摘要
目的探讨双能CT(DECT)虚拟去钙(VNCa)技术在急性创伤患者踝关节处骨髓水肿(BME)中的诊断价值。方法63例患者在踝关节急性外伤后24h内接受双源DECT(80k VP和Sn140k VP)和MRI成像。DECT使用Liver VNC软件三材料分解法生成踝关节处的VNCa图像,由两名放射科医师使用二元系统对图像进行分级(1=存在BME,0=不存在BME),对VNCa图像的CT值进行受试者操作特性曲线(ROC)分析,以MRI结果作为“金标准”。结果MRI显示51/63例患者存在BME,DECT显示49/51例患者存在BME(96.08%),两名医师通过DECT的VNCa图像显示BME的敏感性、特异性、阴性预测值、阳性预测值和准确性分别为96.08%、91.67%、84.62%、98.00%、95.24%和96.00%、92.31%、85.71%、97.96%、95.24%,阅片医师间对DECT图像定性分级的一致性较高(Kappa=0.84)。定量分析DECT的阳性区域平均CT值为(-11.84±35.09)HU,阴性区域平均CT值为(-61.82±39.52)HU,两区域CT值对比有显著差异(P<0.001)。VNCa图像CT值曲线下面积(AUC)为0.83(95%置信区间0.73~0.93),诊断阈值为-24.14HU,定量分析DECT的敏感性、特异性、阴性预测值、阳性预测值和准确性分别为98.00%、92.31%、92.31%、98.00%、96.83%。结论DECT可以诊断踝关节处急性创伤背景下的BME,与MRI相比无明显差别。
Objective To explore the diagnostic value of dual-energy CT virtual noncalcium technology in bone marrow edema at the ankle of patients with acute trauma.Methods Sixty-three patients underwent DECT scan and MRI imaging within 24 hours after acute ankle trauma.VNCa images at the ankles were generated with Liver VNC software by three-factor analysis using DECT scan.These images were graded by two radiologists using a binary system(1=presence of BME,0=absence of BME);CT values of the VNCa images were analyzed by receiver operating characteristic curve(ROC),and MRI results were used as"golden standard".Results The results of MRI imaging showed that BME was present in 51/63 patients(80.95%),and the results of DECT scan showed that BME was present in 49/51patients(96.08%).The DECT-VNCa images analyzed by the two radiologists showed that the sensitivity,specificity,negative predictive value,positive predictive value and accuracy of BME were 96.08%,91.67%,84.62%,98.00%,95.24%and 96.00%,92.31%,85.71%,97.96%,95.24%,respectively.The consistency of qualitative grading of DECT images by them was higher(Kappa=0.84).Quantitative analysis of these images showed that the average CT value of the positive area was(-11.84±35.09)HU,and the average CT value of the negative area was(-61.82±39.52)HU;There was a significant difference between the CT values of the two areas(P<0.001),and the difference was statistically significant.The area under the curve(AUC)for the CT values of the VNCa images was 0.83(95%confidence interval is from 0.73 to 0.93),and the diagnostic threshold was-24.14HU.The sensitivity,specificity,negative predictive value,positive predictive value,and accuracy of the quantitative analysis of DECT were 98.00%,92.31%,92.31%,98.00%,96.83%.Conclusion DECT can be used to diagnose BME in the context of acute trauma at the ankle,and it has no significant difference compared with MRI.
作者
何绪成
叶菊
周闪闪
韩文娟
陈晓霞
王贵生
HE Xu-cheng;YE Ju;ZHOU Shan-shan;HAN Wen-juan;CHEN Xiao-xia;WANG Gui-sheng(Department of Diagnostic Radiology,the Third Medical Center of Chinese PLA General Hospital,Beijing 100039,China)
出处
《中国CT和MRI杂志》
2022年第4期169-172,共4页
Chinese Journal of CT and MRI
关键词
骨髓水肿
磁共振成像
踝关节
体层摄影术
X线计算机
Bone Marrow Edema
Magnetic Resonance Imaging
Ankle Joint
Tomography
X-Ray Computes