Kohyama Sho, Nishiura Yasumasa, Hara Yuki, Ogawa Takeshi, Ikumi Akira, Okano Eriko, Totoki Yasukazu, Yamazaki Masashi
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Tsuchiura Clinical Education and Training Center, Tsukuba University Hospital, Tsuchiura, Japan.
Eur Radiol. 2021 Aug;31(8):5721-5733. doi: 10.1007/s00330-020-07680-1. Epub 2021 Jan 16.
We developed a novel method to create three-dimensional magnetic resonance imaging-CT (3D MRI-CT) fusion images for detailed lesion evaluation and surgical simulation in capitellar osteochondritis dissecans (COCD). This study aimed to clarify its usefulness.
We enrolled 12 boys with COCD (mean age, 13.8 years) and preoperatively constructed 3D models of the humerus and articular cartilage from MR images obtained with a 3-T imager. For better visualization of the articular cartilage outline, we applied 7 kg of axial traction to the elbow during MRI. We also constructed a 3D model of the humerus from CT images. 3D MRI-CT fusion images were created using both models. The average distance difference between two corresponding points as per the 3D CT and 3D MRI models of the humerus was evaluated. Using the 3D MRI-CT fusion images, we measured longitudinal and transverse lesion diameters; evaluated articular cartilage fissures and defects, articular surface deformities, and the International Cartilage Repair Society (ICRS) classification; and validated the results using intraoperative findings.
The mean average distance difference was 0.75 mm. The 3D MRI-CT fusion images accurately reproduced lesion conditions in every case and correctly predicted the ICRS classification with 100% accuracy. Preoperatively measured longitudinal and transverse lesion diameters were not significantly different from intraoperative measurements (p = 0.79, 0.32 respectively).
3D MRI-CT fusion images provide a detailed evaluation of COCD lesion severity by presenting the exact positional relationship between the articular cartilage and subchondral bone.
• We developed a novel method to create three-dimensional magnetic resonance imaging-computed tomography (3D MRI-CT) fusion images for the evaluation of capitellar osteochondritis dissecans. • 3D MRI-CT fusion images enabled the accurate prediction of lesions and provided a detailed evaluation of lesion severity by presenting the exact positional relationship between the articular cartilage and subchondral bone.
我们开发了一种新方法来创建三维磁共振成像 - 计算机断层扫描（3D MRI - CT）融合图像，用于详细评估肱骨小头剥脱性骨软骨炎（COCD）的病变情况并进行手术模拟。本研究旨在阐明其效用。
我们纳入了12名患有COCD的男孩（平均年龄13.8岁），术前从3T成像仪获取的MR图像构建肱骨和关节软骨的三维模型。为了更好地显示关节软骨轮廓，在MRI检查期间对肘部施加7千克的轴向牵引力。我们还从CT图像构建了肱骨的三维模型。使用这两个模型创建3D MRI - CT融合图像。评估肱骨的3D CT和3D MRI模型中两个对应点之间的平均距离差异。使用3D MRI - CT融合图像，我们测量病变的纵向和横向直径；评估关节软骨裂缝和缺损、关节表面畸形以及国际软骨修复协会（ICRS）分类；并使用术中发现验证结果。
平均平均距离差异为0.75毫米。3D MRI - CT融合图像在每种情况下都准确再现了病变情况，并以100%的准确率正确预测了ICRS分类。术前测量的病变纵向和横向直径与术中测量值无显著差异（分别为p = 0.79，0.32）。
3D MRI - CT融合图像通过呈现关节软骨与软骨下骨之间的确切位置关系，对COCD病变严重程度进行了详细评估。
• 我们开发了一种新方法来创建三维磁共振成像 - 计算机断层扫描（3D MRI - CT）融合图像，用于评估肱骨小头剥脱性骨软骨炎。• 3D MRI - CT融合图像能够准确预测病变，并通过呈现关节软骨与软骨下骨之间的确切位置关系，对病变严重程度进行详细评估。
