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DOI: 10.1055/s-0041-1731565
Resurgence of CT for Musculoskeletal Applications: Where Are We in 2021?
Presentation Format: Educational poster presentation.
Purpose or Learning Objective: To illustrate the value of computed tomography (CT) for musculoskeletal applications CT compared with other imaging modalities and also illustrate its problem-solving capacities.
Methods or Background: Magnetic resonance imaging (MRI) has become the standard of care in musculoskeletal imaging except in trauma and the emergency setting. Recent technological improvements in CT technology have contributed to a renewed interest of musculoskeletal applications of CT.
Results or Findings
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Dual-energy CT
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- Allows precise characterization of urate crystals from other types of crystalline deposition.
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- Detects bone marrow edema in radiographic occult fractures and osteomyelitis.
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- Reduces metal artifacts.
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Cone beam computed tomography (CBCT)
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- Offers high spatial resolution at low dose.
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- Plays an emergent role for a more precise diagnosis of fractures, local extent, complexity of fractures, dislocations, and for follow-up.
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Characterizations of lesions: certain CT characteristics can suggest a specific diagnosis.
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- The mineralization matrix: osteoid in bone-forming tumors, ground-glass appearance in fibrous dysplasia, and high-density attenuation measurements in enostosis.
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- Detection of the nidus and central calcification in osteoid osteoma.
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Fracture evaluation
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- CT volume-rendered three-dimensional reconstruction allows for improved visualization of complex fractures, preoperative planning, and postoperative follow-up.
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Staging of cartilage lesions
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- Although MRI is the initial technique to detect osteochondral lesions, increased spatial resolution of CBCT arthrography permits excellent assessment of the articular cartilage.
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Hybrid imaging
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- Imaging techniques such as positron emission tomography/CT (PET/CT) or single-photon emission/computed tomography (SPECT/CT) allow the direct fusion of morphological information and functional information.
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Biomechanical information
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- Four-dimensional computed tomography (4DCT) may provide a thorough understanding of the pathophysiology of joint kinematics and instability.
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CT-guided intervention
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- CT-guided intervention plays a critical role in interventional procedures such as biopsy, abscess drainage, tumor ablation, catheter placement, and minimally invasive spinal surgery.
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- Compared with fluoroscopic guidance, the major advantage of CT is the cross-sectional visualization of the anatomy and interventional materials.
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Conclusion: Although MRI is regarded as the preferred imaging modality for the assessment of musculoskeletal lesions, recent technological improvements have made CT a valuable tool to evaluate selected musculoskeletal problems and to tackle specific clinical scenarios.
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Die Autoren geben an, dass kein Interessenkonflikt besteht.
Publikationsverlauf
Artikel online veröffentlicht:
03. Juni 2021
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