TY - JOUR
T1 - Diffusion tensor imaging and quantitative T2 mapping to monitor muscle recovery following hamstring injury
AU - Monte, Jithsa R.
AU - Hooijmans, Melissa T.
AU - Froeling, Martijn
AU - Oudeman, Jos
AU - Tol, Johannes L.
AU - Strijkers, Gustav J.
AU - Nederveen, Aart J.
AU - Maas, Mario
N1 - Funding Information: This work was supported by a Sportinnovator grant of The Netherlands Organization for Health Research and Development, ZonMw (#50‐53800‐98‐PR020), and by a grant from the Dutch Technology Foundation TTW (DIMASK #15500). Funding Information: This work was supported by a Sportinnovator grant of The Netherlands Organization for Health Research and Development, ZonMw (#50‐53800‐98‐PR020), and by a grant from the Dutch Technology Foundation TTW (DIMASK #15500). Funding information 1 2 3 Publisher Copyright: © 2023 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - MRI examinations are accurate for diagnosing sports-related acute hamstring injuries. However, sensitive imaging methods for assessing recovery of these injuries are lacking. Diffusion tensor imaging (DTI) and quantitative T2 (qT2) mapping have both shown promise for assessing recovery of muscle micro trauma and exercise effects. The purpose of this study was to explore the potential of DTI and qT2 mapping for monitoring the muscle recovery processes after acute hamstring injury. In this prospective study, athletes with an acute hamstring injury underwent a 3-T MRI examination of the injured and contralateral hamstrings including DTI and qT2 measurements at three time points: (1) within 1 week after sustaining the injury, (2) 2 weeks after time point 1, and (3) return to play (RTP). A linear mixed model was used for time-effect analysis and paired t-tests for the detection of differences between injured and uninjured muscles. Forty-one athletes (age 27.8 ± 7 years; two females and 39 males) were included. Mean RTP time was 50 (range 12–169) days. A significant time effect was found for mean diffusivity, radial diffusivity, and the second and third eigenvalues (p ≤ 0.001) in the injured muscles. Fractional anisotropy (p = 0.40), first eigenvalue (p = 0.02), and qT2 (p = 0.61) showed no significant time effect. All DTI indices, except for fractional anisotropy, were significantly elevated compared with control muscles right after the injury (p < 0.001). Values normalized during the recovery period, with no significant differences between control and injured muscles at RTP (p values ranged from 0.08 to 0.51). Mean qT2 relaxation times in injured muscles were not significantly elevated compared with control muscles at any time point (p > 0.04). In conclusion, DTI can be used to monitor recovery after an acute hamstring injury. Future work should explore the potential of DTI indices to predict RTP and recovery times in athletes after an acute strain injury.
AB - MRI examinations are accurate for diagnosing sports-related acute hamstring injuries. However, sensitive imaging methods for assessing recovery of these injuries are lacking. Diffusion tensor imaging (DTI) and quantitative T2 (qT2) mapping have both shown promise for assessing recovery of muscle micro trauma and exercise effects. The purpose of this study was to explore the potential of DTI and qT2 mapping for monitoring the muscle recovery processes after acute hamstring injury. In this prospective study, athletes with an acute hamstring injury underwent a 3-T MRI examination of the injured and contralateral hamstrings including DTI and qT2 measurements at three time points: (1) within 1 week after sustaining the injury, (2) 2 weeks after time point 1, and (3) return to play (RTP). A linear mixed model was used for time-effect analysis and paired t-tests for the detection of differences between injured and uninjured muscles. Forty-one athletes (age 27.8 ± 7 years; two females and 39 males) were included. Mean RTP time was 50 (range 12–169) days. A significant time effect was found for mean diffusivity, radial diffusivity, and the second and third eigenvalues (p ≤ 0.001) in the injured muscles. Fractional anisotropy (p = 0.40), first eigenvalue (p = 0.02), and qT2 (p = 0.61) showed no significant time effect. All DTI indices, except for fractional anisotropy, were significantly elevated compared with control muscles right after the injury (p < 0.001). Values normalized during the recovery period, with no significant differences between control and injured muscles at RTP (p values ranged from 0.08 to 0.51). Mean qT2 relaxation times in injured muscles were not significantly elevated compared with control muscles at any time point (p > 0.04). In conclusion, DTI can be used to monitor recovery after an acute hamstring injury. Future work should explore the potential of DTI indices to predict RTP and recovery times in athletes after an acute strain injury.
KW - diffusion tensor imaging
KW - hamstring injury
KW - quantitative T2 mapping
UR - http://www.scopus.com/inward/record.url?scp=85147342501&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/nbm.4902
DO - https://doi.org/10.1002/nbm.4902
M3 - Article
C2 - 36630472
SN - 0952-3480
VL - 36
JO - NMR in biomedicine
JF - NMR in biomedicine
IS - 7
M1 - e4902
ER -