T-SMART断层融合成像在髋膝关节置换术后影像学检查的意义

Significance of T-SMART in post-operative radiological assessment of total joint replacement

目的探讨断层融合成像技术(tomosynthesis-shimadzu metal artefact reduction technology,T-SMART)在髋膝关节置换患者术后影像学检查中的意义。方法提取2015年1~6月,行T-SMART检查的24例髋膝关节置换术后患者的影像资料[包括数字化X线摄影(digital radiography,DR)、CT],对图像进行主观评价及定量测量,通过比较各种检查方法对假体周围结构的观察效果,研究T-SMART对人工关节假体及其周围结构的显示优势。结果对所得到的图像进行主观评价,T-SMART组优片率为91.7%,DR组优片率为66.7%,而CT组优片率为0%。T-SMART图像显示骨及假体周围结构清晰,较DR有显著优势;在价格、放射剂量、伪影控制等方面,较CT有明显优势。结论 T-SMART能够有效去除伪影,图像质量明显优于DR和CT,可用于关节置换术后假体周围病变的早期诊断,评估假体稳定性,临床意义重大。

Objective To investigate the value of tomosynthesis-shimadzu metal artefact reduction technology（ T-SMART） in post operative radiological assessment of total joint replacement. Methods From Jan 2015 to June 2015, 24 patients who received hip/knee replacement were recruited and the radiological materials, including DR and CT, were compared with subjective evaluation and quantitative measurement. The advantages of T-SMART in observing artificial joint prostheses and its surrounding structure were studied by comparing the observation effects of various radiographic materials. Results The images obtained through the three techniques were subjectively evaluated. The satisfactory rate of T-SMART group was 91.7%, DR group 66.7% and CT group 0%. Compared with DR, the T-SMART showed the bone and periprosthetic structures more clearly. It had significantly more advantages than CT in the price, doses of radiation and the artifacts control. Conclusions T-SMART can effectively remove the artifacts, and the quality of the images was better than DR and CT. It can be used in the early diagnosis of periprosthetic problems after joint replacements, to assess the stability and has clinical significance.