| [Research Background and Objective] With the rapid development of medical techniques and the improvement of human life quality requirements, more and more operations of artificial joint replacement should be accepted by patients with joint disease. So the assessment on the stability of artificial joint replacement has become more and more important. Because there are obvious metal artifacts in CT imaging and metal implant (except titanium alloy) is inadaptable for MRI examination. X-ray is still the most commonly method for assessing the artificial joint replacement. But it’s difficult to observe the details around the prosthesis according to significant overlapping structural in the X-ray plain film. DTS can avoid the influence of metal artifact and the structural overlaps of the deep and complex parts, but the FBP will have a certain degree of linear shadows around the bone prosthesis. T-smart (Tomosynthesis-Shimadzu metal artifact reduction technology)-metal separation, iterative reconstruction method is a new developed image reconstruction method based on the DTS, which can effectively eliminate the linear shadows between the bone and the metal prosthesis. But up to now, few scholars assessed the artificial joint replacement by T-smart technology. This paper aims to analyze the clinical significance about T-smart technique on the artificial joint replacement operation.And providing reliable and effective imaging evidence in the later period follow-up activities.[ Material and Method] 39 patients after the artificial joint replacement (54 joints in total) were examined with T-smart. All patients were well informed and all informed consent, The TOMOS program with the advanced SHIMADZU Sonia vision safire17 digital large flat X-ray radiography system was applied by choosing the appropriate conditions taking considerations of specific parts. And two reconstruction images were obtained through the two reconstruction methods of FBP and T-Smart.5 cases of the patients were examined by 64-lice CT scanning according to the default mode; 3cases accepted the MR examination, which scanned the hip-joint and keen-joint using the1.5T GE superconducting magnetic resonance scanner. Finally, the images quality of the DTS, CT and MRI and according to different algorithm by the FBP and the T-smart were compared and analyzed.[Result] Of the 39 patients, for FBP images,15 cases got 4 points accounting for 38.5%; 22 cases got 3 points,16 cases got 2 points,1 case got 1 point so the average point was 2.94; for T-smart images,31 cases got 4 points, accounting for 79.5%,18 cases got 3 points,5cases got 2 points, no cases got 1 point so the average point is 3.48. According to analysis we got that there were significant differences between the two reconstruction image methods so the research has statistical values (t=6.28, P<0.05). Comparing with CT and MRI imaging, we could see that the reconstructed images using the T-smart had no metallic artefacts while the images using the MSCT and MRI scanning had so many metallic artefacts and the effect of the metal joint replacement couldn’t be determined.[Conclusion] For assessing the image quality with the artificial joint replacement and compared with the reconstructed images using different algorithm, it was easy to see that the reconstructed image using the T-Smart was better in quality using FBP. The T-smart method had eliminated all the artifacts. The relationship between the artificial prosthesis and the surrounding bones can be clearly displayed, then the doctors can find the postoperative complications such as artificial prosthesis loosening and metal wear particles. In conclusion T-Smart should be used as the main checking method of the assessment on the stability of the artificial joint replacement. |
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