The Preliminary Application Of Gemstone Spectral Imaging HDCT In Lesions Of Tendons Of Hand And Foot

Objective:1、To find the best keV in demonstrating tendons of Gemstone spectral imaging HDCT.2、To research the value of Gemstone spectral imaging HDCT in demonstrating anatomy of tendons of hand and foot.3、To evaluate the preliminary application of Gemstone spectral imaging HDCT in lesions of tendons of hand and foot.Materials and Methods:Since October,2010,61patients who suffered from hands or feet tendon diseases were scanned by Gemstone spectral imaging HDCT in the Imaging Department of affiliated Qianfoshan Hospital of Shandong University.Helical thickness:5.0mm,Interval:5.0mm, Scan type:Helical full0.6sec GSI-18,Electricity:640mA, Voltage:140/80kV,Pitch:0.531:1,Coverage speed:17.7mm/sec,Collimation:20.0mm.CT Dose Index volume (CTDIvol):45.97mGy.Scanned area:bilateral hands and wrist joints,bilateral feet and ankle joints if it was necessary.Reform the5.0mm-thicking conventional polychromatic images into0.625mm-thicking monochromatic ones and then send them to AW4.4workstation.Under GSI Viewer.Search the optimal CNR of tendons and their surrounding muscles for three times from three different images using spectral analysis software and write down the matching keV values to calculate their averages.Select30averages random from normal cases to make statistic analysis with SAS software.Compare the monochromatic images with the conventional polychromatic ones with SPSS17.0software.Abstract the series with optimal CNR,Observe and write down the shapes、outlines、 endings and surroundings of tendons by means of post-processing functions such as Volume Rendering Technique(VRT)、Multiplannar Reformation(MPR) and Curved Plannar Reformation(CPR).Using MARS when the patients had Metal fixtures in scanned parts.Results:1、Statistics of the best keV:W=0.956727,P=0.2549>a=0.05,Mean:65.07833,standard deviation:2.99701,95%Confidence interval:(63.96,66.20).So65keV image of tendons and muscles has the optimal CNR.The quality of images acquired at the selected optimal monochromatic level was superior to the conventional polychromatic images (P=0.005<0.05).2、54cases of normal tendons,including24hands and30feet,have normal locations,even density (about87-96Hu),clear,smooth and sharp shapes,and uninterrupted outlines.Almost all the main tendons of hand and foot can be displayed clearly except the endings of flexor digitorum superficialis,extensor indicis, extensor digiti minimi and part of endings of flexor carpi radialis, peroneus longus, the third peroneus and tibialis posterior.3、68cases lesion tendons include:Post-operations of tumors, suture of tendons or fractures were found in23cases; chronic injures in19cases; fractures or dislocations of joint in13cases; tumors or eminence of bones and soft tissue tumors in10cases; rupture of tendo calcaneus in2cases; congenital malformation in1case. The total diagnostic accuracy was89.71%(61/68). Most of the tendon diseases could be diagnosed satisfactorily except the chronic injures.Conclusion:1、65keV is the best monochromatic level to demonstrate tendons.2、Almost all of the tendons in hand and foot can be demonstrated clearly, however, farther tendons in fingers and toes can’t be demonstrated so well. 3、GSI might display hand and foot tendons rupture,post-operation and malformation clearly though the chronic inflammation of tendons cannot be detected so well.