Xavier Alomar

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Extensor Mechanism of the Fingers: MR Imaging–Anatomic Correlation

Radiographics, May 1, 2003

After reading this article and taking the test, the reader will be able to: Ⅲ Identify the anatom... more

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Extensor Mechanism of the Fingers: MR Imaging-Anatomic 1

After reading this article and taking the test, the reader will be able to: Ⅲ Identify the anatom... more

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Preoperative Computed Tomographic Angiogram for Deep Inferior Epigastric Artery Perforator Flap for Breast Reconstruction: The Imaging Mapping Era

InTech eBooks, Feb 3, 2012

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Usefulness of coronary artery calcium for detecting significant coronary artery disease in asymptomatic individuals

Revista clínica española, Jun 1, 2014

To confirm the value of the coronary artery calcium (CAC) score as an indicator of significant co... more To confirm the value of the coronary artery calcium (CAC) score as an indicator of significant coronary artery disease (CAD) in the asymptomatic Spanish population, using noninvasive coronary angiography by multidetector computed tomography (MDCT). This was a retrospective study of 232 asymptomatic individuals, referred for a cardiovascular health checkup that included CAC and MDCT. Participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; mean age was 54.6 years (SD ± 12.8); 73.3% of them were men. The mean CAC value was 117.8 (SD ± 277). The individuals with arterial hypertension, diabetes mellitus, smoking and 3 or more risk factors had significantly greater CAC scores. Some 16.4% of the participants were in the ≥75 percentile population for CAC. The MDCT identified 148 individuals (63.8%) with CAD; the coronary lesions were not significant in 116 individuals (50%) and were significant (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;50% stenosis) in 32 (13.8%). The participants with diabetes, smoking and ≥3 risk vascular factors had a greater prevalence of significant stenosis. The individuals with &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;50% stenosis had higher CAC values (352.5 vs. 1; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.0001), and those in the ≥75 percentile had a high percentage of significant lesions (57.9% vs. 5.2%; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.0001). The predictors of significant CAD were a CAC score &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;300 (OR=10.9; 95% CI 3.35-35.8; P=.0001), belonging to the ≥75 percentile (OR=5.65; 95% CI 1.78-17.93; P=.03) and having 3 or more vascular risk factors (OR=4.19; 95% CI 1.44-12.14; P=.008). CAC quantification is an effective method for determining the extent and magnitude of CAD and delimiting the predictive capacity of traditional risk factors.

MRI findings prior to return to play as predictors of reinjury in professional athletes: a novel decision-making tool

Insights into Imaging

Background Because MRI has shown great accuracy in assessing acute muscle injuries, identificatio... more Background Because MRI has shown great accuracy in assessing acute muscle injuries, identification of risk factors for reinjury before return to play (RTP) in professional athletes during the healing process could be very relevant. We assessed the value of MRI findings prior to RTP as predictors of reinjury. Methods Retrospective observational study of 59 professional athletes, mean age 26 years, with first-time acute muscle injury and successful rehabilitation ready to RTP. They underwent MRI within 6 days of the injury and within 7 days prior to RTP. The primary outcome was reinjury. Risk of reinjury was assessed using radiological signs in control MRI scans before RTP. The risk was classified as low, medium or high when none, one or two radiological signs were observed, respectively. Results Reinjury occurred in 9 participants, with a rate of 15.2%. None of the baseline MRI-related variables was significantly associated with reinjury. In the control MRI scan performed within 7 da...

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Characterization of prostate lesions as Benign or Malignant by Multiparametric 3 T MR Imaging: Comparison of Likert score to the Prostate Imaging Reporting and Data System 2 Version

Poster: "ECR 2016 / C-1918 / Characterization of prostate lesions as Benign or Malignant by ... more Poster: "ECR 2016 / C-1918 / Characterization of prostate lesions as Benign or Malignant by Multiparametric 3 T MR Imaging: Comparison of Likert score to the Prostate Imaging Reporting and Data System 2 Version" by: "V. Catala, M. J. MARTINEZ BARCINA, O. Mayordomo, S. Esquena, A. Breda, X. Alomar, F. Algaba, J. Palou, P. de la Torre; Barcelona/ES"

Renal Vascular Hypertension and Image Techniques: State of the Art

Poster: "ECR 2013 / C-2245 / Renal Vascular Hypertension and Image Techniques: State of the ... more

