Skip to main content
Top
Published in: Advances in Therapy 6/2015

01-06-2015 | Original Research

Evaluation of MRI-US Fusion Technology in Sports-Related Musculoskeletal Injuries

Authors: Manuel Wong-On, Lluís Til-Pérez, Ramón Balius

Published in: Advances in Therapy | Issue 6/2015

Login to get access

Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

Funding

Toshiba Medical Systems Corporation.
Appendix
Available only for authorised users
Literature
2.
go back to reference 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. 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.
3.
go back to reference Yi-Pin C, Ting-Guay W, Shiau-Fu H. Application of ultrasound in sports injury. J Med Ultrasound. 2013;21:1–8.CrossRef Yi-Pin C, Ting-Guay W, Shiau-Fu H. Application of ultrasound in sports injury. J Med Ultrasound. 2013;21:1–8.CrossRef
4.
go back to reference Allen GM, Wilson SJ. Ultrasound in sports medicine—a critical evaluation. Eur J Radiol. 2007;62:79–85.PubMedCrossRef Allen GM, Wilson SJ. Ultrasound in sports medicine—a critical evaluation. Eur J Radiol. 2007;62:79–85.PubMedCrossRef
6.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
7.
go back to reference 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. 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.
8.
go back to reference 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.CrossRef 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.CrossRef
9.
go back to reference Rubin D. Imaging diagnosis and prognostication of hamstring injuries. Am J Roentgenol. 2012;199(3):525–33.CrossRef Rubin D. Imaging diagnosis and prognostication of hamstring injuries. Am J Roentgenol. 2012;199(3):525–33.CrossRef
10.
go back to reference 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. 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.
11.
go back to reference 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. 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.
12.
go back to reference 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. 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.
13.
go back to reference 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. 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.
14.
go back to reference 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. 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.
15.
go back to reference 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.PubMed 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.PubMed
16.
go back to reference 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. 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.
17.
go back to reference Pooley RA. AAPM/RSNA physics tutorial for residents: fundamental physics of MR imaging. Radiographics. 2005;25(4):1087–99. Pooley RA. AAPM/RSNA physics tutorial for residents: fundamental physics of MR imaging. Radiographics. 2005;25(4):1087–99.
18.
go back to reference Brown M, Semelka R. MR imaging abbreviations, definitions, and descriptions: a review. Radiology. 1999;213:647–62.PubMedCrossRef Brown M, Semelka R. MR imaging abbreviations, definitions, and descriptions: a review. Radiology. 1999;213:647–62.PubMedCrossRef
19.
go back to reference 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. 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.
21.
go back to reference Monaco R. Sports ultrasound: a fundamental skill for sports medicine fellows moving forward. Br J Sports Med. 2015;49:141–2.PubMedCrossRef Monaco R. Sports ultrasound: a fundamental skill for sports medicine fellows moving forward. Br J Sports Med. 2015;49:141–2.PubMedCrossRef
22.
go back to reference 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. 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.
25.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
26.
go back to reference Yablon CM, Melville DM, Jacobson JA. Ultrasound of the knee. AJR. 2014;202(3):W284. Yablon CM, Melville DM, Jacobson JA. Ultrasound of the knee. AJR. 2014;202(3):W284.
27.
go back to reference Balius R, Sala X, Alvarez, Jiménez F. Ecografía Musculoesquelética. Sistemática de exploración. Bloqueos nerviosos periféricos. Editorial Paidotribo. 2007:43–70. Balius R, Sala X, Alvarez, Jiménez F. Ecografía Musculoesquelética. Sistemática de exploración. Bloqueos nerviosos periféricos. Editorial Paidotribo. 2007:43–70.
28.
go back to reference Woodhouse J, McNally E. Ultrasound of skeletal muscle injury: an update. Semin Ultrasound CT MRI. 2011;32:91–100.CrossRef Woodhouse J, McNally E. Ultrasound of skeletal muscle injury: an update. Semin Ultrasound CT MRI. 2011;32:91–100.CrossRef
29.
go back to reference Koulouris G, Connell, D. Imaging of hamstring injuries: therapeutic implications. Eur Radiol. 2206;16:1478–87. Koulouris G, Connell, D. Imaging of hamstring injuries: therapeutic implications. Eur Radiol. 2206;16:1478–87.
30.
Metadata
Title
Evaluation of MRI-US Fusion Technology in Sports-Related Musculoskeletal Injuries
Authors
Manuel Wong-On
Lluís Til-Pérez
Ramón Balius
Publication date
01-06-2015
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 6/2015
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-015-0217-1

Other articles of this Issue 6/2015

Advances in Therapy 6/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.