Differences in the magnetic resonance imaging parameter T2☆ may be identified during the course of canine patellar tendon healing: a pilot study

Background: Previous studies have utilized ultrashort echo (UTE) magnetic resonance imaging (MRI), and derived T2(star) maps, to evaluate structures with highly ordered collagen structures such as tendon. T2(star) 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(star) 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(star) 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(star) 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.

Automated summary

The study demonstrated the utility of UTE T2(star) maps and qMRI in evaluating the healing process of tendons after mechanical strain. Changes in T2(star) values were observed in patellar tendons at 4 and 8 weeks post-operatively, along with histologic and biomechanical evaluations indicating tendon damage and healing.