La longitud del tendó lliure no està associada al temps de retorn a la competició en les lesions musculars del bíceps femoral

Effect of Autologous Expanded Bone Marrow Mesenchymal Stem Cells or Leukocyte-Poor Platelet-Rich Plasma in Chronic Patellar Tendinopathy (With Gap >3 mm): Preliminary Outcomes After 6 Months of a Double-Blind, Randomized, Prospective Study

The American Journal of Sports Medicine, 2021

Background: Patellar tendinopathy is common. The success of traditional management, including iso... more Background: Patellar tendinopathy is common. The success of traditional management, including isometric or eccentric exercises combined with shockwave therapy and even surgery, is limited. Therefore, it is important to determine whether biological treatments such as ultrasound-guided intratendinous and peritendinous injections of autologous expanded bone marrow mesenchymal stem cells (BM-MSCs) or leukocyte-poor platelet-rich plasma (Lp-PRP) improve clinical outcomes in athletic patients with patellar tendinopathy. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A prospective, double-blinded, randomized, 2-arm parallel group, active controlled, phase 1/2 single-center clinical study was performed in patients who had proximal patellar tendinopathy with a lesion >3 mm. A total of 20 participants (age 18-48 years) with pain for >4 months (mean, 23.6 months) and unresponsive to nonoperative treatments were randomized into 2 groups. Of these, 10 participant...

Insights into Imaging, 2020

Muscle injuries of the lower limbs are currently the most common sport-related injuries, the impa... more Muscle injuries of the lower limbs are currently the most common sport-related injuries, the impact of which is particularly significant in elite athletes. MRI is the imaging modality of choice in assessing acute muscle injuries and radiologists play a key role in the current scenario of multidisciplinary health care teams involved in the care of elite athletes with muscle injuries. Despite the frequency and clinical relevance of muscle injuries, there is still a lack of uniformity in the description, diagnosis, and classification of lesions. The characteristics of the connective tissues (distribution and thickness) differ among muscles, being of high variability in the lower limb. This variability is of great clinical importance in determining the prognosis of muscle injuries. Recently, three classification systems, the Munich consensus statement, the British Athletics Muscle Injury classification, and the FC Barcelona-Aspetar-Duke classification, have been proposed to assess the s...

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A Histoarchitectural Approach to Skeletal Muscle Injury: Searching for a Common Nomenclature

Orthopaedic Journal of Sports Medicine, 2020

In recent years, different classifications for muscle injuries have been proposed based on the to... more In recent years, different classifications for muscle injuries have been proposed based on the topographic location of the injury within the bone-tendon-muscle chain. We hereby propose that in addition to the topographic classification of muscle injuries, a histoarchitectonic (description of the damage to connective tissue structures) definition of the injury be included within the nomenclature. Thus, the nomenclature should focus not only on the macroscopic anatomy but also on the histoarchitectonic features of the injury.

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Role of the Extracellular Matrix in Muscle Injuries: Histoarchitectural Considerations for Muscle Injuries

Orthopaedic Journal of Sports Medicine, 2018

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Autologous bone marrow expanded mesenchymal stem cells in patellar tendinopathy: protocol for a phase I/II, single-centre, randomized with active control PRP, double-blinded clinical trial

Journal of Orthopaedic Surgery and Research, 2019

Introduction Patellar tendon overuse injuries are common in athletes. Imaging may show a change i... more Introduction Patellar tendon overuse injuries are common in athletes. Imaging may show a change in tissue structure with tendon thickening and disruption of the intratendinous substance. We wish to test the hypothesis that both autologous bone marrow expanded mesenchymal stem cells and autologous leukocyte-poor platelet-rich plasma (LP-PRP) implanted into the area of the disrupted tendinopathic patellar tendon will restore function, but tendon regeneration tissue will only be observed in the subjects treated with autologous bone marrow expanded mesenchymal stem cells. Methods and analysis This is a single-centre, pilot phase I/II, double-blinded clinical trial with randomisation with active control. Twenty patients with a diagnosis of patellar tendinopathy with imaging changes (tendon thickening and disruption of the intratendinous substance at the proximal portion of the patellar tendon) will be randomised in a 1:1 ratio to receive a local injection of either bone-marrow autologous...

