双源CT双能量成像诊断脊柱急性创伤性骨髓损伤的初步观察  

A preliminary study of dual-source computed tomography dual energy imaging in the diagnosis of acute traumatic bone marrow lesions in spine

作　　者：古凌静[1] 洪国斌[2] 梁建超[1,2] 徐启兰[2] 杜中立[1] 柳学国[2] 

机构地区：[1]广东省珠海市人民医院放射科,519000 [2]中山大学附属第五医院放射科

出　　处：《中华医学杂志》2014年第39期3088-3090,共3页National Medical Journal of China

基　　金：广东省珠海市科技计划项目（2014D0401990012）

摘　　要：目的 探讨双源CT（DSCT）双能量成像虚拟去骨技术用于诊断脊柱急性创伤性骨髓损伤的可行性.方法 收集2013年4至9月中山大学附属第五医院诊断脊柱急性创伤性骨髓损伤患者,以MRI作为参考标准,将13例脊柱外伤患者MRI检查和双能量CT扫描的虚拟去骨图由2名医师采用3级评价法分别进行评价.采用kappa统计量对2名医师的主观评价进行一致性检验,考察DSCT双能量成像对脊柱急性创伤性骨髓损伤的敏感性.结果 MRI显示13个椎体为急性骨髓损伤,表现为T2WI抑脂序列高信号;DSCT虚拟去骨图表现为黑色背景下的稍高密度影,与MRI对应的高信号区域一致;2名医师DSCT诊断急性创伤性骨髓损伤的敏感度分别为92.3％和84.6％,对DSCT定性评价有较好的一致性（κ=0.629）.结论 DSCT双能量成像虚拟去骨图和伪彩色图对脊柱急性创伤性骨髓损伤具有较高的敏感性,值得进一步深入研究。Objective To explore the feasibility of virtual noncalcium technique from dual-source computed tomography （DSCT） for the diagnosis of vertebral bone marrow lesions.Methods A total of 13 patients with acute vertebral bone marrow lesions underwent both DSCT and MRI within 3 days.And the DSCT dual-energy CT data were postprocessed for generating virtual noncalcium images and color-coded maps.Two radiologists analyzed the lesions of bone marrow by magnetic resonance （MR） imaging and virtual noncalcium images on a three-level.MR imaging interpretation served as the reference standard.Consistency check was conducted by using kappa statistics.And then the sensitivity of DSCT dual energy imaging was examined in the diagnosis of acute traumatic bone marrow lesions in spine.Results Among them,13 vertebral body with bone marrow lesions were detected by MRI.The T2WI fat-suppression irregular high signal and slightly high density shadow under the background in noncalcium images corresponded to corresponding high signal areas on MRI.Interreader agreement was substantial for qualitative grading of DE CT images （κ =0.629）.The sensitivity of DSCT dual energy virtual noncalcium images in the diagnosis of acute traumatic bone marrow lesions in spine were 92.3％ and 84.6％ for observers 1 and 2.Conclusion Distinct traumatic bone marrow lesions of spine may be diagnosed with a high sensitivity on virtual noncalcium images reconstructed from DSCT and color-coded maps.And it is worth further explorations.

关 键 词：脊柱 体层摄影术 X线计算机 脊柱损伤 

分 类 号：R651.2[医药卫生—外科学] R816.8[医药卫生—临床医学]