TY  - JOUR
A1  - Patzer, Theresa Sophie
A1  - Kunz, Andreas Steven
A1  - Huflage, Henner
A1  - Conrads, Nora
A1  - Luetkens, Karsten Sebastian
A1  - Pannenbecker, Pauline
A1  - Paul, Mila Marie
A1  - Ergün, Süleyman
A1  - Bley, Thorsten Alexander
A1  - Grunz, Jan-Peter
T1  - Ultrahigh-resolution photon-counting CT in cadaveric fracture models: spatial frequency is not everything
JF  - Diagnostics
N2  - In this study, the impact of reconstruction sharpness on the visualization of the appendicular skeleton in ultrahigh-resolution (UHR) photon-counting detector (PCD) CT was investigated. Sixteen cadaveric extremities (eight fractured) were examined with a standardized 120 kVp scan protocol (CTDI\(_{vol}\) 10 mGy). Images were reconstructed with the sharpest non-UHR kernel (Br76) and all available UHR kernels (Br80 to Br96). Seven radiologists evaluated image quality and fracture assessability. Interrater agreement was assessed with the intraclass correlation coefficient. For quantitative comparisons, signal-to-noise-ratios (SNRs) were calculated. Subjective image quality was best for Br84 (median 1, interquartile range 1–3; p ≤ 0.003). Regarding fracture assessability, no significant difference was ascertained between Br76, Br80 and Br84 (p > 0.999), with inferior ratings for all sharper kernels (p < 0.001). Interrater agreement for image quality (0.795, 0.732–0.848; p < 0.001) and fracture assessability (0.880; 0.842–0.911; p < 0.001) was good. SNR was highest for Br76 (3.4, 3.0–3.9) with no significant difference to Br80 and Br84 (p > 0.999). Br76 and Br80 produced higher SNRs than all kernels sharper than Br84 (p ≤ 0.026). In conclusion, PCD-CT reconstructions with a moderate UHR kernel offer superior image quality for visualizing the appendicular skeleton. Fracture assessability benefits from sharp non-UHR and moderate UHR kernels, while ultra-sharp reconstructions incur augmented image noise.
KW  - photon-counting
KW  - tomography
KW  - X-ray computed
KW  - fracture
KW  - cancellous bone
KW  - convolution kernel
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-319281
SN  - 2075-4418
VL  - 13
IS  - 10
ER  - 
TY  - JOUR
A1  - Huflage, Henner
A1  - Karsten, Sebastian
A1  - Kunz, Andreas Steven
A1  - Conrads, Nora
A1  - Jakubietz, Rafael Gregor
A1  - Jakubietz, Michael Georg
A1  - Pennig, Lenhard
A1  - Goertz, Lukas
A1  - Bley, Thorsten Alexander
A1  - Schmitt, Rainer
A1  - Grunz, Jan-Peter
T1  - Improved diagnostic accuracy for ulnar-sided TFCC lesions with radial reformation of 3D sequences in wrist MR arthrography
JF  - European Radiology
N2  - Objectives
Triangular fibrocartilage complex (TFCC) injuries frequently cause ulnar-sided wrist pain and can induce distal radioulnar joint instability. With its complex three-dimensional structure, diagnosis of TFCC lesions remains a challenging task even in MR arthrograms. The aim of this study was to assess the added diagnostic value of radial reformatting of isotropic 3D MRI datasets compared to standard planes after direct arthrography of the wrist.
Methods
Ninety-three patients underwent wrist MRI after fluoroscopy-guided multi-compartment arthrography. Two radiologists collectively analyzed two datasets of each MR arthrogram for TFCC injuries, with one set containing standard reconstructions of a 3D thin-slice sequence in axial, coronal and sagittal orientation, while the other set comprised an additional radial plane view with the rotating center positioned at the ulnar styloid. Surgical reports (whenever available) or radiological reports combined with clinical follow-up served as a standard of reference. In addition, diagnostic confidence and assessability of the central disc and ulnar-sided insertions were subjectively evaluated.
Results
Injuries of the articular disc, styloid and foveal ulnar attachment were present in 20 (23.7%), 10 (10.8%) and 9 (9.7%) patients. Additional radial planes increased diagnostic accuracy for lesions of the styloid (0.83 vs. 0.90; p = 0.016) and foveal (0.86 vs. 0.94; p = 0.039) insertion, whereas no improvement was identified for alterations of the central cartilage disc. Readers' confidence (p < 0.001) and assessability of the ulnar-sided insertions (p < 0.001) were superior with ancillary radial reformatting.
Conclusions
Access to the radial plane view of isotropic 3D sequences in MR arthrography improves diagnostic accuracy and confidence for ulnar-sided TFCC lesions.
KW  - joint instability
KW  - wrist
KW  - arthrography
KW  - magnetic resonance imaging
KW  - triangular fibrocartilage
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-266512
SN  - 1432-1084
VL  - 31
IS  - 12
ER  -