双能CT去钙质成像在骨挫伤诊断上的价值

The value of dual-energy CT noncalcium technique in the diagnosis of bone bruises

目的研究双能CT的去钙质成像技术在诊断骨挫伤方面的价值。方法 17例急性膝关节创伤的患者先后行双能CT(DECT)和MRI检查。DECT扫描数据经Liver VNC软件后处理后去除钙质显示骨髓水肿,并将股骨和胫骨各分为5个区域,由两位独立的医师进行评价。随后以MRI结果作标准进行对比分析。结果有16个区域因为在MRI图像上有明显伪影干扰而排除在外。在股骨的74个可评价区域中,MRI和DECT的阳性区域分别为15个和13个,阴性区域分别为59个和61个;而胫骨的80个可评价区域中,MRI和DECT的阳性区域分别为33个和30个,阴性区域分别为47个和50个。对股骨和胫骨的结果均采取配对设计两样本率比较的Mc Nemar检验法,P值分别等于0.625和0.375,均>0.05。与MRI结果相比,DECT评价骨挫伤的灵敏度为85.41%,特异度为98.11%。结论 DECT的虚拟去钙质技术和磁共振在骨挫伤的诊断上无明显差别。

Objective To evaluate noncalcium technique of DECT in the diagnosis of bone bruise. Methods 17 patients with acute knee trauma underwent DECT and magnetic resonance imaing. DECT datas was processed with liver VNC which sub- tracted calcium from bone to indicate man：ow edema. Each femur and tiba was divided into 5 regions to be evaluated by two radiol- ogists respectively. MRI imaging served as the reference standard. Results After exclusion of 16 regions owing to artifacts, MRI imaging revealed 48 bone bruises in the remaining 154 regions （ 15 of 74 femoral, 33 of 80 of tibial）. McNemar test was used to analyze matched pairs of femur and tibia. P value was 0. 625,0. 375 for femur and tibia. The total sensitivity, specificity of DECT for depicting bone bruises were 85.41% and 98. 11% compared with MRI. Conclusion DECT noncalcium technique is as useful as MRI on the diagnosis of bone bruise.