Postoperative MR Imaging and Ultrasonography of Surgically Repaired Achilles Tendon Ruptures

Purpose: To evaluate and compare MR and US findings in an unselected group of patients with 1-3-year-old surgically repaired complete ruptures of the Achilles tendon. Material and Methods: Thirteen patients with complete Achilles tendon rupture underwent clinical, MR and US examinations. The average time interval from rupture to postoperative imaging was 18 months. Results: The cross-sectional area of a postoperative tendon was 4.2 times that of the unaffected side. The shape of the operated tendon was more rounded than the unaffected side and it had irregular margins both in MR imaging and in US examination. In 4 of 13 cases an intratendinous area of intermediate to high signal intensity on proton density- and T2-weighted images was seen on MR. The size of this area varied from 4 to 18% of the cross-sectional tendon area. Two patients with the largest intratendinous area had poor clinical outcome. On US the tendon had mixed echogenicity in all cases and the tendon bands were thinner and shorter than normal. Comparison of dimension between MR and US revealed that in a.p. dimension the correlation was good (r=0.87, p=0.001), but in transversal width there was no significant correlation (r=0.58, p=0.06). Conclusion: The increased size and round irregular area of the operated Achilles tendon rupture was well detected by both MR and US, but intratendinous lesions were seen only by MR.