ACDSee-10 Gamma Correction MRI for Neat Imaging and Magnifying Lens Measurement of Callused Trabecular Microfracture

Abstract

The excelled usefulness of gamma correction 99mTc-HDP pinhole bone scan for the imaging and diagnosis of callused trabecular microfracture (CTMF) has been well demonstrated and discussed. Now in succession, the same principle of gamma correction of ACDSee-10 version is practically considered to be worthy of importing to magnetic resonance imaging (MRI) to make an in vivo demonstration of CTMF, which occurs in most bone diseases and also in normal bones. Special MRI techniques such as proton spectroscopy and multiparametry can show nearly all kinds of somatic tissues and organs, but apparently excepting trabecular microfracture. Recently, we became to realize that ACDSee-10 gamma correction MRI can visualize and quantitate CTMF (Vide Chap. 13). The aims of this study on ACDSee-10 gamma correction MRI are twofold: first is an extended application of gamma correction to MRI for precise, graphic diagnosis of CTMF by avoiding penumbra and second is to develop handy quantitation method in terms of the number of injured pixel simply using a magnifying lens. Technically, we imaged microfractures by seriated naive and ACDSee-10 gamma correction T2 weighted MRI in nine consecutive cases. The clinical materials consisted of the bones of the shoulder girdle, hip, knee, ankle, and foot. The usefulness of ACDSee-10 gamma correction MRI diagnosis was verified in each case by the corroboratory trabecular microfracture findings of foregone ACDSee-10 99mTc-HDP pinhole bone scan and surgical specimen as well as H&E stain. Results were that the bright MR signal intensity of microfracture was distinctly highlighted and precisely measured by the direct counting of the number of injured pixel using a magnifying optic lens. The injured micrometric pixel was characteristically presented as bright signal intensity against dark background matrix on ACDSee-10 gamma correction MRI, while it was conversely presented as dark microscopic 99mTc-HDP uptake against bright matrix on ACDSee 10 gamma correction pinhole bone scan. The latter was used to validate the former. The smallest size of the unit pixel shown in our computer screen was 200 μm in the x-axis of coordinate. ACDSee-10 gamma correction MRI demonstrated as many as 15 single-pixel CTMF in nine cases, but ACDSee 10 gamma correction pinhole bone scan showed only five single-pixel CTMF and such a difference was theoretically presumed to be due to high sensitivity of MRI. For information, the diagonal of computer monitor we used was 24 inches and screen resolution was 1920 × 1080, Samsung LS23C340, Seoul, South Korea.