Dual-energy CT arthrography: a feasibility study
- PDF / 7,265,409 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 47 Downloads / 240 Views
SCIENTIFIC ARTICLE
Dual-energy CT arthrography: a feasibility study Rashpal Sandhu 1 & Mercan Aslan 1 & Nancy Obuchowski 2 & Andrew Primak 3 & Wadih Karim 1 & Naveen Subhas 1 Received: 28 May 2020 / Revised: 8 September 2020 / Accepted: 10 September 2020 # ISS 2020
Abstract Objective To evaluate the feasibility of producing 2-dimensional (2D) virtual noncontrast images and 3-dimensional (3D) bone models from dual-energy computed tomography (DECT) arthrograms and to determine whether this is best accomplished using 190 keV virtual monoenergetic images (VMI) or virtual unenhanced (VUE) images. Materials and methods VMI and VUE images were retrospectively reconstructed from patients with internal derangement of the shoulder or knee joint who underwent DECT arthrography between September 2017 and August 2019. A region of interest was placed in the area of brightest contrast, and the mean attenuation (in Hounsfield units [HUs]) was recorded. Two blinded musculoskeletal radiologists qualitatively graded the 2D images and 3D models using scores ranging from 0 to 3 (0 considered optimal). Results Twenty-six patients (mean age ± SD, 57.5 ± 16.8 years; 6 women) were included in the study. The contrast attenuation on VUE images (overall mean ± SD, 10.5 ± 16.4 HU; knee, 19.3 ± 10.7 HU; shoulder, 5.0 ± 17.2 HU) was significantly lower (p < 0.001 for all comparisons) than on VMI (overall mean ± SD, 107.7 ± 43.8 HU; knee, 104.6 ± 31.1 HU; shoulder, 109.6 ± 51.0 HU). The proportion of cases with optimal scores (0 or 1) was significantly higher with VUE than with VMI for both 2D and 3D images (p < 0.001). Conclusions DECT arthrography can be used to produce 2D virtual noncontrast images and to generate 3D bone models. The VUE technique is superior to VMI in producing virtual noncontrast images. Keywords CT arthrography . Dual-energy CT . CT technique . Virtual noncontrast . Virtual monoenergetic
Introduction Although magnetic resonance imaging (MRI) is the imaging modality of choice for assessing suspected internal derangement of a joint, computed tomography (CT) arthrography can also be used for this purpose when MRI is not available or is contraindicated. In many of these injuries (e.g., anterior shoulder dislocations), there is a combination of soft tissue and bony injury. In these cases, CT arthrography may be superior to MRI, as CT can better assess both intra-articular and extraarticular bony structures. One of the inherent limitations of CT arthrography, however, is that intra-articular contrast has
* Naveen Subhas [email protected] 1
Imaging Institute, Cleveland Clinic, Cleveland, OH 44195, USA
2
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, USA
3
Siemens Medical Solutions USA, Inc., Malvern, PA 19355, USA
attenuation similar to that of bone (and similar to that of intra-articular synthetic material such as cement or suture anchors, periarticular calcifications, or crystal deposition), thus making it difficult or impossible to separate contrast in the joint from the adjacent bony
Data Loading...
