使用限制回波间隔的计算机断层扫描提高快速场回波诊断手部肌腱损伤的准确性：一项比较研究

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-08-05 DOI:10.1016/j.jhsg.2025.100773

Yukari Matsuzawa MD, PhD , Yusuke Matsuura MD, PhD , Kaoru Kitsukawa MD, PhD , Takahiro Yamazaki MD, PhD , Kayo Inaguma MD , Seiji Ohtori MD, PhD

{"title":"使用限制回波间隔的计算机断层扫描提高快速场回波诊断手部肌腱损伤的准确性：一项比较研究","authors":"Yukari Matsuzawa MD, PhD , Yusuke Matsuura MD, PhD , Kaoru Kitsukawa MD, PhD , Takahiro Yamazaki MD, PhD , Kayo Inaguma MD , Seiji Ohtori MD, PhD","doi":"10.1016/j.jhsg.2025.100773","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing (FRACTURE), a magnetic resonance imaging (MRI) sequence (Philips Healthcare) providing computed tomography-like bone contrast, enables excellent visualization of bones and tendons. Volume rendering (VR) images created from this sequence show anatomical details of a patient’s actual structures. This study evaluated the diagnostic performance of FRACTURE and its VR images for visualizing wrist tendons on MRI images from patients and healthy individuals.</div></div><div><h3>Methods</h3><div>Twenty subjects were included, 10 patients with tendon injuries and 10 healthy individuals who underwent MRI scanning. The imaging protocols were FRACTURE (with VR images), T2-weighted imaging (T2WI), and proton density-weighted volumetric isotropic turbo-spin-echo acquisition (PD-VISTA). An orthopedic surgeon, a hand-surgery specialist, and a radiologist not involved in the surgeries used three methods to interpret the images: FRACTURE multiplanar reconstruction, FRACTURE VR, and PD-VISTA + T2WI. The assessment criteria included tendon injury diagnostic accuracy, interpretation time, and ease-of-interpretation scoring. Diagnostic accuracy was calculated as the correct diagnosis rate. Interpretation time and scoring were analyzed by paired <em>t</em> tests and Bonferroni correction for multiple comparisons.</div></div><div><h3>Results</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing VR showed the highest tendon injury diagnostic accuracy, with considerably better interpretation time performance and ease-of-interpretation scoring versus PD-VISTA + T2WI. In the surgical cases, the tendon rupture sites on FRACTURE images corresponded to the intraoperative findings.</div></div><div><h3>Conclusions</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing was excellent across all assessment criteria, and FRACTURE VR had particularly high diagnostic performance and clinical utility. Although obliquely oriented tendons, such as of the thumb and little finger, require consideration of the magic angle effect, clear visualization of these tendons was possible with appropriate positioning. Additionally, FRACTURE’s high tendon visualization capability enabled the identification of anatomical variations, enhancing its usefulness in clinical hand-surgery practice.</div></div><div><h3>Clinical relevance</h3><div>Tendon injury diagnosis was faster and more accurate with FRACTURE VR than with conventional sequences.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 5","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Enhanced Diagnostic Accuracy of Fast-Field Echo Resembling a Computed Tomography Using Restricted Echo-Spacing for Hand Tendon Injuries: A Comparative Study\",\"authors\":\"Yukari Matsuzawa MD, PhD , Yusuke Matsuura MD, PhD , Kaoru Kitsukawa MD, PhD , Takahiro Yamazaki MD, PhD , Kayo Inaguma MD , Seiji Ohtori MD, PhD\",\"doi\":\"10.1016/j.jhsg.2025.100773\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing (FRACTURE), a magnetic resonance imaging (MRI) sequence (Philips Healthcare) providing computed tomography-like bone contrast, enables excellent visualization of bones and tendons. Volume rendering (VR) images created from this sequence show anatomical details of a patient’s actual structures. This study evaluated the diagnostic performance of FRACTURE and its VR images for visualizing wrist tendons on MRI images from patients and healthy individuals.</div></div><div><h3>Methods</h3><div>Twenty subjects were included, 10 patients with tendon injuries and 10 healthy individuals who underwent MRI scanning. The imaging protocols were FRACTURE (with VR images), T2-weighted imaging (T2WI), and proton density-weighted volumetric isotropic turbo-spin-echo acquisition (PD-VISTA). An orthopedic surgeon, a hand-surgery specialist, and a radiologist not involved in the surgeries used three methods to interpret the images: FRACTURE multiplanar reconstruction, FRACTURE VR, and PD-VISTA + T2WI. The assessment criteria included tendon injury diagnostic accuracy, interpretation time, and ease-of-interpretation scoring. Diagnostic accuracy was calculated as the correct diagnosis rate. Interpretation time and scoring were analyzed by paired <em>t</em> tests and Bonferroni correction for multiple comparisons.</div></div><div><h3>Results</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing VR showed the highest tendon injury diagnostic accuracy, with considerably better interpretation time performance and ease-of-interpretation scoring versus PD-VISTA + T2WI. In the surgical cases, the tendon rupture sites on FRACTURE images corresponded to the intraoperative findings.</div></div><div><h3>Conclusions</h3><div>Fast-field echo resembling a computed tomography using restricted echo-spacing was excellent across all assessment criteria, and FRACTURE VR had particularly high diagnostic performance and clinical utility. Although obliquely oriented tendons, such as of the thumb and little finger, require consideration of the magic angle effect, clear visualization of these tendons was possible with appropriate positioning. Additionally, FRACTURE’s high tendon visualization capability enabled the identification of anatomical variations, enhancing its usefulness in clinical hand-surgery practice.</div></div><div><h3>Clinical relevance</h3><div>Tendon injury diagnosis was faster and more accurate with FRACTURE VR than with conventional sequences.</div></div>\",\"PeriodicalId\":36920,\"journal\":{\"name\":\"Journal of Hand Surgery Global Online\",\"volume\":\"7 5\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-08-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hand Surgery Global Online\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589514125000933\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand Surgery Global Online","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589514125000933","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

