双能CT虚拟去钙技术对急性髋部无移位骨折的诊断价值  

The value of dual-energy CT virtual non-calcium imaging in the diagnosis of acute non-displaced hip fractures

作　　者：张玉婷[1] 姜永宏[1] 刘正华[1] ZHANG Yuting;JIANG Yonghong;LIU Zhenghua(CT Room,Honghui Hospital,Xi’an Jiaotong University,Xi’an 710054,China)

机构地区：[1]西安交通大学附属红会医院CT室,陕西西安710054

出　　处：《实用放射学杂志》2020年第10期1635-1638,1658,共5页Journal of Practical Radiology

摘　　要：目的评价双能CT(DECT)虚拟去钙(VNCa)成像对急性髋部无移位性骨折的诊断价值。方法收集189例因外伤后怀疑急性髋部无移位性骨折(包括股骨近端、耻骨、坐骨)行DECT检查的患者的CT图像,以影像学检查、手术记录为参照标准,最终58例患者纳入研究,其中36例无移位骨折,22例无骨折。2名放射科医师(读片者1、2)分别对CT图像进行视觉分析诊断,先后分别采用3种方法:组1仅采用骨重建图像,组2仅采用VNCa图像,组3采用骨重建联合VNCa图像。并比较3种方法的诊断性能。结果在视觉分析中,2名医师采用组3方法时灵敏度、阴性预测值均有提高。其中读片者1组3方法的灵敏度、准确度均高于组1方法,差异有统计学意义。定量分析中,非移位骨折周围骨髓VNCa值高于健侧相应部位骨髓的VNCa值,且差异有统计学意义。结论通过添加VNCa图像作为骨重建的补充,有助于提高CT对髋部非移位骨折的诊断性能,可用于临床。Objective To evaluate the diagnostic value of virtual non-calcium(VNCa)imaging in acute non-displaced hip fractures using DECT.Methods CT images of 189 patients after trauma who underwent DECT due to suspicion of acute non-displaced fractures(including the proximal femur,pubic bone or ischium)were collected.Radiological or surgical record was the standard of reference.Finally,58 patients were selected in the study,including 36 cases with non-displaced fracture and 22 cases with no fracture.Two radiologists(reader 1 and reader 2)visually interpreted CT images independently,and adopted three methods respectively:bone reconstruction images were used only in group 1,VNCa images were used only in group 2,and bone reconstruction combined with VNCa images were used in group 3.The diagnostic performance of the three methods was compared between them.Results In the visual analysis,sensitivity and negative predictive value of group 3 were improved for both readers.The sensitivity and accuracy of group 3 were higher than that of group 1,and the difference was statistically significant for reader 1.In the quantitative analysis,the VNCa value of the bone marrow around non-displaced fractures was higher than that of the corresponding bone marrow on the healthy side,and the difference was statistically significant.Conclusion Adding VNCa image as the supplement of bone reconstruction,it is helpful to improve the diagnostic performance of CT for non-displaced hip fractures and can be used in clinical practice.

关 键 词：双能CT 骨髓水肿 虚拟去钙 髋部骨折 

分 类 号：R814.42[医药卫生—影像医学与核医学] R681.2[医药卫生—放射医学]