Value of quantitative MRI parameters in predicting and evaluating clinical outcome in conservatively treated patients with chronic midportion Achilles tendinopathy : a prospective study
Deutscher übersetzter Titel: | Wert quantitativer MRI-Parameter für die Prognose und Bewertung des klinischen Therapieergebnisses konservativ behandelter Patienten mit chronischer Midportion-Achillessehnen-Tendinopathie : eine prospektive Studie |
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Autor: | Tsehaie, J.; Poot, D.H.J.; Oei, E.H.G.; Verhaar, Jan A.N.; Vos, Robert-Jan de |
Erschienen in: | Journal of science and medicine in sport |
Veröffentlicht: | 20 (2017), 7, S. 633-637, Lit. |
Format: | Literatur (SPOLIT) |
Publikationstyp: | Zeitschriftenartikel |
Medienart: | Elektronische Ressource (online) Gedruckte Ressource |
Sprache: | Englisch |
ISSN: | 1440-2440, 1878-1861 |
DOI: | 10.1016/j.jsams.2017.01.234 |
Schlagworte: | |
Online Zugang: | |
Erfassungsnummer: | PU201709008334 |
Quelle: | BISp |
Abstract des Autors
Objectives: To evaluate whether baseline MRI parameters provide prognostic value for clinical outcome, and to study correlation between MRI parameters and clinical outcome. Design: Observational prospective cohort study. Methods: Patients with chronic midportion Achilles tendinopathy were included and performed a 16-week eccentric calf-muscle exercise program. Outcome measurements were the validated Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire and MRI parameters at baseline and after 24 weeks. The following MRI parameters were assessed: tendon volume (Volume), tendon maximum cross-sectional area (CSA), tendon maximum anterior–posterior diameter (AP), and signal intensity (SI). Intra-class correlation coefficients (ICCs) and minimum detectable changes (MDCs) for each parameter were established in a reliability analysis. Results: Twenty-five patients were included and complete follow-up was achieved in 20 patients. The average VISA-A scores increased significantly with 12.3 points (27.6%). The reliability was fair-good for all MRI-parameters with ICCs > 0.50. Average tendon volume and CSA decreased significantly with 0.28 cm3 (5.2%) and 4.52 mm2 (4.6%) respectively. Other MRI parameters did not change significantly. None of the baseline MRI parameters were univariately associated with VISA-A change after 24 weeks. MRI SI increase over 24 weeks was positively correlated with the VISA-A score improvement (B = 0.7, R2 = 0.490, p = 0.02). Conclusions: Tendon volume and CSA decreased significantly after 24 weeks of conservative treatment. As these differences were within the MDC limits, they could be a result of a measurement error. Furthermore, MRI parameters at baseline did not predict the change in symptoms, and therefore have no added value in providing a prognosis in daily clinical practice.