{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:49:41Z","timestamp":1786632581422,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the reliability and validity of objective fat quantification using the modified Dixon magnetic resonance imaging sequence for assessing fatty degeneration in conservatively treated patients with proximal hamstring avulsion injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Magnetic resonance imaging with modified Dixon sequence was used. The fat percentage was measured in the modified Dixon FatFraction Map by setting a region of interest, whereby 3 methods were used with decreasing accuracy: anatomical outline of the entire bundle region of interest, respective elliptical region of interest of all 3 muscle bellies, and individual elliptical regions of interest of the bundle. In addition, the ischiocrural muscle cross\u2010sectional area and the Goutallier\u2010like classification were determined as a measure of atrophy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Magnetic resonance imaging was performed 35.8\u2009\u00b1\u200922.43\u2009months after injury. Data from 16 patients (11 women, 5 men) with conservatively treated, unilateral proximal tendon rupture of the ischiocrural muscle (Wood type 3\u20105) were included. When determining the cross\u2010sectional area and the modified Dixon fat content, the inter\u2010 and intraobserver reliability was good (all \u2265\u20090.933). In comparison, the reliability values of the Goutallier\u2010like classification were worse (0.897 and 0.733). The entire bundle and muscle belly region of interest methods for determining the modified Dixon fat content showed comparable results and are therefore suitable for fat quantification. The fat content determined in the anatomical region of interest correlated significantly with the stages of the Goutallier\u2010like classification (0.823, 95% confidence interval: 0.659, 0.912,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2009&lt;\u2009.001) and the muscle cross\u2010sectional area (0.363, 95% confidence interval: \u22120.005, 0.638,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2009=\u2009.041).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The modified Dixon sequence represents a quantitative\u2010objective measure and is suitable as a measurement tool for fatty atrophy after proximal tendon injuries of the ischiocrural muscles. A simplified region of interest placement approach showed good validity and reproducibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective diagnostic comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ars2.70033","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T16:39:29Z","timestamp":1779122369000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnetic Resonance Imaging Modified Dixon Fat Quantification Analysis Is a Quantitative and Reliable Method for Evaluating Fatty Atrophy of the Hamstring Muscle Complex After Proximal Avulsion Injury"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5919-9590","authenticated-orcid":false,"given":"John","family":"Hanke","sequence":"first","affiliation":[{"name":"Department of Trauma and Reconstructive Surgery BG Hospital Bergmannstrost Halle gGmbH  Halle Germany"},{"name":"Department of Trauma Surgery University Hospital Halle, Martin Luther University Halle\u2010Wittenberg  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Schenk","sequence":"additional","affiliation":[{"name":"Research Executive Department BG Hospital Bergmannstrost Halle gGmbH  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irga","family":"Kemal","sequence":"additional","affiliation":[{"name":"Institute of Radiology and Neuroradiology BG Hospital Bergmannstrost Halle gGmbH  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2955-0471","authenticated-orcid":false,"given":"Markus","family":"Heinecke","sequence":"additional","affiliation":[{"name":"German Center of Orthopaedics Waldkliniken Eisenberg  Eisenberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8020-0788","authenticated-orcid":false,"given":"Philipp","family":"Kobbe","sequence":"additional","affiliation":[{"name":"Department of Trauma and Reconstructive Surgery BG Hospital Bergmannstrost Halle gGmbH  Halle Germany"},{"name":"Department of Trauma Surgery University Hospital Halle, Martin Luther University Halle\u2010Wittenberg  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5212-5898","authenticated-orcid":false,"given":"Thomas","family":"Mendel","sequence":"additional","affiliation":[{"name":"Department of Trauma and 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