Study on clinical value of dual-energy CT virtual non-calcium imaging in the diagnose of vertebral bone contusion and occult fracture
Objective To explore the clinical value of dual-energy CT(DECT)virtual non-calcium(VNCa)imaging in the diagnose of vertebral bone contusion and occult fracture.Methods A total of 118 patients with vertebral bone contusion and occult fracture were selected,all of whom underwent dual energy CT and magnetic resonance imaging(MRI).According to their age,the patients were divided into<60-year-old group and≥60-year-old group.Paired-samples t-test and receiver operating characteristic(ROC)curve analysis were established on VNCa imaging between the CT value of lumbar and thoracic bone marrow edema and the CT value of normal vertebrae,as well as the CT value difference(△CT)and the CT value of normal vertebrae.The CT value of lumbar and thoracic bone marrow edema,cut-off point of △CT,area under the curve(AUC),sensitivity and specificity of the two groups were calculated.Results MRI and dual-energy CT were completed in 118 patients,and MRI was used as the gold standard to confirm the diagnosis of 123 vertebral bone marrow edema,with 33 lumbar fractures and 14 thoracic fractures in the<60-year-old group;45 lumbar fractures and 27 thoracic fractures in the≥60-year-old group;and 2 sacral vertebral fracture and 2 cervical vertebral fractures.Vertebral fractures were more likely to occur in the≥60-year-old group,with lumbar fractures predominating in both groups.The CT values of lumbar and thoracic bone marrow edema were quantitatively analyzed on VNCa imaging,and the CT values of vertebrae with bone marrow edema were higher than those of adjacent normal vertebrae in both groups,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the cut-off point,AUC,sensitivity and specificity of CT value of lumbar and thoracic bone marrow edema in<60-year-old group were 14.60 Hu,0.87,94.1%,76.5%and-15.75 Hu,0.74,93.3%,76.7%,while those in the≥60-year-old group were 2.20 Hu,0.93,91.3%,84.8%and 9.95 Hu,0.90,88.6%,89.3%.The △CT value of lumbar and thoracic bone marrow edema was quantitatively analyzed on VNCa imaging.The differences were statistically significant(P<0.05).ROC curve analysis showed that the cut-off point,AUC,sensitivity,and specificity of △CT value of lumbar and thoracic bone marrow edema in the<60 years old group were 6.90 Hu,0.90,95.6%,and 80.6%and 3.25 Hu,0.82,94.8%,and 86.7%,while those in the≥60-year-old group were 9.40 Hu,0.99,97.5%,95.4%and 4.50 Hu,0.94,96.4%,85.7%,respectively.Conclusion The combination of △CT of vertebral bone marrow edema and CT of bone marrow edema can greatly improve the efficacy of dual-energy CT in the diagnosis of vertebral bone contusion and occult fracture,and such combination could achieve basically the same performance as MRI for the diagnosis of vertebral bone marrow edema and could also make up for the inconvenience caused by various MRI contraindications.
万方数据
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