Department of Orthopedic Surgery, University Hospital of Strasbourg, 10 Avenue Molière, Strasbourg, France.
Skeletal Radiol. 2012 Aug;41(8):963-9. doi: 10.1007/s00256-011-1305-1. Epub 2011 Nov 8.
Cone-beam computed tomography (CBCT) has become an important modality in dento-facial imaging but remains poorly used in the exploration of the musculoskeletal system. The purpose of this study was to prospectively evaluate the performance and radiation exposure of CBCT arthrography in the evaluation of ligament and cartilage injuries in cadaveric wrists, with gross pathology findings as the standard of reference.
Conventional arthrography was performed under fluoroscopic guidance on 10 cadaveric wrists, followed by MDCT acquisition and CBCT acquisition. CBCT arthrography and MDCT arthrography images were independently analyzed by two musculoskeletal radiologists working independently and then in consensus. The following items were observed: scapholunate and lunotriquetral ligaments, triangular fibrocartilage complex (TFCC) (tear, integrity), and proximal carpal row cartilage (chondral tears). Wrists were dissected and served as the standard of reference for comparisons. Interobserver agreement, sensitivity, specificity, and accuracy were determined. Radiation dose (CTDI) of both modalities was recorded.
CBCT arthrography provides equivalent results to MDCT arthrography in the evaluation of ligaments and cartilage with sensitivity and specificity between 82 and 100%, and interobserver agreement between 0.83 and 0.97. However, radiation dose was significantly lower (p < 0.05) for CBCT arthrography than for MDCT arthrography with a mean CTDI of 2.1 mGy (range 1.7-2.2) versus a mean of 15.1 mGy (range 14.7-16.1).
CBCT arthrography appears to be an innovative alternative to MDCT arthrography of the wrist as it allows an accurate and low radiation dose evaluation of ligaments and cartilage.
锥形束 CT（CBCT）已成为口腔颌面影像学的重要手段，但在肌肉骨骼系统的研究中仍未得到广泛应用。本研究旨在前瞻性评估 CBCT 关节造影在评估尸体腕关节韧带和软骨损伤中的性能和辐射暴露，以大体病理发现为参考标准。
对 10 具尸体腕关节进行常规关节造影，在透视引导下进行，随后进行 MDCT 采集和 CBCT 采集。两名肌肉骨骼放射科医生独立分析 CBCT 关节造影和 MDCT 关节造影图像，然后进行共识分析。观察项目包括：舟月骨间韧带、月三角骨间韧带、三角纤维软骨复合体（TFCC）（撕裂、完整性）和近侧腕骨列软骨（软骨撕裂）。对腕关节进行解剖，并作为比较的参考标准。确定了观察者间的一致性、敏感性、特异性和准确性。记录两种方式的辐射剂量（CTDI）。
CBCT 关节造影在评估韧带和软骨方面与 MDCT 关节造影具有同等的结果，其敏感性和特异性在 82%至 100%之间，观察者间的一致性在 0.83 至 0.97 之间。然而，与 MDCT 关节造影相比，CBCT 关节造影的辐射剂量明显降低（p<0.05），其平均 CTDI 为 2.1 mGy（范围 1.7-2.2），而平均 CTDI 为 15.1 mGy（范围 14.7-16.1）。
CBCT 关节造影似乎是腕关节 MDCT 关节造影的一种创新替代方法，因为它可以准确、低辐射剂量地评估韧带和软骨。
