Theopold Jan, Weihs Kevin, Feja Christine, Marquaß Bastian, Josten Christoph, Hepp Pierre
Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
Institute of Anatomy, University of Leipzig, Liebigstrasse 13, 04103, Leipzig, Germany.
BMC Med Imaging. 2017 Aug 1;17(1):47. doi: 10.1186/s12880-017-0201-0.
The purpose of this study was to investigate the accuracy of perforation detection with multiplanar reconstructions using a mobile 3D image intensifier.
In 12 paired human humeri, K-wires perforating the subchondral bone and placed just below the cartilage level were directed toward five specific regions in the humeral head. Image acquisition was initiated by a fluoroscopy scan. Within a range of 90°, 45° external rotation (ER) and 45° internal rotation (IR). The number and percentage of detected perforating screws were grouped and analyzed. Furthermore, the fluoroscopic images were converted into multiplanar CT-like reconstructions. Each K-wire perforation was characterized as "detected" or "not detected".
In the series of fluoroscopy images in the standard neutral position at 30° internal rotation, and 30° external rotation, the perforations of all K-wires (n = 56) were detected. Twenty-nine (51.8%) of them were detected in one AP view, 22 (39.3%) in two AP views, and five (8.9%) in three AP views. All K-wire perforations (100%, n = 56) were detected in multiplanar reconstructions.
In order to reveal all of the intraoperative and postoperative screw perforations in a "five screw configuration", conventional AP images should be established in both the neutral positions (0°), at 30° internal rotation and 30° external rotation. Alternatively, the intraoperative 3D scan with multiplanar reconstructions enables a 100% rate of detection of the screw perforations.
本研究旨在探讨使用移动3D影像增强器通过多平面重建检测穿孔的准确性。
在12对人肱骨中，将穿入软骨下骨并置于软骨水平下方的克氏针指向肱骨头的五个特定区域。通过荧光透视扫描开始图像采集。在90°范围内，进行45°外旋（ER）和45°内旋（IR）。对检测到的穿孔螺钉的数量和百分比进行分组和分析。此外，将荧光透视图像转换为多平面CT样重建图像。每个克氏针穿孔被表征为“检测到”或“未检测到”。
在标准中立位、30°内旋和30°外旋的荧光透视图像系列中，所有克氏针（n = 56）的穿孔均被检测到。其中29个（51.8%）在一个前后位视图中被检测到，22个（39.3%）在两个前后位视图中被检测到，5个（8.9%）在三个前后位视图中被检测到。在多平面重建中检测到所有克氏针穿孔（100%，n = 56）。
为了在“五枚螺钉配置”中揭示所有术中及术后螺钉穿孔，应在中立位（0°）、30°内旋和30°外旋时建立传统的前后位图像。或者，术中进行多平面重建的3D扫描能够实现100%的螺钉穿孔检测率。
