3D ultrasound reconstruction of sonographic callus: a novel imaging modality for early evaluation of fracture healing

Bone & Joint Research

article

Jamie A. Nicholson¹  William M. Oliver¹  Tom J. MacGillivray²  C. Michael Robinson¹  A. Hamish R. W. Simpson¹ 

[1] Department of Orthopaedic Surgery, University of Edinburgh;Clinical Research Imaging Centre, University of Edinburgh

关键词: Ultrasound;    Tibia;    Nonunion;    radiographs;    fracture site;    fracture healing;    ultrasound scanning;    intramedullary nailing;    intraclass correlation coefficient (ICC);    tibial shaft fractures;    imaging modality;    fracture reconstruction;   

DOI  :  10.1302/2046-3758.1012.BJR-2021-0250

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsThe aim of this study was to establish a reliable method for producing 3D reconstruction of sonographic callus.MethodsA cohort of ten closed tibial shaft fractures managed with intramedullary nailing underwent ultrasound scanning at two, six, and 12 weeks post-surgery. Ultrasound capture was performed using infrared tracking technology to map each image to a 3D lattice. Using echo intensity, semi-automated mapping was performed to produce an anatomical 3D representation of the fracture site. Two reviewers independently performed 3D reconstructions and kappa coefficient was used to determine agreement. A further validation study was undertaken with ten reviewers to estimate the clinical application of this imaging technique using the intraclass correlation coefficient (ICC).ResultsNine of the ten patients achieved union at six months. At six weeks, seven patients had bridging callus of ≥ one cortex on the 3D reconstruction and when present all achieved union. Compared to six-week radiographs, no bridging callus was present in any patient. Of the three patients lacking sonographic bridging callus, one went onto a nonunion (77.8% sensitive and 100% specific to predict union). At 12 weeks, nine patients had bridging callus at ≥ one cortex on 3D reconstruction (100%-sensitive and 100%-specific to predict union). Presence of sonographic bridging callus on 3D reconstruction demonstrated excellent reviewer agreement on ICC at 0.87 (95% confidence interval 0.74 to 0.96).Conclusion3D fracture reconstruction can be created using multiple ultrasound images in order to evaluate the presence of bridging callus. This imaging modality has the potential to enhance the usability and accuracy of identification of early fracture healing.

【 授权许可】

CC BY-NC