Dual energy CT arthrography in shoulder instability: successful iodine removal with virtual non-contrast images and accurate 3D reformats of the glenoid for assessment of bone loss
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Media type:
E-Article
Title:
Dual energy CT arthrography in shoulder instability: successful iodine removal with virtual non-contrast images and accurate 3D reformats of the glenoid for assessment of bone loss
imprint:
Springer Science and Business Media LLC, 2022
Published in:Skeletal Radiology
Language:
English
DOI:
10.1007/s00256-021-03916-3
ISSN:
0364-2348;
1432-2161
Origination:
Footnote:
Description:
<jats:title>Abstract
</jats:title><jats:sec>
<jats:title>Objective</jats:title>
<jats:p>To evaluate the image quality of dual energy CT (DECT) of the shoulder after arthrography and of virtual non-contrast (VNC) 3D reformats of the glenoid and to compare glenoid measurements on VNC 3D reformats and on 2D CTs.</jats:p>
</jats:sec><jats:sec>
<jats:title>Materials and methods</jats:title>
<jats:p>DECT arthrography (80 kV/140 kV) was performed in 42 shoulders of 41 patients with instability using diluted iodinated contrast media (80 mg/ml). VNC images and VNC 3D reformats of the glenoid were calculated using image postprocessing. Dose parameters, CT values of intraarticular iodine and muscle, image contrast (iodine/muscle), and image quality (5-point scale: 1 = worst, 5 = best) were evaluated. Two independent readers assessed glenoid morphology and performed glenoid measurements on 2D and 3D images.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>Calculation of VNC images and VNC 3D reformats was successful in 42/42 shoulders (100%). The effective dose was mean 1.95 mSv (± 0.9 mSv). CT values of iodine and muscle were mean 1014.6 HU (± 235.8 HU) and 64.5 HU(± 8.6 HU), respectively, and image contrast was mean 950.2 HU (± 235.5 HU). Quality of cross-sectional images, VNC images, and VNC 3D reformats was rated good (median 4 (4–5), 4 (3–4), 4 (3–5), respectively). Detection of an osseous defect was equal on 2D and 3D images (13/42, <jats:italic>P</jats:italic> > 0.99) with no difference for measurement of the glenoid diameter with mean 28.3 mm (± 2.8 mm) vs. 28.4 mm (± 2.9 mm) (<jats:italic>P</jats:italic> = 0.5), width of the glenoid defect with 3.2 mm (± 2.1 mm) vs. 3.1 mm (± 2.3 mm) (<jats:italic>P</jats:italic> = 0.84), surface area with 638.5 mm<jats:sup>2</jats:sup> (± 127 mm<jats:sup>2</jats:sup>) vs. 640.8 mm<jats:sup>2</jats:sup> (± 129.5 mm<jats:sup>2</jats:sup>) (<jats:italic>P</jats:italic> = 0.47), and surface area of the defect with 46.6 mm<jats:sup>2</jats:sup> (± 44.3 mm<jats:sup>2</jats:sup>) vs. 47.2 mm<jats:sup>2</jats:sup> (± 48.0 mm<jats:sup>2</jats:sup>) (<jats:italic>P</jats:italic> = 0.73), respectively.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>DECT shoulder arthrography is feasible and allows successful iodine removal with generation of VNC images and accurate VNC 3D reformats of the glenoid for assessment of bone loss.</jats:p>
</jats:sec>