MRI accurately detects chronic exertional compartment syndrome: a validation study

Abstract

In-scanner exercise-based MRI demonstrated reliability and reproducibility as a non-invasive screening test for CECS, thus reducing the need for invasive INM.

MR Imaging of Muscle Trauma: Anatomy, Biomechanics, Pathophysiology, and Imaging Appearance

“…Conventional MR imaging fluid-sensitive sequences performed immediately after exercise have shown high sensitivity for detecting transient signal intensity alterations noninvasively (60). Increased muscle signal intensity on fluid-sensitive images may be accompanied by muscle swelling and fascial edema; these alterations, identical to those after vigorous concentric contraction, are maximal immediately after exercise and resolve within 30 minutes (Fig 29).…”

“…Increased muscle signal intensity on fluid-sensitive images may be accompanied by muscle swelling and fascial edema; these alterations, identical to those after vigorous concentric contraction, are maximal immediately after exercise and resolve within 30 minutes (Fig 29). Quantitative T2 measurement, spectroscopy, and functional MR imaging afford even higher sensitivity (14,58,60,62). However, the specificity of imaging is not yet established.…”

“…Management consists of activity modification, with fasciotomy reserved for recalcitrant cases (59). The precise pathophysiology responsible for CECS remains unclear; proposed mechanisms include delayed egress of intracellular fluid from activated muscle fibers, metabolite-induced permeability alterations, and periosteal nerve irritation (60)(61)(62).…”

MRI of Muscle Injuries

“…On MRI, this increased water content within muscle during exercise results in an increase in T1 and T2 relaxation times (Litwiller et al 2007;Ringler et al 2013). This is best assessed on proton density or T2-weighted sequences as increased signal hyperintensity relative to a resting state.…”

Ekstremitenin Travmatik Olmayan Acilleri

“…Tanı klinik bulguların yanı sıra kompartman içi basıncın ölçülmesi ile konulur [28]. Kronik kompartman sendromu ise sıklıkla genç sporcularda, egzersizleri ile ilişkili olarak tekrarlayan mikrotravmalara bağlı basınç artışı ile ortaya çıkar [29]. Kompartman sendromunda görüntü-lemenin asıl görevi diğer patolojileri dışlamak olmakla birlikte MRG'de kasta boyut artışı, ödem ve lifsel görünümün bozulması ile fasyal düzlemlerde sıvı intensitesi görülebilir [30].…”