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Published on: February 25, 2015
A method for visualizing high-density porous polyethylene (medpor, porex) with computed tomographic scanning
Nicholas Vendemia1, Jerry Chao, Jana Ivanidze
1New York Presbyterian Hospital, Weill-Cornell Medical Center, New York, New York, USA.
Background:
Medpor (Porex Surgical, Inc, Newnan, GA) is composed of porous polyethylene and is commonly used in craniofacial reconstruction. When complications such as seroma or abscess formation arise, diagnostic modalities are limited because Medpor is radiolucent on conventional radiologic studies. This poses a problem in situations where imaging is necessary to distinguish the implant from surrounding tissues.
Objective:
To present a clinically useful method for imaging Medpor with conventional computed tomographic (CT) scanning.
Materials And Methods:
Eleven patients (12 total implants) who have undergone reconstructive surgery with Medpor were included in the study. A retrospective review of CT scans done between 1 and 16 months postoperatively was performed using 3 distinct CT window settings. Measurements of implant dimensions and Hounsfield units were recorded and qualitatively assessed.
Results:
Of the 3 distinct window settings studied, namely, "bone" (W1100/L450), "soft tissue"; (W500/L50), and "implant" (W800/L200), the implant window proved the most ideal, allowing the investigators to visualize and evaluate Medpor in all cases. Qualitative analysis revealed that Medpor implants were able to be distinguished from surrounding tissue in both the implant and soft tissue windows, with a density falling between that of fat and fluid. In 1 case, Medpor could not be visualized in the soft tissue window, although it could be visualized in the implant window. Quantitative analysis demonstrated a mean (SD) density of -38.7 (7.4) Hounsfield units.
Conclusions:
Medpor may be optimally visualized on conventional CT scans using the implant window settings W800/L200, which can aid in imaging Medpor and diagnosing implant-related complications.
Insights
Imaging Medpor implants, used in craniofacial reconstruction, is challenging due to their radiolucence. This study found that specific computed tomographic (CT) implant window settings (W800/L200) effectively visualize Medpor, aiding in complication diagnosis.
Area of Science:
- Biomedical Engineering
- Medical Imaging
- Plastic Surgery
Background:
- Medpor (porous polyethylene) is widely used in craniofacial reconstruction.
- Conventional radiologic studies have limited diagnostic capabilities for Medpor due to its radiolucence.
- Distinguishing Medpor implants from surrounding tissues can be difficult, complicating complication diagnosis.
Purpose of the Study:
- To establish a practical method for visualizing Medpor implants using standard computed tomographic (CT) scanning.
- To improve diagnostic accuracy for Medpor-related complications.
Main Methods:
- Retrospective review of CT scans from 11 patients (12 implants) post-craniofacial reconstruction.
- Evaluation of three distinct CT window settings: "bone" (W1100/L450), "soft tissue" (W500/L50), and "implant" (W800/L200).
- Quantitative and qualitative assessment of Medpor visualization and density (Hounsfield units).
Main Results:
- The "implant" window setting (W800/L200) was most effective for visualizing Medpor in all cases.
- Medpor implants were distinguishable from surrounding tissues in "implant" and "soft tissue" windows.
- Mean Hounsfield unit density of Medpor was -38.7 (7.4), falling between fat and fluid densities.
Conclusions:
- Optimal visualization of Medpor on conventional CT scans is achieved using "implant" window settings (W800/L200).
- This imaging technique can assist in diagnosing Medpor-related complications.
- The findings provide a clinically useful method for evaluating Medpor implants.
