双能量CT虚拟去钙图诊断椎体骨髓水肿  

Dual-energy CT virtual noncalcium imaging for detecting bone marrow edema in vertebrae

作　　者：章辉庆[1] 刘海燕[1] 邱晓晖[1] 郏立志[1] 解福友[1] 王利[1] ZHANG Huiqing;LIU Haiyan;QIU Xiaohui;JIA Lizhi;XIE Fuyou;WANG Li(Department of Image Center,Bozhou People's Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院影像中心,安徽亳州236800

出　　处：《中国医学影像技术》2019年第2期260-263,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨双源CT双能量虚拟去钙(DE-VNCa)图在不同对比物质相对比值(RCMR)条件下对椎体骨髓水肿的临床诊断价值。方法对37例脊柱外伤及腰背部疼痛患者行双源CT双能量扫描及MR检查,RCMR值分别取1.28、1.45、1.75、1.85,重建4组DE-VNCa图像。以MRI诊断为金标准,计算4组图像诊断椎体骨髓水肿的效能,获得最优RCMR值,并在此最优条件下测量并比较腰椎骨髓水肿区与正常椎体的CT值和脂肪含量,以ROC曲线评价CT值和脂肪含量诊断腰椎骨髓水肿的效能。结果 RCMR值取1.28、1.45、1.75、1.85时,诊断腰椎骨髓水肿的约登指数分别为0.02、0.35、0.82、0.73;RCMR为1.75时,DE-VNCa图诊断效能最高。以RCMR=1.75重建DE-VNCa图,腰椎骨髓水肿区与正常椎体的CT值和脂肪含量差异均有统计学意义(P均<0.01)。以CT值=10.25HU和脂肪含量=24.50%为临界值,诊断腰椎骨髓水肿的AUC分别为0.95和0.91(P均<0.01)。结论双源CT DE-VNCa图在RCMR为1.75时诊断椎体骨髓水肿的临床价值较高;CT值和脂肪含量有助于诊断腰椎骨髓水肿。Objective To observe the value of dual-energy virtual noncalcium(DE-VNCa)using dual-source CT in diagnosis of vertebral bone marrow edema under different relative contrast material ratio(RCMR).Methods Totally 37 patients with spinal trauma and low back pain who underwent dual-source CT dual-energy scan and MR examination were enrolled.Taken RCMR value as 1.28,1.45,1.75 and 1.85,respectively,the 4 groups of DE-VNCa images were reconstructed.The best RCMR value was obtained through calculating the effect of 4 groups of images in diagnosis of vertebral bone marrow edema taken MRI diagnosis as golden standards.CT value and fat content of lumbar vertebral bone marrow edema area and normal vertebral body were measured and compared on the optimal imaging.The efficacy of CT value and fat content in diagnosis of lumbar bone marrow edema were evaluated using ROC curve.Results When RCMR value was 1.28,1.45,1.75 and 1.85,the Youden index in diagnosis of lumbar bone marrow edema was 0.02,0.35,0.82 and 0.73,respectively.DE-VNCa imaging had the highest diagnostic efficiency when RCMR value was 1.75.The difference of CT value and fat content between the edema area of lumbar vertebrae and normal vertebrae was statistically significant on images of RCMR=1.75(both P<0.01).Taking CT value=10.25 HU and fat content=24.50%as the critical value,the AUC under ROC curves in diagnosis of lumbar bone marrow edema was 0.95 and 0.91,respectively(both P<0.01).Conclusion DE-VNCa imaging of dual-source CT has high clinical value in diagnosis of vertebral bone marrow edema when RCMR is 1.75,and CT value and fat content are helpful to diagnosis of lumbar bone marrow edema.

关 键 词：骨髓水肿 椎体 对比物质相对比值 体层摄影术 X线计算机 双能量 

分 类 号：R683.2[医药卫生—骨科学] R445.2[医药卫生—外科学]