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Early Functional and Morphological Muscle Adaptations During Short-Term Inertial-Squat Training

Frontiers in Physiology, 2018

Purpose: To assess early changes in muscle function and hypertrophy, measured as increases in mus... more Purpose: To assess early changes in muscle function and hypertrophy, measured as increases in muscle cross-sectional areas (CSAs) and total volume, over a 4 weeks inertial resistance training (RT) program. Methods: Ten young RT-naive volunteers (age 23.4 ± 4.1 years) underwent 10 training sessions (2-3 per week) consisting of five sets of 10 flywheel squats (moment of inertia 900 kg•cm 2 ). Magnetic resonance imaging (MRI) scans of both thighs were performed before (PRE), and after 2 (IN) and 4 (POST) weeks of training to compute individual muscle volumes and regional CSAs. Scans were performed after ≥96 h of recovery after training sessions, to avoid any influence of acute muscle swelling. PRE and POST regional muscle activation was assessed using muscle functional MRI (mfMRI) scans. Concentric (CON) and eccentric (ECC) squat force and power, as well as maximal voluntary isometric contraction force (MVIC) of knee extensors and flexors, were measured in every training session. Results: Significant quadriceps hypertrophy was detected during (IN: 5.5% ± 1.9%) and after (POST: 8.6% ± 3.6%) the training program. Increases in squat force (CON: 32% ± 15%, ECC: 31 ± 15%) and power (CON: 51% ± 30%, ECC: 48% ± 27%) were observed over the training program. Knee extensor MVIC significantly increased 28% ± 17% after training, but no changes were seen in knee flexor MVIC. No correlation was found between regional muscular activation in the first session and the % of increase in regional CSAs (r = -0.043, P = 0.164). This study reports the earliest onset of whole-muscle hypertrophy documented to date. The process initiates early and continues in response to RT, contributing to initial increases in force. The results call into question the reliability of mfMRI as a tool for predicting the potential hypertrophic effects of a given strengthening exercise.

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Subtraction CT angiography improves evaluation of significant coronary artery disease in patients with severe calcifications or stents—the C-Sub 320 multicenter trial

European Radiology, 2018

Objectives-Diagnostic accuracy of conventional coronary CT angiography (CCTA conv ) may be compro... more Objectives-Diagnostic accuracy of conventional coronary CT angiography (CCTA conv ) may be compromised by blooming artifacts from calcifications or stents. Blooming artifacts may be reduced by subtraction coronary CT angiography (CCTA sub ) in which non-contrast and contrast CT data sets are subtracted digitally. We tested whether CCTA sub in patients with severe coronary calcification or stents reduces the number of false-positive stenosis evaluations compared with CCTA conv . Methods-In this study, 180 symptomatic patients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and CT scanned (2013-2016) at three international centers. CCTA conv , and CCTA sub data sets were reconstructed. Target segments were defined as motionfree coronary segments with a suspected stenosis (> 50% of lumen) potentially due to blooming of either calcium or stents. Target segments were evaluated with respect to misregistration artifacts from the CCTA sub reconstruction process, in which case evaluation was omitted. CCTA sub and Andreas Fuchs

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Length of the free tendon is not associated with return to play time in biceps femoris muscle injuries

Apunts. Medicina de l'Esport, 2019

Abstract Purpose and hypothesis Evaluate the association between long head biceps femoris (BFLH) ... more Abstract Purpose and hypothesis Evaluate the association between long head biceps femoris (BFLH) injuries, BFLH free tendon length, and to return to play time (RTP) and determine the measurement reliability. Methods In 108 athletes with acute BFLH injury, BFLH free tendon length (cm) was measured by magnetic resonance image (MRI) and RTP time (days) was recorded. To evaluate intra-observer reliability, two different and well-trained musculoskeletal radiologists recorded bilateral free tendon length in 30 subjects and repeated the process one week later. To evaluate inter-observer reliability, the radiologists performed the measurements independently. Subsequently, intraclass correlation coefficient (ICC) analysis was carried out. Pearson correlation coefficient was used to analyze the relationship between tendon length and RTP time. Results Intra-observer reliability expressed by ICC ranged from 0.921 (95 CI: 0.832–0.963) to 0.983 (95 CI: 0.963–0.992). Inter-observer ICC ranged from 0.977 (95 CI: 0.952–0.989) to 0.984 (95 CI: 0.966–0.993). Average proximal BFLH free tendon length was 4.8 ± 2.4 cm (right biceps), and 5.0 ± 2.2 cm (left). Average time to return to play (RTP) was 29 ± 15 days. There was no statistically significant correlation between proximal BFLH free tendon length and RTP time (Pearson correlation coefficient = −0.037; p = 0.712). Conclusion Free tendon length can be reliably measured with excellent intra-observer and inter-observer agreement. Length of the proximal BFLH free tendon is not associated with RTP time in BFLH injuries.

