马后肢外侧膝关节闪烁照相定位方法的评估。
Evaluation of a positioning method for equine lateral stifle scintigrams.
机构信息
Section of Diagnostic Imaging, University Animal Hospital Swedish University of Agricultural Sciences, Uppsala, Sweden.
出版信息
Acta Vet Scand. 2012 Jun 15;54(1):38. doi: 10.1186/1751-0147-54-38.
BACKGROUND
The current lack of a standardized protocol for positioning of the gamma camera relative to the horse limb in a lateral stifle scintigram, and thus the reliance on subjective positioning, may be a cause of diagnostic error and inter-operator variability due to variations of the view angle. The aims of this study were to develop a reliable method to obtain a lateral scintigram of the equine stifle based on fixed anatomical landmarks and measure the resulting foot to gamma camera angle on sequential measurements of the same horse and of different horses
METHODS
Technetium filled capsules were glued on the skin on sites adjacent to the origin of the medial and lateral femorotibial collateral ligaments in 22 horses using ultrasound guidance. A lateral view of the stifle was defined as the image where the two radioactive point sources were aligned vertically (point sources guided method). Five sequential lateral acquisitions (one to five) of the stifle with the point sources vertically aligned were acquired in each horse, and the angle between the mid-sagittal foot-axis and the vertical axis of the gamma camera (FC angle) was measured for each of these acquisitions
RESULTS
For acquisition group one to five, the mean of the means FC angle was 91.6 ± 2° (2SD) and the coefficient of variation (COV) was 1.1%. In the 22 horses the 95% CI for the mean FC angles was 91.6° ± 12.1° (2SD) and the COV was 6.6%.
CONCLUSIONS
The use of point sources to guide gamma camera position results in less variation in the lateral scintigram than if the distal limb is used as guidance due to a difference in FC angle between horses. The point source guided positioning method is considered suitable as a reference standard method to obtain lateral scintigrams of the equine stifle, and it will be of value in clinical scintigraphy and research. The use of alignment of specifically located point sources may also be applied in other regions to standardize scintigraphic views.
背景
目前，在侧膝关节闪烁扫描中，伽马相机相对于马肢的定位缺乏标准化的协议，因此依赖于主观定位，这可能是由于视角的变化导致诊断错误和操作者间差异的原因。本研究的目的是开发一种可靠的方法，基于固定的解剖学标志，获得马膝关节的侧位闪烁扫描，并测量同一匹马和不同马的连续测量中，从足部到伽马相机的角度。
方法
在 22 匹马中，使用超声引导，将锝填充胶囊粘在靠近内侧和外侧股胫副韧带起点的皮肤上。将膝关节的侧位定义为两个放射性点源垂直对齐的图像（点源引导法）。在每匹马中，对垂直对齐的点源进行 5 次连续的膝关节侧位采集（1 到 5），并测量每个采集的中矢状足部轴与伽马相机垂直轴之间的夹角（FC 角）。
结果
对于采集组 1 到 5，FC 角均值的均值为 91.6±2°（2SD），变异系数（COV）为 1.1%。在 22 匹马中，FC 角均值的 95%CI 为 91.6°±12.1°（2SD），COV 为 6.6%。
结论
与使用远端肢体作为引导相比，使用点源引导伽马相机位置会导致侧位闪烁扫描的变化更小，因为马之间的 FC 角存在差异。点源引导定位方法被认为是获得马膝关节侧位闪烁扫描的合适参考标准方法，它将在临床闪烁扫描和研究中具有价值。在其他区域使用特定位置点源的对齐也可能用于标准化闪烁扫描视图。
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