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RESEARCH PRODUCT

Magnetic resonance and ultrasound in achilles tendinopathy: Predictive role and response assessment to platelet-rich plasma and adipose-derived stromal vascular fraction injection

Luca Maria SconfienzaAlberto TagliaficoMiriam GrassiCarmelo MessinaFederico Giuseppe UsuelliLaura De GirolamoDomenico AlbanoBianca BignottiCamilla Maccario

subject

AdultMalemedicine.medical_specialtyMagnetic Resonance SpectroscopyIntraclass correlationVisual analogue scaleAdipose-tissue stromal vascular fractionAchilles TendonInjections030218 nuclear medicine & medical imaging03 medical and health sciencesMagnetic resonance imaging0302 clinical medicineVisual analogue scaleNuclear Medicine and ImagingUltrasoundHumansMedicineRadiology Nuclear Medicine and imagingObesityPain MeasurementUltrasonographyAnalysis of Variance030222 orthopedicsAchilles tendonmedicine.diagnostic_testPlatelet-Rich Plasmabusiness.industryUltrasoundMagnetic resonance imagingGeneral MedicineMiddle AgedStromal vascular fractionmedicine.diseaseTendonTreatment Outcomemedicine.anatomical_structureAdipose TissueTendinopathyFemaleRadiologyStromal CellsTendinopathyRadiologybusinessAdipose-tissue stromal vascular fraction; Magnetic resonance imaging; Platelet-rich plasma; Ultrasound; Visual analogue scale; Radiology Nuclear Medicine and Imaging

description

To assess the correlation between magnetic resonance and ultrasound findings and clinical outcome after intratendinous injection of leucocyte-rich platelet-rich plasma or adipose-derived stromal vascular fraction in patients with non-insertional Achilles tendinopathy.Forty-three patients (age: 47.8±5.1, range 29-55) with unilateral or bilateral non-insertional Achilles tendinopathy (58 tendons overall) were randomly assigned to platelet-rich plasma (22 patients, 28 tendons) or adipose-derived stromal vascular fraction (21 patients, 30 tendons) injection group. All patients underwent magnetic resonance (tendon cross-sectional area, signal intensity, maximum anteroposterior thickness were measured), ultrasound (maximum anteroposterior thickness, power Doppler signal, ultrasound gray scale echotexture were measured), and visual analogue scale (VAS) pain evaluation at baseline and at six months from treatment. Wilcoxon, intraclass correlation coefficient, repeated measure ANOVA tests were used.There was a significant (P0.001) decrease of mean VAS from pre-treatment (6.4±1.4) to six-month evaluation (1.8±1.7). Significant increase of tendon thickness measured using magnetic resonance (P=0.013) and ultrasound (P=0.012) and power Doppler signal (P=0.027) was seen. There was no significant difference between pre- and post-treatment cross sectional area, signal intensity, and echotexture (P0.217). None of the pre-treatment parameters was a predictor of treatment outcome (P0.104). There was an excellent agreement between tendon thickness measurement between magnetic resonance and ultrasound (intraclass correlation coefficient=0.986) CONCLUSIONS: Both treatments seem to allow for clinical benefit, associated to early slight increase of tendon size and power Doppler signal. Imaging cannot be used as a predictor of clinical outcome.

yearjournalcountryeditionlanguage
2017-10-01European Journal of Radiology
https://doi.org/10.1016/j.ejrad.2017.08.006