双能CT物质分解成像在椎体压缩性骨折骨髓水肿诊断中的应用价值  

The Value of Dual-Energy CT Material Decomposition Imaging in the Diagnosis of Bone Marrow Edema in Vertebral Compression Fractures

作　　者：姚俊鹏 王建国[2] 樊子健 刘传梅 庄顺达 YAO Junpeng;WANG Jianguo;FAN Zijian(Shandong University of Traditional Chinese Medicine,Jinan,Shandong Province 250014,P.R.China)

机构地区：[1]山东中医药大学,济南250014 [2]山东中医药大学附属医院放射科,济南250014

出　　处：《临床放射学杂志》2021年第5期979-982,共4页Journal of Clinical Radiology

摘　　要：目的探讨双能CT物质分解成像在椎体压缩性骨折骨髓水肿诊断中的价值。方法回顾性分析2019年10月至2020年2月行双能CT和MRI检查的47例椎体压缩性骨折患者的影像图像。以MRI作为参考标准,由两名诊断医师在未知MR结果情况下利用双能CT水-钙物质分解伪彩图像对椎体骨髓水肿进行视觉评估,计算视觉评估在椎体骨髓水肿诊断中的灵敏度、特异度及准确度;并分别在水-钙物质分解图像上选择感兴趣区(ROI)测量所有椎体的相对水含量值(mg/cm3),利用受试者工作特征曲线(ROC)分析双能CT水-钙物质分解中椎体相对水含量值在椎体骨髓水肿诊断中的效能。结果 307个椎体中,MRI显示骨髓水肿椎体56个,双能CT水-钙物质分解伪彩图像显示57个椎体存在骨髓水肿,双能CT水-钙物质分解伪彩图像诊断骨髓水肿灵敏度94.6%,特异度98.4%,准确度97.7%。ROC分析显示,当相对水含量值为1037.25 mg/cm3时,双能CT对椎体骨髓水肿的诊断效能最高,灵敏度96.4%,特异度94.8%,准确度95.1%。结论双能CT物质分解成像在椎体压缩性骨折骨髓水肿诊断中,使用视觉评估和定量评估均具有很好的诊断价值。Objective To explore the diagnostic efficacy of dual-energyCT(DECT)material decomposition imaging in the diagnosis of bone marrow edema in vertebral compression fractures. Methods 47 patients with vertebral compression fracture who underwent DECT and MRI examination from October 2019 to February 2020 were analyzed retrospectively.MRI served as the standard of reference, two diagnostic physicians used DECT water-calcium decomposition pseudo-color images to visually evaluate vertebral bone marrow edema under no MRI results, and calculated the sensitivity, specificity and accuracy of visual evaluation in the diagnosis of vertebral bone marrow edema.The relative water content(mg/cm3) of all vertebral bodies was measured by selecting the region of interest(ROI) on the water-calcium material decomposition images, and the receiver curve was used to analyze the efficiency of vertebral relative water content(ROC) in the diagnosis of vertebral bone marrow edema. Results In 307 vertebral bodies, MRI showed bone marrow edema in 56 vertebral bodies, DECTwater-calcium material decomposition pseudo-color images showed bone marrow edema in 57 vertebral bodies, DECTwater-calcium material decomposition pseudo-color images in the diagnosis of bone marrow edema had a sensitivity of 94.6%,a specificity of 98.4%,and an accuracy of 97.7%.The ROC analysis of the relative water content of the vertebral body of DECT showed that when the relative water content is 1037.25 mg/cm3,DECT has the highest diagnostic efficiency for vertebral bone marrow edema, with a sensitivity of 96.4%,a specificity of 94.8% and an accuracy of 95.1%. Conclusion In the diagnosis of bone marrow edema caused by vertebral compression fractures, DECT material decomposition imaging has good diagnostic value in both visual evaluation and quantitative evaluation.

关 键 词：双能CT 物质分解 椎体压缩性骨折 骨髓水肿 磁共振成像 

分 类 号：R683[医药卫生—骨科学]