Vladimir Juras BMedSc, PhD, Presenter: Nothing to Disclose

Yvonne Winhofer, Abstract Co-Author: Nothing to Disclose

Pavol Szomolanyi PhD, Abstract Co-Author: Nothing to Disclose

Benedikt Hager, Abstract Co-Author: Nothing to Disclose

Anton Luger MD, Abstract Co-Author: Nothing to Disclose

Siegfried Trattnig MD, Abstract Co-Author: Nothing to Disclose

To investigate novel quantitative MRI techniques (sodium MRI, gagCEST, and T2*-mapping) as potential markers for biochemical changes in the Achilles tendon induced by ciprofloxacin intake. 

Fourteen ankles from seven male subjects (32±12 years) were included in the study (all subjects gave written, informed consent). All subjects underwent MRI examinations of the Achilles tendon at baseline (tB), as well as 10 days (t10D) and five months (t5M) after ciprofloxacin intake. For sodium imaging, the variable echo time sequence adapted to x-nuclei capabilities was used in the 2D mode. gagCEST effects were measured by a train of Gaussian RF pulses followed by signal readout with a 3D-RF-spoiled-GRE sequence. The variable-echo-time sequence (vTE) was used to generate the bi-exponential T2*-maps. In order to compare average MRI parameters at different time points, a hierarchical-linear-model was used in order to consider multiple measures per patient.

The mean sodium signal was significantly decreased by 25% in the whole tendon (from 130±8 (tB) [a.u.] to 98±5 (t10D) [a.u.],P = 0.020) and in the insertion part (from 134±8 (tB)[a.u.] to 105±5 (t10D) [a.u.], P = 0.026). The mean gagCEST value was significantly decreased from 4.74±0.75 (tB)[%] to 4.50±0.23[%] (t10D)(P<0.037). Morphologically, there were no significant changes found between tB, t10D, and t5M. 

In conclusion, this study demonstrates a ciprofloxacin induced reversible reduction of the normalized sodium MRI signal and the gagCEST effect in the Achilles tendon of healthy volunteers. The observed changes in glycosaminglycan content contribute to the characterization of the pathomechanism of FQ associated tendinopathy.

Sodium imaging of the Achilles tendon may improve the detection of biochemical alterations after ciprofloxacin intake.

Juras, V, Winhofer, Y, Szomolanyi, P, Hager, B, Luger, A, Trattnig, S, Sodium MRI Detects Glycosaminoglycan Alteration in the Achilles Tendon after Ciprofloxacin Intake in Healthy Subjects.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005518.html