双源双能量CT视觉评估和定量分析对椎体骨髓水肿的诊断价值
Analysis of diagnostic efficacy of dual-source dual-energy CT in visual evaluation and quantitative analysis of vertebral bone marrow edema
张发平 1束玲玲 1戴春宏 2邢斌 2宋方 1朱通1
作者信息
- 1. 241000 安徽,安徽省皖南康复医院放射科
- 2. 241000 安徽,安徽省皖南康复医院骨一科
- 折叠
摘要
目的:探讨双源双能量CT(DECT)虚拟去钙(VNCa)技术中视觉评估(VE)和定量分析对椎体骨髓水肿(BME)的诊断价值.方法:回顾性分析 2020 年 8 月至 2022 年 4 月 60 例胸腰椎新鲜骨折(观察组)及 60 例陈旧性骨折(对照组)患者的临床及影像资料.以 MRI 结果为参考,将 DECT 的 VE结果与之对比,分析 1.75 和 1.45 斜率对 BME 的诊断效能;比较新鲜与陈旧性骨折的定量参数(vCT、rCT、CaD、FF、ΔvCT)差异并绘制ROC曲线,采用Z 检验比较曲线下面积(AUC)差异;进一步评估VE与定量参数联合的诊断效能.结果:1.75 与 1.45 斜率 VE 诊断新鲜与陈旧性骨折的敏感度分别为88.0%、69.3%,特异度分别为 93.8%、87.5%,1.75 斜率的诊断符合率为 90.3%,高于 1.45 斜率的78.7%,差异有统计学意义(χ2＝7.987,P＜0.05).椎体新鲜与陈旧性骨折的 vCT、rCT、FF、ΔvCT 值差异均有统计学意义(P 均＜0.05),其中ΔvCT值的AUC值最高(0.96),诊断阈值为 28.5 HU时,敏感度、特异度分别为 89.3%、96.2%,与其他定量参数差异均有统计学意义(P 均＜0.05).VE 的 Youden指数(0.82)高于vCT(0.62)而略低于ΔvCT(0.86);VE与定量参数联合的 AUC 值(0.95)低于ΔvCT.结论:VNCa技术VE和定量分析对椎体骨髓水肿均具有较高的诊断效能,两者联合的诊断价值不高.
Abstract
Objective:The purpose of this study was to explore the value of the virtual noncalci-um(VNCa)technique of dual-source dual-energy CT(DECT)in visual evaluation(VE)and quantita-tive analysis of vertebral bone marrow edema(BME).Methods:The data of 60 cases with fresh thora-columbar fractures(observation group)and 60 cases with old fractures(control group)in our hospital from August 2020 to April 2022 were retrospectively analyzed.Using MRI results as a reference,the diagnostic efficacy of 1.75 and 1.45 slope to identify BME was analyzed by comparing the VE results of DECT with those of MRI;quantitative parameters(vCT,rCT,CaD,FF,ΔvCT)of fresh and old frac-tures were compared,and ROC curves were drawn,and AUC values were compared by Z test.The effect of VE combined with quantification was further evaluated.Results:The sensitivity and specificity of 1.75 and 1.45 slope VE were 88.0%,93.8%,69.3%,and 87.5%,respectively.The diagnostic accura-cy of 1.75 slope was 90.3%,which was higher than that of 1.45 slope at 78.7%,and the difference was statistically significant(χ2＝7.987,P＜0.05);the values of vCT,rCT,FF andΔvCT of fresh vertebral and old vertebral fractures were statistically significant,among which the AUC of ΔvCT was the high-est(0.96),the diagnostic value was 28.5 HU,the sensitivity and specificity were 89.3%and 96.2%re-spectively,and the differences were statistically significant(P＜0.05);the Youden index of VE was higher than vCT but slightly lower than ΔvCT(0.82 vs 0.62,0.86);the AUC value of VE combined with quantitative parameters(0.95)was lower thanΔvCT.Conclusion:VE and quantitative analysis of the VNCa technique have high diagnostic efficacy,but the combined diagnostic value of the VNCa technique is not high.
关键词
椎体/骨髓水肿/双能量CT/虚拟去钙技术/骨折,压缩性/视觉评估Key words
Vertebral/Bone marrow edema/Dual-energy CT/Virtual noncalcium technology/Fracture,compressibility/Visual evaluation引用本文复制引用
基金项目
皖南医学院教学医院科研专项(JXYY202030)
芜湖市科技计划(2021cg39)
出版年
2024
NETL
NSTL
维普
万方数据