title: Multiparametric MR Imaging Depicts Glycosaminoglycan Change in the Achilles Tendon during Ciprofloxacin Administration in Healthy Men: Initial Observation.
abstract: OBJECTIVE
  To determine if quantitative magnetic resonance (MR) imaging techniques (sodium MR imaging, glycosaminoglycan [GAG] chemical exchange saturation transfer [CEST], and T2* mapping) could be used as potential markers for biochemical changes in the Achilles tendon induced by ciprofloxacin intake.
  
  
  METHODS
  The ethics committee of the Medical University of Vienna approved the protocol (number 1225/2012), and all patients gave written informed consent. Fourteen ankles from seven men (mean age, 32 years ± 12 [standard deviation]) were included in the study. All patients underwent 7-T MR imaging examinations of the Achilles tendon at baseline and 10 days and 5 months after ciprofloxacin intake. Sodium signal and T2* maps were acquired with the variable echo-time sequence and the GAG CEST values were acquired with a three-dimensional radiofrequency spoiled gradient-recalled-echo sequence.
  
  
  RESULTS
  The mean sodium signal was significantly decreased by 25% in the whole tendon (from baseline to 10 days after ciprofloxacin intake, 130 arbitrary units [au] ± 8 to 98 au ± 5, respectively; P = .023) and returned to baseline after 5 months (116 au ± 10), as observed also at the tendon insertion (baseline, 10 days after ciprofloxacin intake, and 5 months after ciprofloxacin intake, 134 au ± 8, 105 au ± 5, and 119 au ± 9, respectively; P = .034). The mean GAG CEST value in the whole tendon was parallel to the sodium signal with a decrease from baseline to 10 days after ciprofloxacin intake, 4.74% ± 0.75 to 4.50% ± 0.23, respectively (P = .028) and an increase at 5 months after ciprofloxacin intake to 4.88% ± 1.02.
  
  
  CONCLUSIONS
  In conclusion, this study demonstrates a ciprofloxacin-induced reversible reduction of the normalized sodium MR imaging signal and the GAG CEST effect in the Achilles tendon of healthy volunteers. Changes in sodium MR imaging and GAG CEST in men may reflect a decrease of GAG content in the Achilles tendon after ciprofloxacin intake.
authors: From the MR Centre of Excellence, Department of Biomedical Imaging and Image-Guided Therapy 7F (V.J., P.S., J.V., B.H., M.W., S.T.), and Department of Internal Medicine III, Division of Endocrinology and Metabolism (Y.W., P.W., A.L.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; and Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia (V.J., P.S.).
authors: Vladimir
authors: V
authors: Juras
authors: Yvonne
authors: Y
authors: Winhofer
authors: Pavol
authors: P
authors: Szomolanyi
authors: Jan
authors: J
authors: Vosshenrich
authors: Benedikt
authors: B
authors: Hager
authors: Peter
authors: P
authors: Wolf
authors: Michael
authors: M
authors: Weber
authors: Anton
authors: A
authors: Luger
authors: Siegfried
authors: S
authors: Trattnig
mesh_terms: D000125:Achilles Tendon / Q000737:chemistry / Q000187:drug effects* / Q000378:metabolism*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology*; D006025:Glycosaminoglycans / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D006025:Glycosaminoglycans; D002939:Ciprofloxacin
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