Cone-beam computed tomography arthrography: an innovative modality for the evaluation of wrist ligament and cartilage injuries

Ramdhian-Wihlm, Reeta; Minor, Jean-Marie Le; Schmittbuhl, Matthieu; Jeantroux, J.; Mahon, Peter Mac; Veillon, F.; Dosch, Jean-Claude; Dietemann, Jean-Louis; Bierry, Guillaume

doi:10.1007/s00256-011-1305-1

Cited by 30 publications

(10 citation statements)

References 35 publications

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“…A comparative evaluation of wrist ligament and cartilage injuries has previously been performed for CBCT and cadaveric specimens by Ramdhian-Wihlm et al (3). They found 100% accuracy for cartilage tears, 77% for TFCC tears, and 74% for Sl/lT ligament tears, in concordance with our findings of 92%, 77%, and 73%.…”

Section: Discussionsupporting

confidence: 90%

Radiocarpal Injuries: Cone Beam Computed Tomography Arthrography, Magnetic Resonance Arthrography, and Arthroscopic Correlation among 21 Patients

et al. 2016

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Cone beam computed tomography is an emerging imaging modality that offers several advantages over computed tomography and magnetic resonance imaging. Its usefulness particularly in ligamentous injuries should be further explored in a larger study. Cone beam computed tomography arthrography seems to offer similar sensitivity, specificity, and accuracy compared to magnetic resonance arthrography and therefore serves as a valuable option in evaluating patients with wrist pain.

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Section: Discussionsupporting

confidence: 90%

Radiocarpal Injuries: Cone Beam Computed Tomography Arthrography, Magnetic Resonance Arthrography, and Arthroscopic Correlation among 21 Patients

et al. 2016

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“…Flat-panel (FP) detectors which consist of cesium-iodide (CsI) scintillator crystals however differ in physical design and potentially enable much higher spatial resolution with isotropic voxel sizes of up to 0.154 mm [9,10]. New cone beam CTs use FP detectors and have recently been shown to allow for accurate wrist assessment at high spatial resolution [11] including the intrinsic wrist ligaments when CT arthrography is performed [12]. Modern angiographic systems are also typically equipped with these FP detectors.…”

Section: Introductionmentioning

confidence: 99%

C-arm flat-panel CT arthrography of the wrist and elbow: first experiences in human cadavers

et al. 2012

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“…CT arthrography is a method in which the contrast agent is injected into the joint of the patient, and the joint surfaces are immediately evaluated from the image. CT arthrography has been used to diagnose cartilage lesions, with sensitivity of 80–94% for grade 2 lesions in shoulder and sensitivity of 82% in wrist …”

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confidence: 99%

In vivo diagnostics of human knee cartilage lesions using delayed CBCT arthrography

et al. 2013

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The aim of this study was to investigate the feasibility of delayed cone beam (CBCT) arthrography for clinical diagnostics of knee cartilage lesions. Knee joints with cartilage lesions were imaged using native radiography, MRI, and delayed CBCT arthrography techniques in vivo. The joints were imaged three times with CBCT, just before, immediately after (arthrography) and 45 min after the intra-articular injection of contrast agent. The arthrographic images enabled sensitive detection of the cartilage lesions. Use of arthrographic and delayed images together with their subtraction image enabled also detection of cartilage with inferior integrity. The contrast agent partition in intact cartilage (ICRS grade 0) was lower (p < 0.05) than that of cartilage surrounding the ICRS grade I-IV lesions. Delayed CBCT arthrography provides a novel method for diagnostics of cartilage lesions. Potentially, it can also be used in diagnostics of cartilage degeneration. Due to shorter imaging times, higher resolution, and lower costs of CT over MRI, this technique could provide an alternative for diagnostics of knee pathologies. However, for comprehensive evaluation of the clinical potential of the technique a further clinical study with a large pool of patients having a wide range of cartilage pathologies needs to be conducted. Keywords: cartilage lesions; contrast agent diffusion; computed tomography; delayed CBCT arthrography; osteoarthrosis Cartilage lesions are common and can lead to progressive joint degeneration at high cost for the healthcare system. Early diagnosis and grading of cartilage lesions could improve the early selection of treatment, enable monitoring the effect of new treatments and therefore reduce the risk for post traumatic osteoarthritis (OA).Detection of acute cartilage lesions or early OA is challenging since cartilage is not visible in X-ray imaging. Resolution of magnetic resonance imaging (MRI) is limited, and queuing times are long, but it is still the routine method used in cartilage lesion diagnostics and in clinical decision making for or against arthroscopy. In planar X-ray imaging the Xray attenuation of the cartilage is similar with that of the surrounding soft tissues and therefore cartilage is not visible in the images. For this reason diagnosis is mainly based on decreased joint separation and changes in subchondral bone. On the other hand, MRI is not based on ionizing radiation and can be used to visualize soft tissues enabling detection of cartilage defects. Cone beam computed tomography (CBCT) utilizes a conical X-ray beam, covering a large volume with a single rotation about the patient. Due to differences in imaging geometry and collimation of X-rays the radiation dose of CBCT is much smaller than that of spiral CT.1 MRI is especially useful for diagnostics of meniscal tears and lesions of anterior cruciate ligament (ACL) with accuracies of 81% to 98% and specificities of 69% to 98%, respectively, 2 but in the diagnostics of cartilage lesions its sensitivity and specificity ha...

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Cone-beam computed tomography arthrography: an innovative modality for the evaluation of wrist ligament and cartilage injuries

Abstract: CBCT arthrography appears to be an innovative alternative to MDCT arthrography of the wrist as it allows an accurate and low radiation dose evaluation of ligaments and cartilage.

Cited by 30 publications

References 35 publications

Radiocarpal Injuries: Cone Beam Computed Tomography Arthrography, Magnetic Resonance Arthrography, and Arthroscopic Correlation among 21 Patients

Radiocarpal Injuries: Cone Beam Computed Tomography Arthrography, Magnetic Resonance Arthrography, and Arthroscopic Correlation among 21 Patients

C-arm flat-panel CT arthrography of the wrist and elbow: first experiences in human cadavers

In vivo diagnostics of human knee cartilage lesions using delayed CBCT arthrography

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