Applications And Comparion Of Computed Tomography Spectral Imaging And Magnetic Resonance Imaging In Hand Or Foot Tendon Disease

Objective To perform a preliminarily investigation of the value of CT spectral imaging (Gemstone Spectral Imaging GSI) and magnetic resonance imaging (MRI) in hand or foot tendon anatomy and disease diagnosis,and can provide useful images for clinical practice. Method hand or foot (Department of Medical Imaging, Qianfoshan hospital affiliated to Shandong University) images of60patients who had undergone GSI and MRI between October,2010and December,2011were analyzed.52patients were confirmed by surgery, pathology,patient history, clinical signs, or other information, Patients presented with6types of tendon disease in line with operation and clinical diagnosis:absence type, compression type, rupture type, adhesion type, degenerative type and tendinous sheath diseases, normal tendon of8patient were used for control group.scanning device:Gemstone spectral imaging (GSI) mode Of GE Dual-energy CT(DECT) system(Discovery CT750HD,GE Healthcare,Milwaukee,Wisconsin); GE1.5T MRI (GE Healthcare signal1.5T HD), limbs specified surface coil and8-channel head coil.MRI scanning sequence:FSE FS PDWI、FSE T1WI、T2WI、3D FSPGR T1WI. scanning position:transverse section, oblique sagittal section, coronal section.image processing:The Kiloelectron volts (KeV) of optimal contrast-to-noise ratio (Optimal CNR) for viewing tendons compared to surrounding soft tissues was selected using energy spectrum analysis software, The Polychromatic images were reconstructed to create monochromatic images using optimal KeV with the slice thickness of0.625mm and spacing of0.625mm, images were then transferred to a workstation where image-processing techniques such as volume rendering (VR), multiple planner reconstruction (MPR), and curved planner reconstruction (CPR) were applied.images of3D FSPGR T1WI were then transferred to a workstation where image-processing techniques such as MPR, CPR were applied. Image evaluation:GSI and MRI images were analyzed by2image experts. The images were evaluated for three methods:CT images quality; The ability to display tendon anatomy and injury; comparison of their ability to reveal tendon disease. GSI and MRI images of tendon disease were compared using SAS9.0software,P<0.05was considered satistically significant.Results Normal anatomy of most tendons could be seen clearly in GSI and MRI, MRI can revealed proximal part of middle phalanx midpiece of extensor digital tendon except distal aponeurosis dorsalis digiti. GSI better displayed flexor tendons than extensor tendons and could not provide images of the distal part of the proximal phalanx midpiece of the extensor digitorum tendon. The image quality of the tendon itself and the contrast of tendons to surrounding tissues were better, especially,GSI can decrease beam-hardening artifacts and image noise,Thus,it can increase image contrast. GSI and MRI both displayed most tendon diseases, There were no Statistical differences between GSI and MRI with regard to tendon compression (χ2=0.5, P>0.05), absence (χ2=0, P>0.05),rupture (χ2=0, P>0.05), and adhesion (χ2=0, P>0.05).,but less sensitivity significantly than MRI in revealing tendon degeneration (χ2=4.17, P<0.05) and tendinous sheath disease (χ2=10.08, P<0.05). Conclusion MRI is usually the preferred imaging method for tendon disease, especially in diagnosing the early stages of tendon and tendinous sheath diseases,and could evaluate treatment outcome after tendon repaired of hand or foot. GSI is great value for imaging of hand or foot tendon injury, it offer a new imaging mode to display tendon anatomy and lesion of hand or foot,and can provide useful images for clinical practice.