Single photon emission computerized tomography and conventional computerized tomography (SPECT/CT) for evaluation of patients after anterior cruciate ligament reconstruction: a novel standardized algorithm combining mechanical and metabolic information.

Autor: Hirschmann MT; Department of Orthopaedic Surgery and Traumatology, Kantonsspital Bruderholz, 4101, Bruderholz, Switzerland. Michael.Hirschmann@ksbh.ch, Mathis D, Afifi FK, Rasch H, Henckel J, Amsler F, Wagner CR, Friederich NF, Arnold MP
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2013 Apr; Vol. 21 (4), pp. 965-74. Date of Electronic Publication: 2012 Jun 13.
DOI: 10.1007/s00167-012-2083-6
Abstrakt: Purpose: The purpose of this study was to introduce a novel standardized algorithm using SPECT/CT, which promises the potential combined assessment of the biology of the joint in particular the bone-graft-fixation complex and the 3D tunnel placement in patients after ACL reconstruction. Its clinical application and inter- and intra-observer reliability should be critically evaluated.
Methods: A novel SPECT/CT localization scheme consisting of 13 tibial, 9 femoral and 4 patellar regions on standardized axial, coronal and sagittal slices is proposed. The tracer activity on SPECT/CT was localized and recorded in 25 consecutive patients using a 3D volumetric and quantitative analysis software. The inter- and intra-observer reliability was assessed for localization and tracer activity. The tunnel position was assessed in 3D-CT using standardized frames of reference. The inter- and intra-observer reliability (OR) of the measured distances were calculated (ICC).
Results: The localization scheme for tracer uptake analysis was useful and easily applicable in all 25 knees. It showed very high inter-OR and intra-ORs for all regions (ICC > 0.80). Tibial and femoral tunnel position measurements showed strong agreement between the readings of the two observers; the ICCs for the position, angulation, length and entry point of the femoral tunnel were >0.88 (intra-OR) and >0.86 (inter-OR). The ICC for the position of the tibial tunnel (angulation, length and entry point) was >0.79 (intra-OR) and >0.74 (inter-OR).
Conclusions: The SPECT/CT algorithm presented is highly reliable and clinically feasible. Combining the 3D-mechanical information on tunnel placement and attachment areas and the 3D metabolic data will be helpful in evaluating patients with pain after ACL reconstruction.
Databáze: MEDLINE
Externí odkaz: