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: 9933482
• 负责人: Kristin Daigle Zhao
• 金额: $ 5.27万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9933482
• 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; injured; innovation; ligament 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/摘要 腕关节允许上肢复杂的运动，这对精确度和力量都至关重要 日常活动中的运动;因此，导致骨关节炎（OA）的腕关节损伤在 由于休假、手术费和相关发病率，造成了巨大的社会经济成本。损伤 舟月骨间韧带（SLIL），在近端连接舟月骨和月骨 腕骨骨折是上肢最常见和最重要的损伤之一。准确诊断 SLIL损伤的位置对于提供最有效的治疗至关重要， 在量身定制的治疗计划中予以考虑。此外，不成功的手术重建发生高达20%- 30%的时间，患者经常发展为OA。目前SLIL损伤的诊断方法包括 磁共振成像缺乏评估损伤位置的特异性，腕关节镜检查， 是侵入性的，导致损伤等级是主观的，易于观察者之间的变化。因此， 迫切需要一种准确、无创、定量的方法来评估SLIL损伤位置， 治疗结果;我们的新型动态计算机断层扫描（CT）成像技术将填补这一空白。我们 高空间和时间分辨率4D（3D +时间）CT技术（4DCT）能够精确量化 SLIL损伤患者腕关节运动过程中的关键指标。这种成像方法， 经过验证并基于强大的科学前提，将通过取代侵入性和 不准确的诊断测试，并提供了一种量化手术修复结果的方法。在这个项目中， 我们建议：建立SLIL损伤和体外4DCT指标之间的关系（目的1）;评估 是否可以使用4DCT指标预测患者SLIL损伤的位置（目标2）;并确定 韧带损伤的靶向治疗是否改善了术后结局（目标3）。的创新之处 该项目是使用严格验证的，动态的，非侵入性的4DCT指标，以满足关键需求， 为SLIL损伤的诊断和治疗提供循证信息。其意义在于 SLIL损伤的准确诊断，将导致最佳治疗方法，从而预防OA 由于受伤或不正确的维修。