单源双能量CT检测膝骨关节炎骨髓水肿的价值研究  

The value of single source dual energy CT in detecting bone marrow edema of knee osteoarthritis

作　　者：李生虎[1] 孟祥鸿[1] 刘栋[1] 胡云鹏 尹恒[1] 王莉莉[2] LI Shenghu;MENG Xianghong;LIU Dong;HU Yunpeng;YIN Heng;WANG Lili(Department of Radiology,Wuxi City Hospital of TCM,Wuxi 214000,P.R.China;Department of Radiology,Gansu Provincal Hospital,Lanzhou 730000,P.R.China)

机构地区：[1]江苏省无锡市中医医院放射科,江苏无锡214071 [2]甘肃省人民医院放射科,甘肃兰州730000

出　　处：《医学影像学杂志》2019年第11期1959-1961,1965,共4页Journal of Medical Imaging

基　　金：江苏省自然科学基金资助项目(编号:BK20180167)

摘　　要：目的探讨单源双能量CT虚拟去钙技术对于膝关节骨关节炎骨髓水肿的诊断价值。方法回顾性研究2016年~2019年进行单源双能量膝关节检查的患者40例,同期90天内进行了膝关节MRI检查。将膝关节图像根据解剖部位分为5区,由放射诊断医生采用盲法对膝关节磁共振图像和双能量虚拟骨髓显像进行评估。Kappa检验评价结果的一致性。ROC曲线评估双能量虚拟骨髓显像检测骨髓水肿的效能,以磁共振图像为金标准计算敏感度、特异度。结果(1)两种方法一致性良好,Kappa=0.82,P=0.018;(2)敏感度90.43%,特异度66.98%;(3)ROC曲线下面积为0.883,P=0.000,95%可信区间为(0.834,0.932)。结论单源双能量虚拟骨髓显像和磁共振图像一致性良好,可用于膝关节骨关节炎骨髓水肿的评估。Objective To study the value of single source and dual energy CT virtual non-calcium technique in the diagnosis of bone marrow edema in knee osteoarthritis.Methods This retrospective study included 40 patients who underwent both MRI and dual-energy computed tomography from 2013 to 2019 within 90 days.All images were divided into 5 regions according to the anatomy and judged independently by different radiologists.The consistency of the evaluation results was tested by Kappa.Receiver operating characteristic curve was used to evaluate the efficacy of dual-energy virtual bone marrow imaging in detecting bone marrow edema.MRI was used as the gold standard to calculate the sensitivity and specificity.Results (1)The two methods were in good agreement with each other,Kappa=0.82,P=0.018;(2)The sensitivity was 90.43%and the specificity was 66.98%.Receiver operating characteristic analysis revealed an area under the curve of 0.883,P=0.000,and the 95%confidence interval(0.834,0.932).Conclusion Single-source dual-energy CT virtual non-calcium technique and magnetic resonance imaging have excellent consistency and feasibility for bone marrow edema of knee joint in osteoarthritis.

关 键 词：骨髓水肿 骨关节炎 膝 体层摄影术 X线计算机 磁共振成像 

分 类 号：R744[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]