Meier R, Geerling J, Hüfner T, Kfuri M, Krettek C
Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Hannover, Deutschland.
Unfallchirurg. 2011 Jul;114(7):587-90. doi: 10.1007/s00113-011-2008-8.
In addition to conventional C-arms which can be used for intraoperative imaging, C-arm image amplifiers with an option for three-dimensional imaging (ISO-C3D) are available to visualize reduction of fragments and positions of implants. In ten cadaver wrists intra-articular steps and intra-articular screw positions were simulated. Images obtained by conventional two-dimensional C-arm image amplifier, computed tomography and ISO-C3D were evaluated by four investigators using a questionnaire. For 2D image amplifier scans the investigators rated the quantity of the articular steps correctly in 45%, incorrectly in 51% and were uncertain in 4%. Concerning CT scans these values were 57, 40 and 3%, respectively. With a slow 190° ISO-C3D mode the investigators rated the steps correctly in 47%, incorrectly in 44% and were uncertain in 9%. The positions of the tip of the screw were rated correctly for 2D scans in 56%, incorrectly in 40% and were uncertain in 4%. For CT screw positions were assessed correctly in 40%, incorrectly in 43% and were uncertain in 17%. For ISO-C3D in fast 190° mode the rating was correct in 59%, wrong in 30% and uncertain in 11%. In the slow Iso-C3D mode the results were inferior with correct assessment in 51%, wrong results in 36% and uncertain evaluation in 13%. In our cadaveric study, ISO-C3D scans have been found valuable for intraoperative controls of implant positions and assessment of intra-articular steps.
除了可用于术中成像的传统C形臂外，还可使用具有三维成像选项（ISO-C3D）的C形臂图像放大器来观察骨折碎片的复位情况和植入物的位置。在10具尸体手腕上模拟了关节内台阶和关节内螺钉位置。由4名研究人员使用问卷对通过传统二维C形臂图像放大器、计算机断层扫描和ISO-C3D获得的图像进行评估。对于二维图像放大器扫描，研究人员正确评定关节台阶数量的比例为45%，错误评定的比例为51%，不确定的比例为4%。对于CT扫描，这些值分别为57%、40%和3%。在ISO-C3D的慢速190°模式下，研究人员正确评定台阶的比例为47%，错误评定的比例为44%，不确定的比例为9%。二维扫描时，螺钉尖端位置评定正确的比例为56%，错误评定的比例为40%，不确定的比例为4%。对于CT，螺钉位置评估正确的比例为40%，错误评估的比例为43%，不确定的比例为17%。对于快速190°模式下的ISO-C3D，评定正确的比例为59%，错误的比例为30%，不确定的比例为11%。在慢速Iso-C3D模式下，结果较差，正确评估的比例为51%，错误结果的比例为36%，不确定评估的比例为13%。在我们的尸体研究中，已发现ISO-C3D扫描对于术中控制植入物位置和评估关节内台阶很有价值。
