Table 4: AT pathology qualitative classification for DW and ADC images graded in accordance with physical performance and clinical examination scores applied, cell structure and MR signal appearance on routine images.
|AT injury patient Performance Scoring||Pathology||Impact on cell structure and diffusivity||MR Image Appearance||Qualitative DW & ADC five-number summary scoring|
|Poor||Tears, Complete Rupture||Deformity with retraction, little/high swelling.||Hyper-intense signal subtotal and complete discontinuity of the Achilles tendon. Possible wavy tendon morphology and retraction.||High|
|Fair||Partial/Micro Tears||Up to 50% of the AT is damaged, swelling, positive for significant fibre disruption, probably including some retraction||Possible hyper-intense focal defect and partial retraction of tendon fibres||High-mid|
|Good||Thickening and Tendinopathy||A small number of ligament fibres are damaged. There is usually an area of increased oedematous swelling.||MRI negative (hypo-intense AT). MR signal intensity increase is seen only in association with cases of oedema||Medium|
|Great||Inflammation||No abnormalities or diffuse bleeding||MRI negative (hypo-intense AT), No structural damage||Mid-low|
|Excellent||Normal||Normal intact tendon||Normal hypo-intense signal||Low|