Introduction / Objective: Metal Artifact Reduction (MAR) systems, which have been patented by the firms and specific to them, have been developed to reduce the losses in the images, which are caused by artifacts, and to increase the diagnostic value of CT. The objective of this study is to determine the effectiveness of the MAR technique, which minimizes the image loss caused by metal artifacts in CTs taken for the lumbar spinal region where metallic implants are located, and its contributions to radiological evaluation.
Material Method: Patients with spinal stabilization, whose CT imaging records of both standard and SMAR reconstruction were performed between June 2020 and March 2021 and could be accessed, were evaluated. Critical anatomical structures were defined as the spinal canal (SC), neural foramen (NF), and prevertebral-paravertebral area (P-PA). The image quality of critical anatomical structures evaluated using a 5-point image quality scale for soft tissue (400/35 HU) and bone window settings (2500/480 HU) on standard and SMAR reconstructed CT images. In addition, the size of the flame artifact was measured and recorded in millimeters in standard and SMAR images.
Results: Of the 24 patients with lumbar spinal stabilization who met the inclusion criteria, 8 were male, and 16 were female (66%). The age range was determined to be between 26 and 82 years (mean=60). The stabilization of all patients was in the form of posterior transpedicular screw and rod fixation. The radiation dose distribution ranged between 3.23 and 14.1 millisieverts (mSv) (mean=8.95 mSv). The worst visualization score was obtained on spinal canal imaging, which was evaluated in the soft tissue window. In bone window evaluations of these structures, the visualization scores (median) in standard and SMAR imagings were found to be 3 and 4 (Z=-3.926, P
Key words: Computed tomography, Metal artifact, Flame artifact, Lumbar stabilization
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