A Novel Quantitative Index for Objective MRI Grading of Gastrocnemius Muscle Strain

Koray Kaya Kiliç; Nevfel Kahvecioglu; Murat Yüncü; Mehmet Barış Ertan; Özkan Köse

Makale detayları

A Novel Quantitative Index for Objective MRI Grading of Gastrocnemius Muscle Strain

Yazarlar:

Koray Kaya Kiliç | Nevfel Kahvecioglu | Murat Yüncü | Mehmet Barış Ertan | Özkan Köse

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Ortopedi | Radyoloji ve Organ Görüntüleme

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.263-269

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350317

pISSN:

1300-414X

Anahtar kelimeler:

Özet:

 This study presents a quantitative MRI-based method to improve the objectivity and diagnostic accuracy of grading calf muscle strains. Ninety-six patients with MRI-confirmed medial gastrocnemius injuries who underwent bilateral lower leg MRI between January 2018 and December 2023 were retrospectively analyzed. Injuries were graded using the Dai classification Grades IIII. Axial T2-weighted SPAIR images were used to measure the medial gastrocnemius cross-sectional area CSA at the distal one-third between the knee joint and the musculotendinous junction. The Gastrocnemius Medial Head Ratio GCM ratio was calculated by dividing the CSA of the injured side by that of the uninjured side. Two experienced radiologists independently performed the measurements twice. Intra- and interobserver reliability were assessed using intraclass correlation coefficients ICC and Cohens kappa. A one-way ANOVA with the Bonferroni correction was used for group comparisons. ROC analysis evaluated the diagnostic performance of the GCM ratio. The GCM ratio significantly differed among Grade I 1.03  0.02, Grade II 1.18  0.06, and Grade III 1.35  0.05 injuries p  0.001. Ipsilateral CSA increased with injury severity, whereas contralateral CSA remained consistent. CSA measurements showed excellent intra- and interobserver reliability ICC  0.87, and lesion grading demonstrated substantial to almost perfect agreement κ  0.750.88. ROC analysis revealed strong diagnostic accuracy AUC  0.986 for Grade I vs. II; AUC  1.000 for Grade II vs. III. The GCM ratio provides a reproducible and objective MRI marker to aid in grading gastrocnemius strains, offering excellent diagnostic performance and clinical applicability.

 This study presents a quantitative MRI-based method to improve the objectivity and diagnostic accuracy of grading calf muscle strains. Ninety-six patients with MRI-confirmed medial gastrocnemius injuries who underwent bilateral lower leg MRI between January 2018 and December 2023 were retrospectively analyzed. Injuries were graded using the Dai classification Grades IIII. Axial T2-weighted SPAIR images were used to measure the medial gastrocnemius cross-sectional area CSA at the distal one-third between the knee joint and the musculotendinous junction. The Gastrocnemius Medial Head Ratio GCM ratio was calculated by dividing the CSA of the injured side by that of the uninjured side. Two experienced radiologists independently performed the measurements twice. Intra- and interobserver reliability were assessed using intraclass correlation coefficients ICC and Cohens kappa. A one-way ANOVA with the Bonferroni correction was used for group comparisons. ROC analysis evaluated the diagnostic performance of the GCM ratio. The GCM ratio significantly differed among Grade I 1.03  0.02, Grade II 1.18  0.06, and Grade III 1.35  0.05 injuries p  0.001. Ipsilateral CSA increased with injury severity, whereas contralateral CSA remained consistent. CSA measurements showed excellent intra- and interobserver reliability ICC  0.87, and lesion grading demonstrated substantial to almost perfect agreement κ  0.750.88. ROC analysis revealed strong diagnostic accuracy AUC  0.986 for Grade I vs. II; AUC  1.000 for Grade II vs. III. The GCM ratio provides a reproducible and objective MRI marker to aid in grading gastrocnemius strains, offering excellent diagnostic performance and clinical applicability.

 This study presents a quantitative MRI-based method to improve the objectivity and diagnostic accuracy of grading calf muscle strains. Ninety-six patients with MRI-confirmed medial gastrocnemius injuries who underwent bilateral lower leg MRI between January 2018 and December 2023 were retrospectively analyzed. Injuries were graded using the Dai classification Grades IIII. Axial T2-weighted SPAIR images were used to measure the medial gastrocnemius cross-sectional area CSA at the distal one-third between the knee joint and the musculotendinous junction. The Gastrocnemius Medial Head Ratio GCM ratio was calculated by dividing the CSA of the injured side by that of the uninjured side. Two experienced radiologists independently performed the measurements twice. Intra- and interobserver reliability were assessed using intraclass correlation coefficients ICC and Cohens kappa. A one-way ANOVA with the Bonferroni correction was used for group comparisons. ROC analysis evaluated the diagnostic performance of the GCM ratio. The GCM ratio significantly differed among Grade I 1.03  0.02, Grade II 1.18  0.06, and Grade III 1.35  0.05 injuries p  0.001. Ipsilateral CSA increased with injury severity, whereas contralateral CSA remained consistent. CSA measurements showed excellent intra- and interobserver reliability ICC  0.87, and lesion grading demonstrated substantial to almost perfect agreement κ  0.750.88. ROC analysis revealed strong diagnostic accuracy AUC  0.986 for Grade I vs. II; AUC  1.000 for Grade II vs. III. The GCM ratio provides a reproducible and objective MRI marker to aid in grading gastrocnemius strains, offering excellent diagnostic performance and clinical applicability.

