School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Edgbaston, UK. B15 2TT.
Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, London, UK. SE1 9RT.
Acta Biomater. 2020 Apr 15;107:338-348. doi: 10.1016/j.actbio.2020.02.038. Epub 2020 Feb 28.
Magnetic Resonance Imaging (MRI) is critical in diagnosing post-operative complications following implant surgery and imaging anatomy adjacent to implants. Increasing field strengths and use of gradient-echo sequences have highlighted difficulties from susceptibility artefacts in scan data. Artefacts manifest around metal implants, including those made from titanium alloys, making detection of complications (e.g. bleeding, infection) difficult and hindering imaging of surrounding structures such as the brain or inner ear. Existing research focusses on post-processing and unorthodox scan sequences to better capture data around these devices. This study proposes a complementary up-stream design approach using lightweight structures produced via additive manufacturing (AM). Strategic implant mass reduction presents a potential tool in managing artefacts. Uniform specimens of Ti-6Al-4V structures, including lattices, were produced using the AM process, selective laser melting, with various unit cell designs and relative densities (3.1%-96.7%). Samples, submerged in water, were imaged in a 3T MRI system using clinically relevant sequences. Artefacts were quantified by image analysis revealing a strong linear relationship (RR = 0.99) between severity and relative sample density. Likewise, distortion due to slice selection errors showed a squared relationship (RR = 0.92) with sample density. Unique artefact features were identified surrounding honeycomb samples suggesting a complex relationship exists for larger unit cells. To demonstrate clinical utility, a honeycomb design was applied to a representative cranioplasty. Analysis revealed 10% artefact reduction compared to traditional solid material illustrating the feasibility of this approach. This study provides a basis to strategically design implants to reduce MRI artefacts and improve post-operative diagnosis capability. STATEMENT OF SIGNIFICANCE: MRI susceptibility artefacts surrounding metal implants present a clinical challenge for the diagnosis of post-operative complications relating to the implant itself or underlying anatomy. In this study for the first time we demonstrate that additive manufacturing may be exploited to create lattice structures that predictably reduce MRI image artefact severity surrounding titanium alloy implants. Specifically, a direct correlation of artefact severity, both total signal loss and distortion, with the relative material density of these functionalised materials has been demonstrated within clinically relevant MRI sequences. This approach opens the door for strategic implant design, utilising this structurally functionalised material, that may improve post-operative patient outcomes and compliments existing efforts in this area which focus on data acquisition and post-processing methods.
磁共振成像(MRI)在诊断植入手术后的并发症和成像毗邻植入物的解剖结构方面至关重要。随着磁场强度的增加和梯度回波序列的使用,扫描数据中的磁敏感性伪影问题日益凸显。这些伪影出现在金属植入物周围,包括钛合金制成的植入物,使得并发症(如出血、感染)的检测变得困难,并阻碍了对大脑或内耳等周围结构的成像。现有研究侧重于后处理和非常规扫描序列,以更好地捕捉这些设备周围的数据。本研究提出了一种使用增材制造(AM)生产的轻量级结构的互补上游设计方法。战略性地减少植入物的质量可能是管理伪影的一种潜在工具。使用 AM 工艺选择性激光熔化制造了包括晶格在内的 Ti-6Al-4V 结构的均匀样本,具有各种单元胞设计和相对密度(3.1%-96.7%)。将样本浸入水中,在 3T MRI 系统中使用临床相关序列进行成像。通过图像分析量化伪影,发现严重程度与样本相对密度之间存在很强的线性关系(RR=0.99)。同样,由于切片选择错误引起的失真与样本密度呈平方关系(RR=0.92)。围绕蜂窝状样本确定了独特的伪影特征,这表明对于较大的单元胞存在复杂的关系。为了展示临床实用性,将蜂窝设计应用于代表性的颅骨修复体。分析表明,与传统实心材料相比,该设计可将伪影减少 10%,这证明了这种方法的可行性。本研究为有策略地设计植入物以减少 MRI 伪影并提高术后诊断能力提供了依据。
金属植入物周围的 MRI 磁敏感性伪影对与植入物本身或其下解剖结构相关的术后并发症的诊断构成了临床挑战。在这项研究中,我们首次证明,增材制造可以用来创建预测性地降低钛合金植入物周围 MRI 图像伪影严重程度的晶格结构。具体来说,在临床相关的 MRI 序列中,已经证明了伪影严重程度(总信号丢失和失真)与这些功能化材料的相对材料密度之间存在直接相关性。这种方法为利用这种结构功能化材料进行战略性植入物设计开辟了道路,这可能会改善术后患者的预后,并补充了该领域现有专注于数据采集和后处理方法的努力。