Orthopedic Hardware Complications Diagnosed with Multi–Detector Row CT

Ohashi, Kousaburo; El‐Khoury, Georges Y.; Bennett, D. Lee; Restrepo, José Manuel; Berbaum, Kevin S.

doi:10.1148/radiol.2372041681

Cited by 44 publications

(21 citation statements)

References 25 publications

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“…The detection rate of hardware complication (hardware malplacement or fracture, persistent non-union or perihardware fracture, septic or mechanical loosening) is higher with MDCT than with radiography, both in the spine and in the appendicular skeleton [11].…”

Section: Clinical Indications For Mdct Of the Patient With Metal Hardmentioning

confidence: 96%

Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art

et al. 2009

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The projectional nature of radiogram limits its amount of information about the instrumented spine. MRI and CT imaging can be more helpful, using cross-sectional view. However, the presence of metal-related artifacts at both conventional CT and MRI imaging can obscure relevant anatomy and disease. We reviewed the literature about overcoming artifacts from metallic orthopaedic implants at high-field strength MRI imaging and multi-detector CT. The evolution of multichannel CT has made available new techniques that can help minimizing the severe beam-hardening artifacts. The presence of artifacts at CT from metal hardware is related to image reconstruction algorithm (filter), tube current (in mA), X-ray kilovolt peak, pitch, hardware composition, geometry (shape), and location. MRI imaging has been used safely in patients with orthopaedic metallic implants because most of these implants do not have ferromagnetic properties and have been fixed into position. However, on MRI imaging metallic implants may produce geometric distortion, the so-called susceptibility artifact. In conclusion, although 140 kV and high milliamperage second exposures are recommended for imaging patients with hardware, caution should always be exercised, particularly in children, young adults, and patients undergoing multiple examinations. MRI artifacts can be minimized by positioning optimally and correctly the examined anatomy part with metallic implants in the magnet and by choosing fast spin-echo sequences, and in some cases also STIR sequences, with an anterior to posterior frequencyencoding direction and the smallest voxel size.

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Section: Clinical Indications For Mdct Of the Patient With Metal Hardmentioning

confidence: 96%

Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art

et al. 2009

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“…However, MPR images often suffer from the same technical failures as conventional CT, with the presence of artifacts related to hardware placement, whereas volume-rendered 3D CT images may be viewed with a wide range of opacities, from opaque to transparent, enabling substantial reduction of metal artifacts [9,19], a distinct advantage over both axial and MPR views (Figs. 6c, 7a, b).…”

Section: Optimal Imaging Techniques In the Post-operative Settingmentioning

confidence: 99%

Recognition, assessment, and treatment of non-union after surgical fixation of fractures: emphasis on 3D CT

et al. 2011

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For the post-operative patient, conventional axial computed tomography (CT) imaging and 2D multiplanar reconstruction are of limited value because of the beam-hardening artifact. However, three-dimensional (3D) CT imaging is an effective means of detecting subtle fracture healing, or confirming non-union, and for evaluating the integrity of metal hardware. In this article we emphasize the advantages of 3D CT imaging in the assessment and preoperative planning of non-union for patients who have been surgically treated for fractures.

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“…Fatty degeneration of the rotator cuff muscles is commonly assessed by a grading system published by Goutallier et al [10] (Table 1). CT is also useful in the detection of periprosthetic fracture of the humerus, stress fractures of the acromion, and the coracoid as well as prosthetic loosening [11] (Fig. 5).…”

Section: Computed Tomographymentioning

confidence: 99%

Shoulder arthroplasty

2008

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Shoulder prostheses are now commonly used. Clinical results and patient satisfaction are usually good. The most commonly used types are humeral hemiarthroplasty, unconstrained total shoulder arthroplasty, and semiconstrained inversed shoulder prosthesis. Complications of shoulder arthroplasty depend on the prosthesis type used. The most common complications are prosthetic loosening, glenohumeral instability, periprosthetic fracture, rotator cuff tears, nerve injury, infection, and deltoid muscle dysfunction. Standard radiographs are the basis of both pre- and postoperative imaging. Skeletal scintigraphy has a rather limited role because there is overlap between postoperative changes which may persist for up to 1 year and early loosening and infection. Sonography is most commonly used postoperatively in order to demonstrate complications (hematoma and abscess formation) but may also be useful for the demonstration of rotator cuff tears occurring during follow-up. CT is useful for the demonstration of bone details both pre- and postoperatively. MR imaging is mainly used preoperatively, for instance for demonstration of rotator cuff tears.

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Orthopedic Hardware Complications Diagnosed with Multi–Detector Row CT

Abstract: Multi-detector row CT is an effective tool for depicting orthopedic hardware complications.

Cited by 44 publications

References 25 publications

Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art

Metal-related artifacts in instrumented spine. Techniques for reducing artifacts in CT and MRI: state of the art

Recognition, assessment, and treatment of non-union after surgical fixation of fractures: emphasis on 3D CT

Shoulder arthroplasty

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