 Bu çalışmanın amacı, medial gastroknemius kasının yaralı ve sağlam taraflardaki kesitsel alan KA ölçumlerini karşılaştırarak baldır kası yaralanmalarının sınıflamasında nesnelliği ve tanısal doğruluğu artırmak uzere MRG tabanlı kantitatif bir yaklaşım geliştirmektir. Bu retrospektif çalışmaya, Ocak 2018 ile Aralık 2023 tarihleri arasında çift taraflı alt ekstremite MRGsi çekilmiş ve MRG ile baldır kası yırtığı doğrulanmış 96 hasta dahil edildi. Kas yaralanmaları Dai sınıflamasına göre Grade IIII sınıflandırıldı. Medial gastroknemius kasının KA ölçumleri, diz eklemi ile muskulo-tendinöz bileşke arasındaki distal uçte birlik seviyede elde edilen aksiyel T2-ağırlıklı SPAIR sekanslar kullanılarak yapıldı. Gastroknemius Medial Baş Oranı GKM oranı, yaralı tarafın KAsının sağlam tarafın KAsına oranlanmasıyla hesaplandı. İki deneyimli radyolog ölçumleri birbirinden bağımsız ve iki kez gerçekleştirdi. İntra ve inter-observer guvenilirlik intraclass correlation coefficient ICC ve Cohens kappa istatistikleri ile değerlendirildi. Gruplar arası karşılaştırmalarda Bonferroni duzeltmeli tek yönlu ANOVA testi kullanıldı. GKM oranının tanısal performansı ROC analizi ile değerlendirildi. GKM oranı Grade I 1,03  0,02, Grade II 1,18  0,06 ve Grade III 1,35  0,05 arasında anlamlı fark gösterdi p  0,001. Yaralı taraftaki KA, yaralanma şiddetiyle birlikte artış gösterirken; sağlam taraf KAsı gruplar arasında anlamlı fark göstermedi. KA ölçumlerinin inter- ve intra-observer guvenilirliği mukemmeldi ICC  0,87, lezyon derecelendirmesi ise anlamlı duzeyde tutarlıydı κ  0,750,88. ROC analizi, GKM oranı için yuksek tanısal doğruluk gösterdi Grade I ile II için AUC  0,986; Grade II ile III için AUC  1,000. Gastroknemius kasının GKM oranına dayalı kantitatif MRG ölçumleri, yaralanma sınıflamasında yuksek tekrarlanabilirlik ve guçlu tanısal performans ile guvenilir ve objektif bir değerlendirme aracı sunmaktadır.

Makale detayları

A Novel Quantitative Index for Objective MRI Grading of Gastrocnemius Muscle Strain

Yazarlar:

Koray Kaya Kiliç | Nevfel Kahvecioglu | Murat Yüncü | Mehmet Barış Ertan | Özkan Köse

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Ortopedi | Radyoloji ve Organ Görüntüleme

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.263-269

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350317

pISSN:

1300-414X

tennis leg

gastrocnemius

MRI

cross-sectional area

muscle grading

quantitative imaging.tenisçi bacağı

gastroknemius

MRG

kesitsel alan

kas sınıflaması

kantitatif görüntüleme

Sayı

Makale detayları

Yazarlar: Koray Kaya Kiliç | Nevfel Kahvecioglu | Murat Yüncü | Mehmet Barış Ertan | Özkan Köse

Yayıncı: Bursa Uludağ University

Ana Başlıklar: Ortopedi | Radyoloji ve Organ Görüntüleme

Dergi: Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.263-269

Belge Tipi: Makale

Yayın Tarihi: 8/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001350317

pISSN: 1300-414X

Sayı

Yazarlar:

Koray Kaya Kiliç | Nevfel Kahvecioglu | Murat Yüncü | Mehmet Barış Ertan | Özkan Köse

Yayıncı:

Bursa Uludağ University

Ana Başlıklar:

Ortopedi | Radyoloji ve Organ Görüntüleme

Dergi:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.51 Issue 2, pp.263-269

Belge Tipi:

Makale

Yayın Tarihi:

8/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350317

pISSN:

1300-414X