Sandgren B, Skorpil M, Nowik P, Olivecrona H, Crafoord J, Weidenhielm L, Persson A
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Bone Joint Res. 2016 Jul;5(7):307-13. doi: 10.1302/2046-3758.57.2000566.
Computed tomography (CT) plays an important role in evaluating wear and periacetabular osteolysis (PAO) in total hip replacements. One concern with CT is the high radiation exposure since standard pelvic CT provides approximately 3.5 millisieverts (mSv) of radiation exposure, whereas a planar radiographic examination with three projections totals approximately 0.5 mSv. The objective of this study was to evaluate the lowest acceptable radiation dose for dual-energy CT (DECT) images when measuring wear and periacetabular osteolysis in uncemented metal components.
A porcine pelvis with bilateral uncemented hip prostheses and with known linear wear and acetabular bone defects was examined in a third-generation multidetector DECT scanner. The examinations were performed with four different radiation levels both with and without iterative reconstruction techniques. From the high and low peak kilo voltage acquisitions, polychrmoatic images were created together with virtual monochromatic images of energies 100 kiloelectron volts (keV) and 150 keV.
We could assess wear and PAO while substantially lowering the effective radiation dose to 0.7 mSv for a total pelvic view with an accuracy of around 0.5 mm for linear wear and 2 mm to 3 mm for PAO.
CT for detection of prosthetic wear and PAO could be used with clinically acceptable accuracy at a radiation exposure level equal to plain radiographic exposures.Cite this article: B. Sandgren, M. Skorpil, P. Nowik, H. Olivecrona, J. Crafoord, L. Weidenhielm, A. Persson. Assessment of wear and periacetabular osteolysis using dual energy computed tomography on a pig cadaver to identify the lowest acceptable radiation dose. Bone Joint Res 2016;5:307-313. DOI: 10.1302/2046-3758.57.2000566.
计算机断层扫描（CT）在评估全髋关节置换术中的磨损和髋臼周围骨溶解（PAO）方面发挥着重要作用。CT的一个问题是辐射暴露量高，因为标准骨盆CT提供约3.5毫希沃特（mSv）的辐射暴露，而三张投照的平面X线检查总计约0.5 mSv。本研究的目的是评估在测量非骨水泥金属部件的磨损和髋臼周围骨溶解时，双能CT（DECT）图像的最低可接受辐射剂量。
在第三代多探测器DECT扫描仪中检查带有双侧非骨水泥髋关节假体且已知线性磨损和髋臼骨缺损的猪骨盆。使用四种不同辐射水平并结合迭代重建技术进行检查。从高、低峰值千伏采集数据，生成多色图像以及能量为100千电子伏特（keV）和150 keV的虚拟单色图像。
我们能够评估磨损和PAO，同时将全骨盆视图下的有效辐射剂量大幅降低至0.7 mSv，线性磨损的测量精度约为0.5 mm，PAO的测量精度为2至3 mm。
用于检测假体磨损和PAO的CT在辐射辐射辐射暴露水平等同于普通X线摄影时，可达到临床可接受的准确性。引用本文：B. 桑德格伦，M. 斯科皮尔，P. 诺维克，H. 奥利维克隆纳，J. 克拉福德，L. 魏登希尔姆，A. 佩尔松。使用双能计算机断层扫描对猪尸体进行磨损和髋臼周围骨溶解评估以确定最低可接受辐射剂量。骨关节研究2016；5：307 - 313。DOI：10.1302/2046 - 3758.57.2000566。
