双能CT诊断膝关节前交叉韧带损伤可行性探讨

Feasibility of Diagnosis in Cruciate Anterior Ligament Injuries in the Knee Using Dual-energy CT

目的:探讨双能CT在膝关节前交叉韧带(ACL)损伤中的应用可行性。方法:30例膝关节外伤患者行双能CT和MR检查,观察软组织CT图像、双能CT肌腱伪彩(DETC)图像和MR图像上ACL。以MR图像为参考标准,评估双能CT图像诊断ACL损伤的预测值。结果:MR图像、软组织CT图像、联合软组织CT图像和DETC图像诊断明确的ACL损伤的例数分别为23、11和20。软组织CT图像诊断ACL损伤的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为47.8%、100.0%、100.0%、36.8%和60.0%;联合软组织CT图像和DETC图像诊断ACL损伤的各预测值分别为82.6%、85.7%、95.0%、60.0%和83.3%。与软组织CT图像相比,联合软组织CT图像和DETC图像诊断ACL损伤的敏感度和准确度均有明显增加(敏感度和准确度相应的?2值分别为6.133和4.022,P值均<0.05)。结论:联合双能CT的软组织CT图像和DETC图像可诊断ACL损伤,并具有较高的预测值。

Objective： To explore feasibility of diagnosis in anterior cruciate ligament injuries （ACL） in the knee using dual-energy CT. Methods： 30 patients with trauma in the knee were underwent dual-energy CT and MR examinations, ACL was evaluated on soft tissue CT images, dual-energy tendon-specific color （DETC） images and MR images. MR images were served as the standard of reference; diagnostic predictive values of ACL injuries were evaluated for dual-energy CT images. Result： On MR images, 23 cases had significant ACL injuries, 11 cases had significant ACL injuries on soft tissue CT, and significant ACL injuries were diagnosed in 20 cases using combination of soft tissue CT images and DETC images. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 47.8%, 100.0%, 100.0%, 36.8% and 60.0% for ACL injury using soft tissue CT images, respectively, and these values were 82.6%, 85.7%, 95.0%, 60.0% and 83.3% for ACE injury using combination of soft tissue CT images and DETC images, respectively. Compared with soft tissue CT images, the sensitivity and diagnostic accuracy for ACL injuries using combination of soft tissue CT images and DETC images were all increased significantly （χ^2 values of sensitivity and accuracy were 6.133 and 4.022, respectively, all P values 〈 0.05）. Conclusion： Combination of soft tissue CT images and DETC images can be used to diagnosis in ACL injuries, which has relative high predictive values.