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Keywords:
Pathology, Diagnostic procedure, Cone beam CT, Musculoskeletal system, Extremities, Bones
Authors:
A. Vasiliev, E. Egorova, N. Blinov, D. V. Makarova, E. G. Gorlycheva; Moscow/RU
DOI:
10.1594/ecr2015/C-1972
Aims and objectives
Injuries and diseases of musculoskeletal system occupy the 4th place in the overall structure of morbidity in the world.
They are located on the 2nd place among all the causes of temporary disability [1].
To characterize a bone structure or to detect its changes the diagnosis algorithm is limited mostly by a standard radiography,
as a technique of the «first step» in such cases.
Along with this the main trend in the development of modern radiology in osteology is a new class of a contemporary digital technologies elaboration (equipment and techniques) for musculoskeletal system researches with low radiation dose and bone structure detailed mapping.
There are also several reasons which conditioning the requirement of specialized visualization techniques for bones and joints of upper and lower limb studies.
The optimization of spatial resolution and signal / noise ratio,
improved tissue contrast,
reducing the number of artifacts from metal,
and functional information obtaining (studies of a lower limb under load are of particular relevance) are among them [2,
5,
6–8].
For potential clinical use cone-beam computed tomography (CBCT) was first proposed in 1982 in Mayo Clinic Biodinamics Reserch Laboratory (USA).
Application capabilities of cone-beam computed unit,
which was intended for the maxillofacial region researches were presented by P.
Mozzo et al.
for the first time in 1998.
However CBCT became widely adopted in diagnosis of maxillofacial region in 2001 only.
X-ray electro-optical transducer and circular detector were used in first cone-beam computed scanners.
X-ray beam was spread in the form of a cone and that was behind the name of the technique.
However,
there is no entire coincidence in terminology till now.
It could be termed variously,
for example,
«digital volume tomography».
Currently,
CBCT-images obtaining is based on scanning of an interest area with pulsed X-ray beam,
collimated in such a way that the radiation is distributed in the form of a cone.
It strikes subsequently a flat panel detector weakened by tissues.
Just one circular rotation of the gantry around the examined area is resulted in a primary three-dimensional image that is ready for further processing (fig.
1).
CB-system allows avoiding a loss of graphic information,
which is an important factor when studying the bone structure.
Despite the obvious advantages,
CBCT still does not have a wide application in everyday clinical practice for the knee joint researches,
the obtained information about it among the available publications is scanty,
that`s why in the framework of our research CBCT capabilities in assessment of knee joint pathological changes have been analyzed [3,
4,
6].