Differences in the magnetic resonance imaging parameter T2* may be identified during the course of canine patellar tendon healing: a pilot study
Sarah L. Pownder, Kei Hayashi, Bin Lin, Kathleen N. Meyers, Brian G. Caserto, Ryan Breighner, Hollis G. Potter, Matthew F. Koff
Abstract
BACKGROUND: Previous studies have utilized ultrashort echo (UTE) magnetic resonance imaging (MRI), and derived T2* maps, to evaluate structures with highly ordered collagen structures such as tendon. T2* maps may provide a noninvasive means to assess tendon damage and healing. This pilot study evaluated the longitudinal relationship of an induced mechanical strain on the patellar tendon with corresponding UTE T2* metrics, histologic and biomechanical evaluation at two post-operative time points. METHODS: A total of 27 patellar tendons in male Beagles were surgically subjected to stretching by a small diameter (SmD) or a large diameter (LgD) diameter rod to induce damage due to strain, and evaluated at 4- and 8-week intervals using quantitative MRI (qMRI), biomechanical testing, and histology. A separate set of 16 limbs were used as controls. RESULTS: The tendons experienced a 67% and 17% prolongation of short T2* values as compared to controls at 4 and 8 weeks post-operatively, respectively. Histologic analysis displayed a trend of increased collagen disruption at 4 weeks followed by presence of greater organization at 8 weeks. Biomechanical evaluation found a reduction of tendon modulus and failure strain at both time points, and an increase in cross-sectional area at 4 weeks as compared to controls. CONCLUSIONS: These findings display tendon healing in response to an imposed strain and present the utility of qMRI to evaluate longitudinal differences of patellar tendon T2* values in a model of induced subclinical tendon damage. The qMRI technique of UTE provides a means to non-invasively evaluate the healing process of a mechanically damaged tendon.