目的：快速场回波类似于使用有限回波间隔（FRACTURE）的计算机断层扫描，一种磁共振成像（MRI）序列（Philips Healthcare）提供类似计算机断层扫描的骨骼对比，使骨骼和肌腱能够很好地可视化。从这个序列创建的体绘制（VR）图像显示了患者实际结构的解剖细节。本研究评估了骨折及其VR图像在患者和健康人的MRI图像上显示手腕肌腱的诊断性能。方法选取20例受试者，10例肌腱损伤患者和10例健康人进行MRI扫描。成像方案为骨折（VR图像）、t2加权成像（T2WI）和质子密度加权体积各向同性涡轮自旋回波采集（PD-VISTA）。一名骨科医生、一名手外科专家和一名未参与手术的放射科医生使用了三种方法来解读图像：骨折多平面重建、骨折VR和PD-VISTA + T2WI。评估标准包括肌腱损伤诊断准确性、解读时间和解读难易程度评分。诊断准确率以正确诊断率计算。解释时间和评分采用配对t检验和Bonferroni多重比较校正进行分析。结果与PD-VISTA + T2WI相比，使用限制回波间隔VR的快速场回波类似计算机断层扫描显示出最高的肌腱损伤诊断准确性，具有明显更好的解释时间性能和易于解释评分。在手术病例中，骨折图像上的肌腱断裂部位与术中发现相符。结论快速场回波类似于限制回波间隔的计算机断层扫描，在所有评估标准中都很出色，其中FRACTURE VR具有特别高的诊断性能和临床应用价值。虽然斜向肌腱，如拇指和小指，需要考虑魔角效应，但通过适当的定位可以清晰地看到这些肌腱。此外，FRACTURE的高肌腱可视化能力使解剖变异的识别成为可能，增强了其在临床手外科实践中的实用性。与常规序列相比，骨折VR对肌腱损伤的诊断更快、更准确。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Enhanced Diagnostic Accuracy of Fast-Field Echo Resembling a Computed Tomography Using Restricted Echo-Spacing for Hand Tendon Injuries: A Comparative Study

Purpose

Fast-field echo resembling a computed tomography using restricted echo-spacing (FRACTURE), a magnetic resonance imaging (MRI) sequence (Philips Healthcare) providing computed tomography-like bone contrast, enables excellent visualization of bones and tendons. Volume rendering (VR) images created from this sequence show anatomical details of a patient’s actual structures. This study evaluated the diagnostic performance of FRACTURE and its VR images for visualizing wrist tendons on MRI images from patients and healthy individuals.

Methods

Twenty subjects were included, 10 patients with tendon injuries and 10 healthy individuals who underwent MRI scanning. The imaging protocols were FRACTURE (with VR images), T2-weighted imaging (T2WI), and proton density-weighted volumetric isotropic turbo-spin-echo acquisition (PD-VISTA). An orthopedic surgeon, a hand-surgery specialist, and a radiologist not involved in the surgeries used three methods to interpret the images: FRACTURE multiplanar reconstruction, FRACTURE VR, and PD-VISTA + T2WI. The assessment criteria included tendon injury diagnostic accuracy, interpretation time, and ease-of-interpretation scoring. Diagnostic accuracy was calculated as the correct diagnosis rate. Interpretation time and scoring were analyzed by paired t tests and Bonferroni correction for multiple comparisons.

Results

Fast-field echo resembling a computed tomography using restricted echo-spacing VR showed the highest tendon injury diagnostic accuracy, with considerably better interpretation time performance and ease-of-interpretation scoring versus PD-VISTA + T2WI. In the surgical cases, the tendon rupture sites on FRACTURE images corresponded to the intraoperative findings.

Conclusions

Fast-field echo resembling a computed tomography using restricted echo-spacing was excellent across all assessment criteria, and FRACTURE VR had particularly high diagnostic performance and clinical utility. Although obliquely oriented tendons, such as of the thumb and little finger, require consideration of the magic angle effect, clear visualization of these tendons was possible with appropriate positioning. Additionally, FRACTURE’s high tendon visualization capability enabled the identification of anatomical variations, enhancing its usefulness in clinical hand-surgery practice.