Dong Han Shin1, You Seon Song2, Yunjung Choi3,4, Wan-Hee Yoo3,4, Florian Kummel5, Eun Hae Park1,4. 1. Department of Radiology, Jeonbuk National University Medical School, Jeonju, Republic of Korea. 2. Department of Radiology, Pusan National University Hospital, Biomedical Research Institute, Pusan, Republic of Korea. 3. Division of Rheumatology, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea. 4. Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea. 5. SHS DI CT M&S PCMM, Siemens Healthcare GmbH, Forchheim, Germany.
Abstract
OBJECTIVES: To accurately differentiate clumpy artifacts from tophi with foot and ankle DECT. METHODS AND MATERIALS: In session 1, 108 clumpy artifacts from 35 patients and 130 tophi images from 25 patients were analyzed. Reviewers classified green pixelation according to anatomic location, shape (linear, stippled, angular, oval), and height and width ratio. In session 2, green pixelation confined to the tendon was evaluated (shape, height and width ratio, occupied area in the tendon, accompanied peritendinous green pixelation). RESULTS: In session 1, while tophi were noted at various locations, almost all clumpy artifacts were located at the tendon (99%, p < 0.0001). Most clumpy artifacts were linear, stippled, and wide, while most tophi were angular and oval (p < 0.05). In session 2, the shape of green pixelation from clumpy artifacts and tophi was significantly different (p < 0.0001) and most clumpy artifacts occupied less than 50% of the tendon (p = 0.02), and most tophi were accompanied by peritendinous green pixelation (p < 0.0001). Univariant logistic regression showed that tophi were significantly correlated with peritendinous deposits, angular and oval shape, and more than 50% of the tendon (p < 0.05). CONCLUSION: Clumpy artifacts can be differentiated from tophi in DECT. Clumpy artifacts typically are located in the tendon with a linear or stippled shape, wide, and less than 50% of a tendon's cross-section. Tophi, on the other hand, typically are oval, larger than 50% of the tendon's cross-section, and associated with adjacent peritendinous green pixelation. ADVANCES IN KNOWLEDGE: Clumpy artifacts can be differentiated from tophi in image findings by their location and shape.
OBJECTIVES: To accurately differentiate clumpy artifacts from tophi with foot and ankle DECT. METHODS AND MATERIALS: In session 1, 108 clumpy artifacts from 35 patients and 130 tophi images from 25 patients were analyzed. Reviewers classified green pixelation according to anatomic location, shape (linear, stippled, angular, oval), and height and width ratio. In session 2, green pixelation confined to the tendon was evaluated (shape, height and width ratio, occupied area in the tendon, accompanied peritendinous green pixelation). RESULTS: In session 1, while tophi were noted at various locations, almost all clumpy artifacts were located at the tendon (99%, p < 0.0001). Most clumpy artifacts were linear, stippled, and wide, while most tophi were angular and oval (p < 0.05). In session 2, the shape of green pixelation from clumpy artifacts and tophi was significantly different (p < 0.0001) and most clumpy artifacts occupied less than 50% of the tendon (p = 0.02), and most tophi were accompanied by peritendinous green pixelation (p < 0.0001). Univariant logistic regression showed that tophi were significantly correlated with peritendinous deposits, angular and oval shape, and more than 50% of the tendon (p < 0.05). CONCLUSION: Clumpy artifacts can be differentiated from tophi in DECT. Clumpy artifacts typically are located in the tendon with a linear or stippled shape, wide, and less than 50% of a tendon's cross-section. Tophi, on the other hand, typically are oval, larger than 50% of the tendon's cross-section, and associated with adjacent peritendinous green pixelation. ADVANCES IN KNOWLEDGE: Clumpy artifacts can be differentiated from tophi in image findings by their location and shape.
Authors: Tyler M Coupal; Paul I Mallinson; Sharon L Gershony; Patrick D McLaughlin; Peter L Munk; Savvas Nicolaou; Hugue A Ouellette Journal: AJR Am J Roentgenol Date: 2016-01 Impact factor: 3.959
Authors: Michelle Hui; Alison Carr; Stewart Cameron; Graham Davenport; Michael Doherty; Harry Forrester; Wendy Jenkins; Kelsey M Jordan; Christian D Mallen; Thomas M McDonald; George Nuki; Anthony Pywell; Weiya Zhang; Edward Roddy Journal: Rheumatology (Oxford) Date: 2017-07-01 Impact factor: 7.580
Authors: Nicola Dalbeth; Meaghan E House; Opetaia Aati; Paul Tan; Christopher Franklin; Anne Horne; Gregory D Gamble; Lisa K Stamp; Anthony J Doyle; Fiona M McQueen Journal: Ann Rheum Dis Date: 2015-01-30 Impact factor: 19.103