Evaluation of MRI-US Fusion Technology in Sports-Related Musculoskeletal Injuries
Tóm tắt
A combination of magnetic resonance imaging (MRI) with real-time high-resolution ultrasound (US) known as fusion imaging may improve visualization of musculoskeletal (MSK) sports medicine injuries. The aim of this study was to evaluate the applicability of MRI-US fusion technology in MSK sports medicine. This study was conducted by the medical services of the FC Barcelona. The participants included volunteers and referred athletes with symptomatic and asymptomatic MSK injuries. All cases underwent MRI which was loaded into the US system for manual registration on the live US image and fusion imaging examination. After every test, an evaluation form was completed in terms of advantages, disadvantages, and anatomic fusion landmarks. From November 2014 to March 2015, we evaluated 20 subjects who underwent fusion imaging, 5 non-injured volunteers and 15 injured athletes, 11 symptomatic and 4 asymptomatic, age range 16–50 years, mean 22. We describe some of the anatomic landmarks used to guide fusion in different regions. This technology allowed us to examine muscle and tendon injuries simultaneously in US and MRI, and the correlation of both techniques, especially low-grade muscular injuries. This has also helped compensate for the limited field of view with US. It improves spatial orientation of cartilage, labrum and meniscal injuries. However, a high-quality MRI image is essential in achieving an adequate fusion image, and 3D sequences need to be added in MRI protocols to improve navigation. The combination of real-time MRI and US image fusion and navigation is relatively easy to perform and is helping to improve understanding of MSK injuries. However, it requires specific skills in MSK imaging and still needs further research in sports-related injuries. Toshiba Medical Systems Corporation.
Tài liệu tham khảo
Conn JM, Annest JL, Gilchrist J. Sports and recreation relates injuries in US population, 1997–99. Inj Prev. 2003;9:117–23.
Center for Disease Control and Prevention. Nonfatal sports and recreation-related injuries treated in the emergency departmentes—United States, July 2000–June 2001. MOrbid Mortal Wkly Rep. 2002;51:736–40.
Yi-Pin C, Ting-Guay W, Shiau-Fu H. Application of ultrasound in sports injury. J Med Ultrasound. 2013;21:1–8.
Allen GM, Wilson SJ. Ultrasound in sports medicine—a critical evaluation. Eur J Radiol. 2007;62:79–85.
Costa AF, Di Primio GA, Schweitzer ME. Magnetic resonance imaging of muscle disease: a pattern-based approach. Muscle Nerve. 2012;46:465–81. doi:10.1002/mus.23370.
Balius R, Rodas G, Pedret C, Capdevila L, Alomar X, Bong D. Soleus muscle injury: sensitivity of ultrasound patterns. Skeletal Radiol. 2014;43:805–12.
Reurink G, Brilman EG, Jan de Vos R, Maas M, Moen MH, Weir A, Jan G, Tol JL. Magnetic resonance imaging in acute hamstring injury: can we provide a return to play prognosis? Sports Med. 2015;45(1):133–46.
Connell DA, Schneider-Kolsky ME, Lucas J, Malara F, Buchbinder R, Koulouris G, Burke F, Bass C. Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries. Am J Roentgenol. 2004;183(4):975–84.
Rubin D. Imaging diagnosis and prognostication of hamstring injuries. Am J Roentgenol. 2012;199(3):525–33.
Valerio M, Donaldson I, Emberton M, Ehdaie B, Hadaschik BA, Marks LS, Mozer P, Rastinehad AR, Ahmed HU. Detection of clinically significant prostate cancer using magnetic resonance imaging-ultrasound fusion targeted biopsy: a systematic review. Eur Urol. 2014; pii: S0302-2838(14)01040-9.
Minami T1, Minami Y, Chishina H, Arizumi T, Takita M, Kitai S, Yada N, Inoue T, Hagiwara S, Ueshima K, Nishida N, Kudo M. Combination guidance of contrast-enhanced US and fusion imaging in radiofrequency ablation for hepatocellular carcinoma with poor conspicuity on contrast-enhanced US/fusion imaging. Oncology. 2014;87 Suppl 1:55–62. doi:10.1159/000368146.
