Diffusion tensor imaging has prognostic value on return to play in hamstring injuries: A prospective cohort study.

Area of Science:

• Sports Medicine
• Radiology
• Biomedical Engineering

Background:

• Predicting return to play (RTP) after hamstring injuries is challenging.
• Diffusion tensor imaging (DTI) can detect muscle micro-trauma, potentially improving RTP prediction.

Purpose of the Study:

• To assess the predictive capability of DTI-derived metrics for RTP prognosis in athletes with hamstring injuries.
• To determine the added value of DTI parameters compared to conventional MRI classifications.

Main Methods:

• Prospective cohort study including athletes with acute hamstring injuries.
• 3T MRI with DTI acquisition within 7 days of injury.
• Calculation of DTI parameters (eigenvalues, mean diffusivity, radial diffusivity, fractional anisotropy) and correlation with self-reported RTP time using linear regression.

Main Results:

• 91 athletes were analyzed, with a median RTP of 37 days.
• All DTI parameters showed univariate associations with RTP time, explaining 5.4–15.0% of variance.
• Multivariate analysis indicated independent associations between most DTI parameters and RTP time.

Conclusions:

• DTI parameters are associated with RTP time after hamstring injury.
• DTI parameters, particularly those reflecting radial diffusivity, offer significant added value for predicting RTP prognosis.