低剂量双能量CT成像与MRI成像在跟腱撕裂诊断中的对比研究  

Comparative Study of Low-dose Dualenergy CT Imaging and MRI Imaging in the Diagnosis of Achilles Tendon Tear

作　　者：肖梦强[1] 黄培楷 罗妮苑[1] 张萌[1] 刘晓玲 徐旺东 刘金丰[1] XIAO Meng-qiang;HUANG Pei-kai;LUO Ni-yuan(Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai 519015,Guangdong Province,China)

机构地区：[1]广东省中医院珠海医院,广东珠海519015

出　　处：《中国CT和MRI杂志》2019年第1期126-129,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨低剂量单源双能量CT在跟腱撕裂诊断中的应用价值。方法对42例怀疑跟腱撕裂患者行双能量CT和MRI检查,经查跟腱撕裂36例、正常6例。36例跟腱撕裂患者中,25例跟腱完全撕裂均经手术确诊;11例不完全性撕裂中,7例经MRI随访确诊,4例经手术及MRI确诊。6例跟腱正常患者,经查为跟骨粉碎性骨折,骨折线累及跟腱附着处,手术明确及MRI未见跟腱撕裂。行多平面重组(MPR)、肌腱3D容积再现(VR)等二维及三维图像后处理,用以显示跟腱;双能CT虚拟去钙质成像诊断踝关节骨质水肿;计算撕裂及正常跟腱80KeV图像与135KeV图像上的CT差,CT差=CT均值135-CT均值80。结果 99KeV软组织图像窗上横断面结合MPR均能诊断跟腱完全撕裂患者,诊断跟腱完全撕裂灵敏性100%、特异性100%,诊断跟腱部分撕裂的灵敏性81.8%、特异性100%;VR图像上,诊断跟腱完全撕裂的灵敏性100%、特异性100%,诊断跟腱部分撕裂的灵敏性63.6%、特异性100%;虚拟去钙图上,诊断骨质水肿患者灵敏性77.5%、特异性80%。MRI诊断完全及部分跟腱断裂和骨质肿患者的灵敏性100%、特异性100%,诊断骨折的灵敏性40%、特异性100%。结论双能CT成像能有效诊断跟腱完全撕裂和部分撕裂,发现骨折优于MRI、发现骨质水肿差于MRI。Objective To investigate the application value of low-dose single-source dual-energy CT and MRI in diagnosis of Achilles tendon rupture.Methods A total of 42 patients with suspected Achilles tendon rupture underwent dual-energy CT and MRI scanning.36 cases of Achilles tendon rupture and 6 cases of normal patients were tested.In 36 cases of Achilles tendon rupture patients,25 patients with complete Achilles tendon rupture were diagnosed by MRI.11 patients with partial rupture,7 patients were diagnosed by follow-up MRI,4 patients were diagnosed by operation and MRI.6 patients with normal tendons were diagnosed as calcaneal fracture,the fracture line involved the attachment of the Achilles tendon.The operation was clear and no rupture of Achilles tendon was observed in operation.Two-dimensional and three-dimensional image post processing,such as multiplanar reconstruction(MPR),tendon 3D volume rendering(VR),to show Achilles tendon,dual-energy CT virtual decalcification imaging for diagnosis of ankle bone edema,calculation of tear and normal tendon CTD,CTD=CTmean135-CTmean80.Results 99 KeV soft tissue image window combined with MPR can diagnose the complete rupture of Achilles tendon.The sensitivity and specificity of diagnosis of complete rupture of Achilles tendon were 100%and 100%,respectively.The sensitivity and specificity of diagnosis of partial rupture of Achilles tendon were 81.8%and 100%,respectively,on VR imaging,the sensitivity and specificity of diagnosis of complete rupture of Achilles tendon were 100%and 100%,respectively.The sensitivity and specificity of diagnosis of complete rupture of Achilles tendon were 63.6%and 100%,respectively,on virtual calcium removal imaging,the sensitivity and specificity of diagnosis of bone edema were 77.5%and 80%respectively.The sensitivity and specificity of MRI diagnosis of complete and partial Achilles tendon rupture and bone edema patients were 100%and 100%,respectively.The sensitivity and specificity of bone fracture patients were 40%and 100%,respectively.Conclusion

关 键 词：双能量CT 跟腱撕裂 

分 类 号：R686[医药卫生—骨科学]