4D CT Imaging for Improved Diagnosis and Treatment of Wrist Ligament Injuries

4D CT 成像可改善手腕韧带损伤的诊断和治疗

• 批准号: 9905487
• 负责人: Kristin Daigle Zhao
• 金额: $ 46.59万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9905487
• 关键词: 3-Dimensional; Address; Affect; Arthritis; Arthroscopy; Cadaver; Complex; Contralateral; Deformity; Degenerative polyarthritis; Diagnosis; Diagnostic; Diagnostic tests; Dorsal; Evaluation; Fees; Grant; Image; Imaging Techniques; In Vitro; Injury; Interobserver Variability; Joints; Lead; Left; Ligaments; Location; Magnetic Resonance Imaging; Measurement; Measures; Methods; Morbidity - disease rate; Motion; Movement; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Operative Surgical Procedures; Outcome Measure; Pain; Palmar Region; Patient-Focused Outcomes; Patients; Pattern; Postoperative Period; Prevention; Radial; Reporting; Scanning; Scaphoid bone; Semilunar Bone; Severities; Specificity; Specimen; Surgeon; Techniques; Time; Treatment outcome; United States National Institutes of Health; Upper Extremity; Work; Wrist; Wrist Injuries; Wrist joint; X-Ray Computed Tomography; accurate diagnosis; base; bone; clinical practice; cost; effective therapy; evidence base; imaging approach; improved; individualized medicine; innovation; ligament injury; limb injury; novel; optimal treatments; reconstruction; repaired; socioeconomics; surgery outcome; targeted treatment; temporal measurement; treatment planning; wrist motion

PROJECT SUMMARY/ABSTRACT The wrist joint permits complex motion of the upper extremity that is crucial for both precision and power movements during daily activities; therefore, wrist injuries which result in osteoarthritis (OA) come at a significant socioeconomic cost due to time off work, surgical fees and associated morbidity. Injury to the scapholunate interosseus ligament (SLIL), which connects the scaphoid and lunate bones in the proximal carpal row, is one of the most important and common upper extremity injuries. Accurate diagnosis of the location of SLIL injuries is crucial for providing the most effective treatments so that the location of the tear can be considered in a tailored treatment plan. Further, unsuccessful surgical reconstructions occur up to 20%- 30% of the time, with patients often developing OA. Current diagnostic approaches for SLIL injury include magnetic resonance imaging, which lacks the specificity to assess injury location, and wrist arthroscopy, which is invasive and results in an injury grade that is subjective and prone to interobserver variability. Thus, there is a critical need for an accurate, noninvasive, quantitative method for assessing SLIL injury location and treatment outcomes; our novel, dynamic computed tomography (CT) imaging technique will fill this gap. Our high spatial and temporal resolution 4D (3D + time) CT technique (4DCT) enables accurate quantification of key metrics during wrist motion in patients with SLIL injury. This imaging approach, which has been rigorously validated and is based on strong scientific premise, will improve clinical practice by replacing invasive and inaccurate diagnostic tests and providing a means of quantifying outcomes of surgical repairs. In this project, we propose to: establish the relationship between SLIL injury and 4DCT metrics in vitro (Aim 1); assess whether the location of SLIL injury in patients can be predicted using 4DCT metrics (Aim 2); and determine whether targeted treatment of ligament injury improves post-surgical outcomes (Aim 3). The innovation of this project is the use of rigorously validated, dynamic, noninvasive 4DCT metrics to meet the critical need to provide evidence-based information for the diagnosis and treatment of SLIL injury. The significance lies in the accurate diagnosis of SLIL injuries that will lead to optimal treatment approaches, resulting in prevention of OA due to injury or incorrect repair.

项目总结/文摘