Quantifying the Fascicular Changes in Recovered Achilles Tendon Patients Using Diffusion Magnetic Resonance Imaging and Tractography.

Shabnam Rahimnezhad, Tanzil M Arefin, Xiaoxiao Bai, Thomas Neuberger, Daniel Cortes
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Abstract

Regardless of the way of treatment, persistent deficits in calf muscles in recovered patients from Achilles tendon rupture (ATR) exist long-term postinjury. Studies on calf muscle changes mostly highlight morphological changes in the calf muscles and Achilles tendon. However, limited attention has been given to fascicular changes. Diffusion tensor imaging (DTI) can provide a better understanding of the characteristics and properties of tissues with organized microstructure. In the current study, we used DTI-derived indices (mean diffusivity (MD), fractional anisotropy (FA), and eigenvalues-λ 1, λ 2, and λ 3) and fiber tractography to better understand the soleus muscle after recovery from ATR by comparing the results of injured legs with healthy ones. Our findings suggest that the standard deviations of measured parameters (FA, MD, and eigenvalues) within the soleus muscle are better predictors of the changes associated with the ATR as compared to the control counterpart for the volumetric region of interest (ROI). Additionally, in four out of five participants, smaller tracts were observed in the injured leg compared to the healthy one, as evidenced by the fiber length distribution of the tracts. Altogether, this study demonstrates the feasibility of the DTI and fiber tractography approaches to quantify the fascicular changes in the individuals recovered from ATR.

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利用弥散磁共振成像和韧带造影术量化跟腱康复患者的筋膜变化
无论采用何种治疗方法,跟腱断裂(ATR)康复者的小腿肌肉在伤后长期存在持续性缺陷。有关小腿肌肉变化的研究大多强调小腿肌肉和跟腱的形态变化。然而,人们对筋膜变化的关注有限。弥散张量成像(DTI)可以更好地了解具有组织微观结构的组织的特征和特性。在本研究中,我们使用了 DTI 衍生指数(平均扩散率 (MD)、分数各向异性 (FA)、特征值-λ 1、λ 2 和 λ 3)和纤维束成像,通过比较受伤腿和健康腿的结果,更好地了解比目鱼肌从 ATR 恢复后的情况。我们的研究结果表明,与对照组相比,比目鱼肌内测量参数(FA、MD 和特征值)的标准偏差能更好地预测与 ATR 相关的容积感兴趣区(ROI)的变化。此外,从纤维束的长度分布来看,在五名参与者中的四名,受伤腿部的纤维束比健康腿部的要小。总之,这项研究证明了用 DTI 和纤维束成像方法量化 ATR 康复者筋膜变化的可行性。
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