Abstract
Objective
To evaluate three-dimensional (3D) turbo spin-echo (TSE) magnetic resonance imaging (MRI) for the assessment of acute muscle injuries in elite athletes in comparison with two-dimensional (2D) MRI.
Methods
Elite athletes with clinically suspected acute muscle injury of the thigh who underwent both 2D and 3D MRI protocols on the same day were retrospectively included. Two musculoskeletal radiologists independently assessed 2D and 3D MRIs, with both techniques evaluated separately 1-month apart. Muscle injuries were evaluated using the BAMIC and the INSEP classifications. A second assessment of injuries was performed by each reader 2 months after the initial readings. Agreement was determined using weighted kappa statistics. The level of diagnostic confidence in classifying injuries was also assessed for both MRI protocols.
Results
A total of 40 athletes were included. Intra-reader agreement when comparing injury grades from 2D vs. 3D for both INSEP and BAMIC classifications was almost perfect for both readers and ranged between 0.84 and 0.98. Inter-reader agreement was substantial to almost perfect and ranged from 0.78 to 0.93 for the 2D protocol, and from 0.78 to 0.95 for the 3D protocol. Intra-reader agreement for each MRI protocol separately was almost perfect to perfect for both readers and ranged between 0.84 and 1.00. Diagnostic confidence for grading injuries improved for both readers when using the 3D protocol.
Conclusions
Compared to 2D MRI, 3D TSE MRI is a reliable technique for acute muscular injury assessment, providing faster acquisition times and improving the diagnostic confidence.
Key Points
• Compared to 2D MRI, 3D TSE MRI is a reliable technique for the assessment of acute muscular injuries.
• 3D TSE MRI has the advantage of faster total acquisition times, thinner sections, and multiplanar reconstruction, improving the confidence for structural assessment including connective tissue involvement.
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Abbreviations
- 2D:
-
Two-dimensional
- 3D:
-
Three-dimensional
- BAMIC:
-
British Athletics Muscle Injury Classification
- FS:
-
Fluid sensitive
- INSEP:
-
Institut National du Sport de l’Expertise et de la Performance (French National Institute of Sports)
- mm:
-
Millimeters
- MRI:
-
Magnetic resonance imaging
- ms:
-
Milliseconds
- s:
-
Seconds
- min:
-
Minutes
- NSA:
-
Number of signals averaged
- RTP:
-
Return to play
- SPAIR:
-
Spectral attenuated inversion recovery
- TE:
-
Echo time
- TR:
-
Repetition time
- TSE:
-
Turbo spin-echo
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Acknowledgements
We would like to thank our technologists Jordane Soster and Pierre-Etienne Groussin for their help in optimizing the MRI sequences used in this study. We would like to thank Dr. David Chechin from Philips Healthcare for his scientific support.
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The scientific guarantor of this publication is Michel D. Crema, MD.
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One of the authors (Ling Li) has significant statistical expertise.
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Minssen, L., Renoux, J., Abar, G. et al. Three-dimensional turbo spin-echo (TSE) MRI assessment of indirect acute muscle injuries in athletes: comparison with two-dimensional TSE MRI. Eur Radiol 33, 587–594 (2023). https://doi.org/10.1007/s00330-022-09005-w
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DOI: https://doi.org/10.1007/s00330-022-09005-w