more was significantly higher in Group B (54.5%) than in Group A (9.3%). It is concluded that the majority of the grafts showed no changes in signal intensity during the first two years of reconstruction. The increase in signal intensity observed in some patients may be a reflection of a deterioration in graft integrity following reconstruction.

Download Full-text

The joint involvement in adult onset Still's disease is characterised by a peculiar magnetic resonance imaging and a specific transcriptomic profile

Scientific Reports ◽

10.1038/s41598-021-91613-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Piero Ruscitti ◽

Antonio Barile ◽

Onorina Berardicurti ◽

Sonia Iafrate ◽

Paola Di Benedetto ◽

...

Keyword(s):

Signal Intensity ◽

Clinical Characteristics ◽

High Signal Intensity ◽

Adult Onset Still’S Disease ◽

Joint Involvement ◽

High Signal ◽

Bone Erosions ◽

Transcriptomic Profile ◽

Synovial Tissues ◽

Bone Oedema

AbstractAdult onset Still's disease (AOSD) is a rare systemic autoinflammatory disease, characterised by fever, arthritis, and skin rash, and joint involvement is one of its clinical manifestations. The aims of this work were to assess joint involvement, to describe main patterns of involvement, and associated clinical characteristics. In this work, we aimed at assessing the joint involvement in AOSD by using MRI, to describe main patterns and associated clinical characteristics. In addition, we aimed at assessing the global transcriptomic profile of synovial tissues in AOSD to elucidate possible pathogenic pathways involved. We also evaluated the global transcriptomic profile of synovial tissues to elucidate possible pathogenic pathways involved in the disease. Thus, AOSD patients, who underwent to MRI exam on joints, were assessed to describe patterns of joint involvement and associated clinical characteristics. Some synovial tissues were collected for RNA-sequencing purposes. The most common MRI finding was the presence of synovitis on 60.5%, mainly in peripheral affected joints, with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. Bone oedema and MRI-bone erosions were reported on 34.9% and 25.6% MRI exams, respectively. Patients with MRI-bone erosions showed a higher prevalence of splenomegaly, a more frequent chronic disease course, lower levels of erythrocyte sedimentation rate, and ferritin. In AOSD synovial tissues, a hyper-expression of interleukin (IL)-1, IL-6, and TNF pathways was shown together with ferritin genes. In conclusion, in AOSD patients, the most common MRI-finding was the presence of synovitis, characterised by intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. MRI-bone erosions and bone oedema were also observed. In AOSD synovial tissues, IL-1, IL-6, and TNF pathways together with ferritin genes resulted to be hyper-expressed.

Download Full-text