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Rofo 2018; 190(01): 31-41
DOI: 10.1055/s-0043-118127
Review
© Georg Thieme Verlag KG Stuttgart · New York

CT and MRI Techniques for Imaging Around Orthopedic Hardware

CT- und MRT-Bildgebung bei orthopädischen Implantaten
Thuy Duong Do
1   Department of Clinical Radiology, University of Heidelberg, Germany
,
Reto Sutter
2   Radiology, Uniklinik Balgrist, Zurich, Switzerland
,
Stephan Skornitzke
1   Department of Clinical Radiology, University of Heidelberg, Germany
,
Marc-André Weber
1   Department of Clinical Radiology, University of Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

30 November 2016

25 July 2017

Publication Date:
21 September 2017 (online)

Also available at
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Abstract

Orthopedic hardware impairs image quality in cross-sectional imaging. With an increasing number of orthopedic implants in an aging population, the need to mitigate metal artifacts in computed tomography and magnetic resonance imaging is becoming increasingly relevant. This review provides an overview of the major artifacts in CT and MRI and state-of-the-art solutions to improve image quality. All steps of image acquisition from device selection, scan preparations and parameters to image post-processing influence the magnitude of metal artifacts. Technological advances like dual-energy CT with the possibility of virtual monochromatic imaging (VMI) and new materials offer opportunities to further reduce artifacts in CT and MRI. Dedicated metal artifact reduction sequences contain algorithms to reduce artifacts and improve imaging of surrounding tissue and are essential tools in orthopedic imaging to detect postoperative complications in early stages.

Key points 

  • Tissues around orthopaedic hardware can still be well visualised despite metal artifacts.

  • Artefact reduction in CT: acquisition parameters, iterative reconstruction, Dual-energy CT and VMI.

  • Artefact reduction in MRI: choice of device, sequences, acquisition parameters and MARS

Citation Format

  • Do TD, Sutter R, Skornitzke S et al. CT and MRI Techniques for Imaging Around Orthopedic Hardware. Fortschr Röntgenstr 2018; 190: 31 – 41

Zusammenfassung

Orthopädische Implantate verringern die Bildqualität in der Schnittbildgebung. Bei steigendem Einsatz von orthopädischen Implantaten in einer alternden Bevölkerung ist eine Metallartefaktreduktion von zunehmender Bedeutung. Im folgenden Review möchten wir einen Überblick über die wesentlichen Artefakte in der Computertomografie und Magnetresonanztomografie sowie die neuesten Standards zur Verbesserung der Bildqualität geben. Alle Schritte der Bildakquisition von Gerätewahl über Scanvorbereitungen und -parameter bis hin zur Bildverarbeitung beeinflussen das Ausmaß der Metallartefakte. Technische Fortschritte wie die Dual-energy-Computertomografie mit der Option der Virtuellen monochromatischen Bildgebung sowie neue Implantatmaterialien bieten weitere Möglichkeiten der Metallartefaktreduktion in CT und MRT. Dezidierte Metallartefakt-Sequenzen beinhalten Algorithmen zur Artefaktreduktion und zur Verbesserung der Bildqualität des umgebenden Gewebes und sind essenzielle Werkzeuge in der orthopädischen Bildgebung zur frühzeitigen Detektion von postoperativen Komplikationen.

Kernaussagen:

  • Periprothetisches Weichteilgewebe können trotz Metallartefakte gut visualisiert werden

  • Artefaktreduktion in der Computertomographie: Akquisitionsparameter, iterative Rekonstruktionen, Dual-energy CT und VMS

  • Artefaktreduktion im MRT: Gerätewahl, Sequenzen, Akquisitionsparameter und MARS

Key words

metal artifact - artifact reduction - MRI - CT
 

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