الفهرس 
MRI BASIC PRINCIPLESOnly 14 pages are availabe for public view
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Abstract
Skeletal muscle is the single largest tissue in the body. Muscle fiber is the smallest contractile unit.-Muscle injuries can be classified into indirect and direct trauma. Indirect trauma injuries include DOMS, lengthening, contracture and strains. Directly applied traumatic lesions include muscle contusions and lacerations.MRI and Ultrasound modalities are therefore important for a correct classification of the injury, assessment of severity and to exclude complications.MRI is the method of choice for diagnosis of musculoskeletal injuries.MR imaging generally can be used in targeting the site, severity and degree of painful generators. MR imaging of muscles can be utilized in establishing an accurate diagnosis, excluding underneath disorders as stress fractures, narrowing the diagnosis possibilities, predicting the progress and sequalae of the lesion, directing the nature and site of interventions as biopsies and monitoring the response for treatment.US is considered as the first choice to assess muscular injuries. With proper techniques and accurate reviews, its capability to show minimal disorders makes US higher sensitivity to evaluate these traumatic muscular injuries.The availability, low cost, ease of examination, exclusion of ionizing radiation and dynamic capabilities of Ultrasound favor its utilization for primary evaluation and consequent follow up of most of muscular lesions. MR imaging offers superior imaging contrast resolution than Ultrasound does, so MRI may be usually useful in differentiation of hematomas from soft tissue masses. Sometimes the two techniques may be utilized as the results may complete each other. Also there are many factors that determine the selection the needed method to assess traumatic muscular lesions such as local availability, cost, expertise and local clinical practice.The aim of this study is to compare efficacy of US versus single sequence MRI in evaluation of traumatic muscle lesions.This study was performed on 50 patients (38 male and 12 female). Their age ranged from 10 to 65 years old (mean age is 33.6).Most injuries were seen in lower extremities especially the thigh in 25 patients , the next site is the calf area in 12 patients and the reminder cases occurred in the shoulder , ankle and pelvis.Injuries usually involve the myotendinous junction (MTJ) in 20 patients.Multiple muscles were affected, the most frequent involved muscle was quadriceps in 13 patients, the next most affected muscle was hamstrings in 10 patients, and then gastrocnemius muscle in 9 patients.Most common patterns presented in this study included muscle edema in 35 patients and hematoma in 18 patients.MRI detected all injuries in the 50 cases especially with T2WI and STIR sequences.In 44 cases, there was complete agreement between MR imaging and ultrasound findings concerning the injury location, nature and degree. A number of 6 false -ve cases were recorded by ultrasound: 4 with minor traumas and 2 with major traumas. Ultrasound is highly sensitive (88%) to identify traumatic muscular lesions.Ultrasound sensitivity for the two subcategories of cases with major (35 patients) and minor traumas (15 patients) recorded 94.29% and 73.33%, respectively. Ultrasound sensitivity to types of lesion recorded 50% in delayed onset muscle soreness, 100% in lengthenings, 75% in contractures, 88.24% in muscular strains, 80% in mild contusions and 100% in severe contusions -US has a significant role as an adjunct imaging method, but seems less sensitive than MRI (the golden standard) for assessing the extent of the injury.To reach an accurate diagnosis of muscle injuries there should be a combination between multiple MRI sequences. Correlation between MRI and US findings is helpful in correct diagnosis of muscle injuries and narrows the differential diagnosis of the lesion.