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Real-time spatial compound sonography of Achilles tendon in patients with heterozygous familial hypercholesterolaemia and normal physical examination

Studio con “real-time compound sonography” del tendine d’Achille in pazienti con ipercolesterolemia familiare eterozigotica ed esame clinico negative

  • Musculoskeletal Radiology Radiologia Muscoloscheletrica
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

This study was undertaken to assess the prevalence and ultrasound features of Achilles tendon xanthomas (ATX) in patients with heterozygous familial hypercholesterolemia (HFH) and normal physical examination studied with high-resolution ultrasonography (HRUS) and, secondarily, to evaluate the role of real-time spatial compound sonography (CS) in terms of image quality.

Materials and methods

Both Achilles tendons of 40 patients with HFH were studied with HRUS and CS. Two experienced radiologists evaluated by consensus the presence of ATX described as (1) tendon thickening and/or (2) focal hypoechoic areas and the quality of images obtained with the two techniques.

Results

Ten out of 80 tendons showed thickening (mean: 11.2 mm). Twelve xanthomas 4.1–9.8 mm were identified in 9/80 tendons of five patients. In 5/80 tendons, both tendon thickening and focal hypoechoic areas were observed. There was no difference in the number of xanthomas detected at conventional US or CS. With respect to image quality, the performance of CS was considered significantly higher than HRUS in 72/80 (90%) cases and equal to HRUS in the remaining 8/80 (10%) (p<0.001).

Conclusions

CS is an effective tool in the assessment of ATX in patients with HFH and normal physical examination, and provides a better image quality when compared with HRUS.

Riassunto

Obiettivo

Valutare l’incidenza e gli aspetti ecografici degli xantomi del tendine d’Achille (XTA) in pazienti con ipercolesterolemia familiare eterozigotica (IFE) ed esame clinico negativo, studiati con ecografia ad elevata risoluzione (HRUS) e, secondariamente, l’apporto fornito dalla “real-time spatial compound sonography” (CS) in termini di qualità dell’immagine.

Materiali e metodi

Entrambi i tendini d’Achille di 40 pazienti con IFE sono stati studiati con HRUS e CS. Due esperti radiologi hanno valutato in consenso sia la presenza di XTA intesi come: a) incremento dello spessore e/o b) presenza di aree focali ipoecogene, sia la qualità delle immagini ottenute con entrambe le tecniche.

Risultati

Dieci su 80 tendini erano ispessiti (media: 11,2 mm). In 9/80 tendini di 5 pazienti sono stati identificati 12 xantomi (media: 7,1 mm). In 5/80 tendini si è osservato l’ispessimento associato alla presenza di aree ipoecogene. Il numero di xantomi identificati si è rivelato uguale con HRUS o CS. Riguardo la qualità dell’immagine, la CS è stata valutata significativamente superiore in 72/80 (90%) casi o, nei rimanenti 8/80 (10%), pari all’HRUS (p<0,001).

Conclusioni

L’ecografia CS è in grado di individuare XTA in pazienti con IFE ed esame clinico negativo, offrendo una migliore qualità dell’immagine rispetto all’HRUS.

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Authors and Affiliations

  1. Dipartimento di Biotecnologie Mediche e Medicina Legale-Sezione di Diagnostica per Immagini, Policlinico Universitario, Via del Vespro 127, I-90127, Palermo, Italy

    T. V. Bartolotta, A. Taibbi, G. Malizia, G. Mamone, M. Midiri & R. Lagalla

  2. Dipartimento di Medicina Interna, Policlinico Universitario, Via del Vespro 127, I-90127, Palermo, Italy

    C. Barbagallo

Authors
  1. T. V. Bartolotta
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  2. A. Taibbi
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  3. G. Malizia
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  4. G. Mamone
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  5. C. Barbagallo
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  6. M. Midiri
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  7. R. Lagalla
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Correspondence to T. V. Bartolotta.

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Bartolotta, T.V., Taibbi, A., Malizia, G. et al. Real-time spatial compound sonography of Achilles tendon in patients with heterozygous familial hypercholesterolaemia and normal physical examination. Radiol med 112, 562–571 (2007). https://doi.org/10.1007/s11547-007-0162-4

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  • DOI: https://doi.org/10.1007/s11547-007-0162-4

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