Sandaulescu DL, Cumitrescu D, Rogoveanu I, Satoiu A. Hybrid ultrasound imaging techniques (fusion imaging). World J Gastroenterol WJG. 2011;17(1):49–52.doi:10.3748/wjg.v17.i1.49.
Salomon LJ, Bernard JP, Milischer A-E, et al. MRI and ultrasound fusión imaging for prenatal diagnosis. Am J Obstet Gynecol. 2013;209:148.e1–9.
Klauser AS, De Zordo T, Feuchtner GM, Djedovic G, Weiler RB, Faschingbauer R, Schirmer M, Moriggl B. Fusion of real-time US with CT images to guide sacroiliac joint injection in vitro and in vivo. Radiology. 2010;256(2):547–53.
Galiano K, Obwgeseser AA, Bale R, et al. Ultrasound-guided and CT-navigation-assisted periarticular and facet joint injections in the lumbar and cervical spine: a new teaching tool to recognize the sonoanatomic pattern. Reg Anesth Pain Med. 2007;32:254.
Vollman A, Hulen R, Dulchavsky S, Pinchcofsky H, Amponsah D, Jacobsen G, Dulchavsky A, van Holsbeeck M. Educational benefits of fusing magnetic resonance imaging with sonograms. J Clin Ultrasound. 2014;42(5):257–63.
Pooley RA. AAPM/RSNA physics tutorial for residents: fundamental physics of MR imaging. Radiographics. 2005;25(4):1087–99.
Brown M, Semelka R. MR imaging abbreviations, definitions, and descriptions: a review. Radiology. 1999;213:647–62.
Klauser A, McNally E, Chhem R. Training musculoskeletal ultrasound specialists: european education and clinical guidelines: work in progress. In: Van Deven T, Hibbert K, Chhem R, editors. Enhancing the practice of radiology education, Challenges and trends. Berlin: Springer; 2010. p. 143–159.
Khan KM, Pluim B. AMSSM: increasingly valuable for primary care sports and exercise medicine physicians. Br J Sports Med. 2015;49:137–8. doi:10.1136/bjsports-2014-094555.
Monaco R. Sports ultrasound: a fundamental skill for sports medicine fellows moving forward. Br J Sports Med. 2015;49:141–2.
Finnoff JT, Berkoff D, Brennan F, DiFiori J, Hall MH, Harmon K, Lavallee M, Martin S, Smith J, Stovak M. American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships. Consensus statement. Br J Sports Med. 2015;49:145–50.
Hall MM, Mautner K. Evolution of musculoskeletal and non-musculoskeletal sports ultrasound. Br J Sports Med. 2015;49(3):139–40. doi:10.1136/bjsports-2014-094192.
Jacobson J. Musculoskeletal ultrasound: focused impact on MRI. AJR. 2009;193:619–27.
McGrath MG, Stringer MD. Bony landmarks in the sacral región: the posterior superior iliac spine and the second dorsal sacral foramina: a potential guide for sonography. Surg Radiol Anat. 2011;33:279–86.
Yablon CM, Melville DM, Jacobson JA. Ultrasound of the knee. AJR. 2014;202(3):W284.
Balius R, Sala X, Alvarez, Jiménez F. Ecografía Musculoesquelética. Sistemática de exploración. Bloqueos nerviosos periféricos. Editorial Paidotribo. 2007:43–70.
Woodhouse J, McNally E. Ultrasound of skeletal muscle injury: an update. Semin Ultrasound CT MRI. 2011;32:91–100.
Koulouris G, Connell, D. Imaging of hamstring injuries: therapeutic implications. Eur Radiol. 2206;16:1478–87.
Pedret C, Balius R. Lesiones musculares en el deporte. Actualización de un artículo del Dr. Cabot, publicado en Apuntes de Medicina Deportiva en 1965. Apunts Med Esport. 2015. doi:10.1016/j.apunts.2015.01.005.
Peetrons P. Ultrasound of muscles. Eur Radiol. 2002;12(1):35–43.