대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제78권1호
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  • Pages.22-29
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  • 2018
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  • 1738-2637(pISSN)
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  • 2951-0805(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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정형외과 임플란트용 금속 인공물 감소법 적용 CT 영상과 표준 여과 후 역투영적용 CT 영상의 비교: 고관절치환술 환자의 수술 후 CT 영상의 가치

Comparison of Metal Artifact Reduction for Orthopedic Implants versus Standard Filtered Back Projection: Value of Postoperative CT after Hip Replacement

  • 임지원 (한림대학교 동탄성심병원 영상의학과) ;
  • 최정아 (한림대학교 동탄성심병원 영상의학과) ;
  • 이선아 (한림대학교 동탄성심병원 영상의학과) ;
  • 길은경 (한림대학교 동탄성심병원 영상의학과)
  • Rim, Jiwon (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital) ;
  • Choi, Jung-Ah (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital) ;
  • Lee, Seun Ah (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital) ;
  • Khil, Eun Kyung (Department of Radiology, Hallym University Dongtan Sacred Heart Hospital)
  • 투고 : 2017.06.08
  • 심사 : 2017.09.21
  • 발행 : 2018.01.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 정형외과 임플란트용 금속 인공물 감소법(Metal Artifact Reduction for Orthopedic Implants; 이하 O-MAR) 적용 CT 영상이 표준 여과 후 역투영적용 CT 영상과 비교하여 영상잡음 감소와 수술 후 합병증 발견에 도움이 되는지 평가해 보고자 하였다. 대상과 방법: 고관절 치환술 시행 후 standard filtered back projection (이하 SFBP)과 O-MAR가 적용된 CT을 얻은 환자 56명을 후향적으로 분석하였다. 관심영역은 비구컵과 대퇴골두가 가장 크게 보이는 영상에서 비구의 전방 및 후방, 인접한 대둔근 및 피하지방, 그리고 소전자가 가장 크게 보이는 영상에서 인공삽입물 근처에 위치하였다. 인공음영 정도의 평가를 위해 SFBP 적용영상과 O-MAR 적용영상에서 region of interests의 평균 Hounsfield unit (이하 HU)과 HU의 표준편차를 계산하여 차이가 있는지 비교하였다. 인공삽입물 주위 합병증을 평가하였고 그 합병증의 가시성을 두 가지 영상재구성기술에서 비교하여 다음과 같이 수치화하였다; 1- SFBP이 더 나음, 2-SFBP이 O-MAR와 동일, 3-O-MAR이 더 나음. 결과: 평균 HU값은 비구 후방, 대둔근, 피하지방에서 O-MAR 적용영상이 유의하게 낮게 나타났다(p < 0.05). HU의 표준편차는 모두에서 O-MAR 적용영상이 유의하게 낮게 나타났다(p < 0.05). 인공삽입물 주위 합병증의 평균 가시성은 2.0으로 두 영상재구성기술이 동등하였다. 결론: O-MAR를 적용하여 재구성된 고관절치환술 후 영상은 SFBP 적용 CT영상과 비교하여 영상 잡음이 통계적으로 의미 있게 감소함을 정량적으로 확인하였다. 반면에 인공삽입물 주위 합병증의 진단은 영상재구성기술의 차이에 영향을 받지 않았다.

Purpose: To evaluate Metal Artifact Reduction for Orthopedic Implants (O-MAR, Philips Healthcare) technique compared with standard filtered back projection (SFBP) technique on post-operative hip CT regarding image noise reduction and detection of post-operative complications. Materials and Methods: Fifty-six hip CT scans after hip replacement with SFBP technique and O-MAR application were retrospectively reviewed. Region of interests (ROIs) were drawn at levels wherein acetabular cup and femoral head were largest at anterior and posterior acetabula, gluteus maximus muscle, subcutaneous fat adjacent to gluteus maximus muscle, and in area adjacent to prosthesis stem wherein lesser trochanter is largest. Hounsfield units (HU) were measured to evaluate artifact quantitatively; mean and standard deviations (SDs) calculated and compared. Periprosthetic complications were evaluated, and visibility rated between two reconstruction techniques; 1-SFBP better, 2-SFBP same as O-MAR, 3-O-MAR better. Results: Average HU was significantly lower in O-MAR at posterior acetabulum, gluteus maximus muscle, and subcutaneous fat (p < 0.05). SD for HU was significantly lower in O-MAR at all ROIs (p < 0.05). Mean visibility of periprosthetic complications was 2.0, so equivalent. Conclusion: Reconstruction with O-MAR technique in post-operative hip CT scans after hip replacement yielded statistically significant decrease in image noise. However, visibility of periprosthetic complications was not impacted by reconstruction technique.

키워드

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피인용 문헌

  1. Dual-Energy and Iterative Metal Artifact Reduction for Reducing Artifacts Due to Metallic Hardware: A Loosening Hip Phantom Study vol.212, pp.5, 2018, https://doi.org/10.2214/ajr.18.20413
  2. Comparison of quantitative measurements of four manufacturer’s metal artifact reduction techniques for CT imaging with a self-made acrylic phantom vol.28, pp.None, 2020, https://doi.org/10.3233/thc-209028