Gondim Teixeira Pedro Augusto, Formery Anne-Sophie, Jacquot Adrien, Lux Guillaume, Loiret Isabelle, Perez Manuela, Blum Alain
1 Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy 54035, France.
2 Service de Chirurgie Orthopedique et Traumatologique, Centre Chirurgical Emile Gallé, Nancy, France.
AJR Am J Roentgenol. 2017 Jan;208(1):150-158. doi: 10.2214/AJR.16.16434. Epub 2016 Nov 3.
The purpose of this study was to show the application of quantitative 4D CT for subtalar joint evaluation in healthy volunteers and cadavers.
Fifteen healthy volunteers with no history of subtalar joint trauma and three cadavers were prospectively evaluated with dynamic CT. The subtalar joint was evaluated during a pronosupination cycle. All acquisitions (cadavers and healthy volunteers) were performed using intermittent sequential mode with a 320-MDCT scanner. Angles and distances between the talus and the calcaneus were measured semiautomatically. Measurement variation was described in healthy volunteers and in cadavers, the latter before and after resection of the cervical and interosseous ligaments. The mean effective dose was below 0.1 mSv.
In cadavers, mean increases in joint amplitude over 19% and of 22% were seen after partial ligament sectioning and after full ligament sectioning, respectively. The interobserver variability of the measurement ratios was considered to be excellent for three of the measurements made (ICC > 0.87) and moderate for the fourth (ICC = 0.57). The normal range of joint motion in healthy volunteers is described, with joint amplitudes varying from 6.4% to 22.8%.
Quantitative dynamic CT of the subtalar joint can provide a detailed analysis of joint motion, supporting its potential role in the evaluation of subtalar instability.
本研究旨在展示定量4D CT在健康志愿者和尸体距下关节评估中的应用。
对15名无距下关节创伤史的健康志愿者和3具尸体进行动态CT前瞻性评估。在旋前-旋后周期中对距下关节进行评估。所有采集（尸体和健康志愿者）均使用320排MDCT扫描仪的间歇序列模式进行。半自动测量距骨和跟骨之间的角度和距离。描述了健康志愿者和尸体（后者在切除颈韧带和骨间韧带之前和之后）的测量变异。平均有效剂量低于0.1 mSv。
在尸体中，部分韧带切断后和完全韧带切断后，关节活动幅度平均分别增加超过19%和22%。对于所进行的三项测量，测量比值的观察者间变异性被认为极佳（ICC>0.87），第四项测量为中等（ICC = 0.57）。描述了健康志愿者关节活动的正常范围，关节活动幅度从6.4%到22.8%不等。
距下关节定量动态CT可提供关节活动的详细分析，支持其在距下关节不稳定评估中的潜在作用。
