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Accuracy of radiography, computed tomography and magnetic resonance imaging in diagnosing foreign bodies in the foot

Accuratezza diagnostica della radiografia tradizionale, della tomografia computerizzata e della risonanza magnetica nell’identificazione di corpi estranei nel piede

  • Musculoskeletal Radiology / Radiologia Muscolo-Scheletrica
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to determine the accuracy of conventional radiography, computed tomography (CT) and magnetic resonance imaging (MRI) in detecting foreign bodies by using cadaver feet.

Materials and methods

One hundred and sixty foreign bodies consisting of 5×2-mm fresh wood, dry wood, glass, porcelain and plastic fragments were randomly placed in the plantar soft tissue of the forefoot and sole. An additional 160 incisions were made without the insertion of foreign bodies. Radiographs, CT and MRI scans were assessed in a blinded fashion for the presence of a foreign body.

Results

Overall sensitivity and specificity for foreign body detection was 29% and 100% for radiographs, 63% and 98% for CT and 58% and 100% for MRI. The sensitivity of radiography was lower in the forefoot. CT and MRI detection rates depended on the attenuation values of the foreign bodies and on the susceptibility artefact, respectively. CT was superior to MRI in identifying waterrich fresh wood.

Conclusions

Radiography, CT and MRI are highly specific in detecting foreign bodies but sensitivity is poor. The detection rate depends on the type of foreign body for all techniques and on location for radiography. To identify foreign bodies with MRI, pulse sequences should be used to enhance the susceptibility artefact. In water-rich wood, as in chronically retained wood, CT is more accurate than MRI.

Riassunto

Obiettivo

Lo scopo di questo studio è determinare l’accuratezza della radiografia tradizionale, della tomografia computerizzata (TC) e della risonanza magnetica nucleare (RMN) nell’identificazione dei corpi estranei inseriti nei piedi di cadaveri.

Materiali e metodi

Nei tessuti molli plantari dell’avampiede e del meso-retropiede sono stati posizionati, in maniera casuale, centosessanta corpi estranei di legno fresco, legno secco, vetro, porcellana e plastica dalle dimensioni di 5×2 mm. Sono state inoltre praticate centosessanta incisioni senza inserire alcun corpo estraneo. Le radiografie, TC e RMN alla ricerca dei corpi estranei sono state interpretate in cieco.

Risultati

La sensibilità e la specificità complessive sono risultate rispettivamente del 29% e 100% usando le radiografie, del 63% e 98% usando la TC e del 58% e 100% usando la RMN. La sensibilità della radiologia tradizionale è risultata minore nell’avampiede. Le percentuali di identificazione di TC e RMN sono dipese rispettivamente dai valori di attenuazione dei corpi estranei e dagli artefatti da suscettibilità. La TC si è rivelata migliore rispetto alla RMN nell’individuazione del legno fresco, ricco di acqua.

Conclusioni

Radiologia tradizionale, TC e RMN sono altamente specifiche nella rilevazione dei corpi estranei ma presentano una bassa sensibilità. Le percentuali di identificazione dipendono, per tutte le metodiche, dal tipo di corpo estraneo e, per quanto riguarda la radiologia tradizionale, anche dalla posizione. In RMN andrebbero usate sequenze pulsate per esaltare gli artefatti da suscettibilità dei corpi estranei. La TC è superiore alla RMN nel legno fresco ricco di acqua e in quello ritenuto a lungo nei tessuti.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    N. Pattamapaspong, T. Srisuwan & C. Sivasomboon

  2. Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100, Foggia, Italy

    M. Nasuto & G. Guglielmi

  3. Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    P. Suwannahoy

  4. Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    J. Settakorn

  5. Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    J. Kraisarin

  6. Department of Radiology, Scientific Institute Hospital “Casa Sollievo della Sofferenza”, Viale Cappuccini 1, 71013, San Giovanni Rotondo (FG), Italy

    G. Guglielmi

Authors
  1. N. Pattamapaspong
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  2. T. Srisuwan
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  3. C. Sivasomboon
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  4. M. Nasuto
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  5. P. Suwannahoy
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  6. J. Settakorn
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  7. J. Kraisarin
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  8. G. Guglielmi
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Corresponding author

Correspondence to G. Guglielmi.

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Pattamapaspong, N., Srisuwan, T., Sivasomboon, C. et al. Accuracy of radiography, computed tomography and magnetic resonance imaging in diagnosing foreign bodies in the foot. Radiol med 118, 303–310 (2013). https://doi.org/10.1007/s11547-012-0844-4

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  • DOI: https://doi.org/10.1007/s11547-012-0844-4

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