第三代双源CT虚拟去钙成像对膝关节创伤性骨髓水肿的诊断价值  

The Value of the Third Generation Dual Source CT Virtual Non-Calcium Imaging in the Diagnosis of Traumatic Bone Marrow Edema of Knee Goint

作　　者：孙姗姗 黄奔 祁良[1] 邹月芬[1] 陶欣慰 张也乐[1] SUN Shanshan;HUANG Ben;QI Liang(The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210009,P.R.China)

机构地区：[1]南京医科大学第一附属医院,210009 [2]上海西门子医疗器械有限公司,200126

出　　处：《临床放射学杂志》2022年第5期913-917,共5页Journal of Clinical Radiology

摘　　要：目的探讨Siemens第三代Force双源CT虚拟去钙(VNCa)图像在不同相对钙比率(Rel.Ca)条件下对膝关节隐匿性骨折骨髓水肿的诊断价值。方法回顾性分析26例外伤患者的膝关节双能量CT(DECT)和MRI检查的影像资料。将每个膝关节分为12个区域(股骨下段及胫骨上段各6个),以MRI图像为标准,对取不同Rel.Ca值(1.59、1.69、1.79、1.89)获得的VNCa图所显示骨髓水肿的效能进行分析,选出最佳Rel.Ca值,并在此最优条件下测量骨髓水肿区域与正常区域的CT值。结果Rel.Ca取1.59、1.69、1.79、1.89的VNCa图诊断膝关节隐匿性骨折骨髓水肿的受试者工作特征曲线(ROC)曲线下面积(AUC)分别为0.70、0.90、0.93、0.88,Rel.Ca 1.79时诊断效能最高。Rel.Ca 1.79时对应的VNCa图中骨髓水肿区域平均CT值为(-15.27±20.03)HU,正常区域的平均CT值为(-114.52±14.18)HU,差异具有统计学意义(P<0.001)。结论Rel.Ca值为1.79的VNCa图对膝关节隐匿性骨折骨髓水肿的诊断效能最佳,VNCa图上CT值测量有助于骨髓水肿的定量分析。Objective To investigate the value of the third generation force dual source CT virtual non-calcium image(VNCa)in the diagnosis of bone marrow edema of occult fracture of knee joint under different relative calcium ratio(Rel.Ca).Methods The imaging data of DECT and MRI of knee joint in 26 patients with trauma were collected retrospectively.Each knee joint was divided into 12 areas(6 in the lower femur and 6 in the upper tibia).Based on MRI images,the effectiveness of bone marrow edema of the knee joint shown by VNCa images obtained with different Rel.Ca values(1.59,1.69,1.79 and 1.89)was analyzed,the best Rel.Ca value was selected,and the CT values of bone marrow edema area and normal area were measured under this optimal condition.Results the areas under the ROC curve of VNCa of 1.59,1.69,1.79 and 1.89 were 0.70,0.90,0.93 and 0.88 respectively.The diagnostic efficiency was the highest when Rel.Ca=1.79.When Rel.Ca=1.79,the average CT value of bone marrow edema area was(-15.27±20.03)HU and that of normal area was(-114.52±14.18)HU,The difference was statistically significant(P<0.001).Conclusion VNCa with Rel.Ca value of 1.79 was the best in the diagnosis of bone marrow edema of occult fracture of knee joint.The measurement of CT value on VNCa is helpful to the quantitative analysis of bone marrow edema.

关 键 词：双能量CT 虚拟去钙成像 相对钙比率 膝关节 骨髓水肿 

分 类 号：R551.3[医药卫生—血液循环系统疾病]