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Wenjian Xu: Yes, there is a special focus on sports imaging within continuing education training or courses that are organised by the Chinese Society of Radiology and different university hospitals across the country.



WX: I work at Qingdao University Hospital, and sports-related imaging diagnoses take up a substantial part of my daily work.



WX: Knee and ankle injuries during football and basketball practice require medical imaging. Most cases can be diagnosed via plain radiography, but more complex cases require performing a magnetic resonance imaging (MRI) examination. The biggest challenge to radiologists may be having to diagnose tendon, ligaments, muscle and cartilage injuries.



WX: I am most familiar with MRI examinations of acute and chronic injuries of cartilage.



WX: To name a few: fracture and joint dislocation, fatigue fracture, tendon and ligament injuries or tear, contusion and laceration of brain, liver, spleen, kidney.


ESR: Radiologists are part of a team; for sports imaging this likely consists of surgeons, orthopaedists, cardiologists and/or neurologists. How would you define the role of the radiologist within this team, and how would you describe the cooperation between radiologists, surgeons, and other physicians?

WX: Radiologists play the most important role in diagnosis before treatment and in treatment effectiveness follow-up. They provide evidence for surgeons or orthopaedists to determine the most appropriate treatment. Multidetector computed tomography (MDCT) is a nice modality for cooperation between radiologists, surgeons, and other physicians.



WX: Diagnoses and suggestions from radiologists using sports imaging should be the most important input before treatment and follow-up.



WX: Yes, radiology can be used to pre-empt injuries in professional athletes and the general population who likes to practise sports. The information from medical imaging could prevent some sports injuries, from light to worse, from happening.



WX: I am not involved in such centres. Maybe the radiologists can acquire knowledge from continuing education and courses given through local, national and international conferences held by radiology societies or other academic institutions, and skills disseminated during special commercial training.



WX: Yes, the demand for sports imaging and generally sports medicine has increased in China, especially after the Olympic Games in Beijing in 2008. A lot of people like to exercise every day, for example in basketball, football, marathon, walking, and so on. Many healthcare centres and private imaging centres have recently been built across the country, but there is still a lack of radiologists in public hospitals, with a large number of patients who need imaging services. Imaging centres and Internet-based diagnostic centres would be an option to take care of more patients.



WX: Lead protection against radiation must be provided in examinations that use ionising radiation. CT examination must be carried out with low radiation dose, and MRI should be used more widely.


European Society of Radiology: Sports imaging also applies to sports-related injuries of the brain. In case you are familiar with this, please also answer the following questions:


ESR: Which sports have the highest risk of inducing brain injuries?

WX: I would say boxing, football, riding, wrestling and high-speed sports like automotive racing.


ESR: What imaging modalities do you use with traumatic brain injury specifically in athletes?

WX: CT and MRI are the modalities I use in these patients.


ESR: How have advances in brain imaging allowed you to predict patient outcomes more accurately?

WX: We can use some new imaging modalities to make quantitative evaluation on brain injuries, for example, DCE-MR, SWI, DKI, IVIM, and so on.

Prof. Wenjian Xu is Professor of Radiology and Chairman of the Department of Radiology at the Affiliated Hospital of Qingdao University. He is a renowned expert in musculoskeletal imaging in China. His main research interests are musculoskeletal imaging, especially in the field of bone and joint tumour imaging. Prof. Xu has authored or co-authored more than 160 peer-reviewed publications and more than ten books and chapters published; and he has given numerous invited lectures, tutorials and refresher courses at national and international meetings. From 2009 to 2015 he was chairman of the musculoskeletal imaging board of the Chinese Society of Radiology (CSR).

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