Fiala T G, Novelline R A, Yaremchuk M J
Department of Surgery, Massachusetts General Hospital, Boston.
Plast Reconstr Surg. 1993 Dec;92(7):1227-32.
This study compares the artifacts caused by craniomaxillofacial internal fixation devices in CT images. Mandibular reconstruction and "mini" titanium, Vitallium, and stainless steel systems, "micro" titanium and Vitallium systems, and stainless steel wires were evaluated. The hardware was placed on a nylon grid and submerged in water. CT images were obtained with both bone and soft-tissue window settings. All artifacts were compared and graded after a minimum of five observations each. The severity of "starburst" artifact was found to be related to the physical size of the fixation hardware and its composition. Titanium hardware caused the least amount of artifact. Vitallium and stainless steel fixation devices, with the exception of interfragmentary wiring, produced significantly more artifact. These results agree with theoretical predictions. The data indicate that when postoperative imaging is an important clinical consideration, (1) the least amount of implant material necessary to achieve stable fixation should be used, (2) the proximity of implant material to the area of interest should be considered, and (3) titanium implants produce less artifact than Vitallium or stainless steel implants.
本研究比较了颅颌面内固定装置在CT图像中产生的伪影。对下颌骨重建以及“微型”钛、钴铬合金和不锈钢系统、“微型”钛和钴铬合金系统以及不锈钢丝进行了评估。将硬件放置在尼龙网格上并浸入水中。使用骨窗和软组织窗设置获取CT图像。在对每个硬件至少进行五次观察后，对所有伪影进行比较和分级。发现“星芒状”伪影的严重程度与固定硬件的物理尺寸及其成分有关。钛硬件产生的伪影最少。除了骨碎片间的金属丝外，钴铬合金和不锈钢固定装置产生的伪影明显更多。这些结果与理论预测一致。数据表明，当术后成像成为重要的临床考虑因素时，（1）应使用实现稳定固定所需的最少植入材料，（2）应考虑植入材料与感兴趣区域的接近程度，以及（3）钛植入物产生的伪影比钴铬合金或不锈钢植入物少。
