Effect of different multiplanar reformation algorithms on image quality of intraoperative three-dimensional fluoroscopy

摘要

Different multiplanar reformation (MPR-512 and -256) algorithms of intraoperative acquired 3-D-fluoroscopy data exist without recommendations for use in the literature. To compare algorithms, 3-D-fluoroscopic data sets of 46 radius fractures were blinded and processed using MPR-256 and -512 (Ziehm, Vision-Vario 3D). Each reformatted data set was analysed to evaluate image quality, fracture reduction quality and screw misplacements. Overall image quality was higher rated in the MPR-512 compared with the MPR-256 (3.2 vs. 2.2 points, scale 1-5 points), accompanied by a reduced number of scans that could not be analysed (10 vs. 19). Interobserver evaluation of fracture reduction quality was fair to moderate (independent of the algorithm). In contrast, for screw misplacements MPR-depended ratings were found (MPR-256: fair to moderate; MPR-512: moderate to substantial). Optimization of post-processing algorithms, rather than modifications of image acquisition, may increase the image quality for assessing implant positioning, but limitations in evaluating fracture reduction quality still exist.