Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin street MSB 2.130B, Houston, TX 77030 USA.
Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, 6431 Fannin street MSB 2.130B, Houston, TX 77030 USA.
Eur J Radiol. 2018 Nov;108:155-164. doi: 10.1016/j.ejrad.2018.09.028. Epub 2018 Sep 27.
Muscle injury accounts for about one-third of total sports-related injuries. The lower limb muscles have one of the highest predisposition for injury in high-level professional athletic sports, such as the National Football League. The commonest group of muscles injured among football players include the hamstrings, followed by the quadriceps. Muscle injuries lead to significant time, off the field and affect return to play. Sports physicians and teams have been keen on assessing such injuries and also relying on multiple tools to safely return the player back to the field. MRI plays a key role in evaluation, follow-up, and assessment for return to play (RTP). In this review, we will discuss details of muscle anatomy, incidence of muscle injuries, injury mechanisms, and use of MRI in assessment, grading, follow-up and in predicting the natural course of muscle injuries in the high-end athletic players. While the use of MRI is clear in diagnosis, and for follow up of muscle injuries, there is some limitation in its ability to predict RTP, based on current MRI classification systems. Footballers who have clinical injuries without MRI evidence of significant muscle injury (grade 0 and 1) have a shorter period of RTP. Injuries classified as high grade (3 and 4) on MRI do not correlate well with time to RTP. Further trials are required to improve the capability of MRI in its prediction of RTP.
肌肉损伤约占运动相关损伤的三分之一。在高水平职业运动中，下肢肌肉受伤的风险最高，例如国家橄榄球联盟。足球运动员中最常见的受伤肌肉群包括腘绳肌，其次是股四头肌。肌肉损伤会导致运动员大量缺阵，影响重返赛场的时间。运动医学医生和球队一直热衷于评估此类损伤，并依赖多种工具来确保运动员安全重返赛场。MRI 在评估、随访和重返赛场（RTP）方面发挥着关键作用。在这篇综述中，我们将讨论肌肉解剖学的细节、肌肉损伤的发生率、损伤机制以及 MRI 在评估、分级、随访和预测高端运动员肌肉损伤自然病程中的应用。虽然 MRI 在诊断和肌肉损伤的随访方面具有明确的作用，但根据目前的 MRI 分类系统，其预测 RTP 的能力存在一定的局限性。有临床损伤但 MRI 无明显肌肉损伤证据的足球运动员（0 级和 1 级）的 RTP 时间较短。MRI 分级较高（3 级和 4 级）的损伤与 RTP 时间没有很好的相关性。需要进一步的试验来提高 MRI 预测 RTP 的能力。