Time Course and Association of Functional and Biochemical Markers in Severe Semitendinosus Damage Following Intensive Eccentric Leg Curls: Differences between and within Subjects

Frontiers in physiology, 2018

To investigate the extent and evolution of hamstring muscle damage caused by an intensive bout of... more To investigate the extent and evolution of hamstring muscle damage caused by an intensive bout of eccentric leg curls (ELCs) by (1) assessing the time course and association of different indirect markers of muscle damage such as changes in the force-generating capacity (FGC), functional magnetic resonance (fMRI), and serum muscle enzyme levels and (2) analyzing differences in the degree of hamstring muscle damage between and within subjects (limb-to-limb comparison). Thirteen male participants performed six sets of 10 repetitions of an ELC with each leg. Before and at regular intervals over 7 days after the exercise, FGC was measured with maximal isometric voluntary contraction (MVC). Serum enzyme levels, fMRI transverse relaxation time (T2) and perceived muscle soreness were also assessed and compared against the FGC. Two groups of subjects were identified according to the extent of hamstring muscle damage based on decreased FGC and increased serum enzyme levels: high responders ( ...

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Semimembranosus Muscle Injuries In Sport. A Practical MRI use for Prognosis

Sports Medicine International Open, 2017

The aim of this work was to study semimembranosus musculotendinous injuries (SMMTI) and return to... more The aim of this work was to study semimembranosus musculotendinous injuries (SMMTI) and return to play (RTP). The hypothesis is that some related anatomic variables of the SM could contribute to the prognosis of RTP. The retrospective study was done with 19 athletes who suffered SMMTI from 2010 to 2013 and in whose cases a 3.0T MRI was performed. We evaluated the A, B, C SM regions damaged and calculated the relative length and percentage of cross-sectional area (CSA) affected. We found the correlation of these variables with RTP. The data was regrouped in those cases where the part C of the injury was of interest and those in which the C region was unscathed (pooled parts). We used the Mann-Whitney U test and there was a higher RTP when the injury involved the C part of SM (49.1 days; 95% CI [27.6– 70.6]) compared to non-C-part involvement (27.8 days; 95% CI [19.5–36.0]). The SMMTI with longer RTP typically involves the C part with or without participation of the B part. In daily p...

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Detection of muscle gap by L-BIA in muscle injuries: clinical prognosis

Physiological Measurement, 2017

Sport-related muscle injury classifications are based basically on imaging criteria such as ultra... more Sport-related muscle injury classifications are based basically on imaging criteria such as ultrasound (US) and magnetic resonance imaging (MRI) without consensus because of a lack of clinical prognostics for return-toplay (RTP), which is conditioned upon the severity of the injury, and this in turn with the muscle gap (muscular fibers retraction). Recently, Futbol Club Barcelona's medical department proposed a new muscle injury classification in which muscle gap plays an important role, with the drawback that it is not always possible to identify by MRI. Localized bioimpedance measurement (L-BIA) has emerged as a non-invasive technique for supporting US and MRI to quantify the disrupted soft tissue structure in injured muscles. Objective: To correlate the severity of the injury according to the gap with the RTP, through the percent of change in resistance (R), reactance (Xc) and phase-angle (PA) by L-BIA measurements in 22 muscle injuries. Main results: After grouping the data according to the muscle gap (by MRI exam), there were significant differences in R between grade 1 and grade 2f (myotendinous or myofascial muscle injury with feather-like appearance), as well as between grade 2f and grade 2g (myotendinous or myofascial muscle injury with feather and gap).

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Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application

Sports medicine (Auckland, N.Z.), Jan 23, 2016

Muscle injuries are among the most common injuries in sport and continue to be a major concern be... more Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is essential for a full understanding of the injury and to optimize its management and return-to-play process. The ongoing failure to establish a classification system with broad acceptance has resulted from factors such as limited clinical applicability, and the inclusion of subjective findings and ambiguous terminology. The purpose of this article was to describe a classification system for muscle injuries with easy clinical application, adequate grouping of injuries with similar functional impairment, and potential prognostic value. This evidence-informed and expert consensus-based classification system for muscle injuries is based on a four-letter initialism system: MLG-R, respectively refe...

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