T2-Weighted Imaging & Stimulated Echo Diffusion Tensor Imaging in Chronic Exertional Compartment Syndrome Calf Muscle

Eric Edward Sigmund¹, Dabang Sui¹, Philip A. Hodnett², Kecheng Liu³, KellyAnne McGorty¹, Michael Mechlin¹, Jenny Bencardino¹

Chronic exertional compartment syndrome (CECS) is a muscular disorder with fluid retention following exertion causing hypoperfusion and disability whose microscopic pathophysiology is not completely understood. T2-weighted imaging (T2w) and stimulated echo diffusion tensor imaging (DTI) were applied to suspected CECS patients before and after exertion. T2w signal intensity increases following exercise by at least 20% in some groups (defined as CECS positive). Diffusion eigenvalues increase in all groups following exertion by ~10%, and larger increases occur in CECS positive groups (20-40%). Fractional anisotropy also decreases in all groups following exertion, suggesting at least a partial role of myofiber dilation.