Salvage techniques in osteochondritis dissecans.

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Abstract

[Indexed for MEDLINE] 15. Ultrasound Med Biol. 2023 Sep;49(9):1979-1995. doi: 10.1016/j.ultrasmedbio.2023.05.001. Epub 2023 Jun 23. Improving Visualization of Osteochondritis Dissecans Using Delay-Multiply-and-Sum Reconstruction. Holmes PM(1), Chen KH(2), Lee HK(3), Fitzsimmons JS(2), O'Driscoll SW(2), Urban MW(3). Author information: (1)Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA. Electronic address: Holmes.Philip@mayo.edu. (2)Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. (3)Department of Radiology, Mayo Clinic, Rochester, MN, USA. OBJECTIVE: Osteochondritis dissecans (OCD) of the capitellum is a joint defect that is common among adolescent athletes. It is important to diagnose OCD as early as possible, because early-stage OCD lesions have a high rate of spontaneous healing with rest. Medical ultrasound could potentially be used as a screening tool for OCD but is limited by the use of delay-and-sum (DAS) reconstruction. In this study, we tested conventional delay-multiply-and-sum (DMAS) and novel low-pass DMAS reconstruction algorithms for better visualization of OCD lesions. METHODS: We created phantom and cadaveric OCD models that simulated a range of OCD lesion severities and stabilities. We also imaged an in vivo case of OCD in a patient study. In the reconstructed images, several profiles were taken to measure OCD lesion contrast, cartilage contrast, crack thickness error and bone interface clarity. RESULTS: In the phantom and cadaveric OCD models, we found that histogram-matched conventional DMAS reconstruction improved lesion contrast by up to 16%, cartilage contrast by 26% and bone interface clarity by 15% on average compared with DAS reconstruction. Histogram-matched low-pass DMAS reconstruction improved lesion contrast by up to 22%, cartilage contrast by 45%, and bone interface clarity by 29% on average compared with DAS reconstruction. In the in vivo case of OCD, we found that histogram-matched conventional and low-pass DMAS reconstruction improved lesion contrast by 22% and 26%, respectively. CONCLUSION: The application of DMAS reconstruction improved the ability of medical ultrasound to detect OCD lesions of the capitellum when compared with DAS reconstruction. Copyright © 2023 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.ultrasmedbio.2023.05.001