双能量CT虚拟去钙技术对骶髂关节炎骨髓水肿的诊断价值  

Diagnostic performance of dual-energy CT virtual non-calcium technique for bone marrow edema in sacroiliitis

作　　者：沈瑞 吴胤赟 李玲[1] 徐驰杰 邓小毅 SHEN Rui;WU Yinyun;LI Ling;XU Chijie;DENG Xiaoyi(Department of Imaging,the Affiliated Aoyang Hospital of J iangsu University,Zhangjiagang,J iangsu Province 215600,China)

机构地区：[1]江苏大学附属澳洋医院影像科,江苏张家港215600

出　　处：《实用放射学杂志》2023年第4期621-625,共5页Journal of Practical Radiology

基　　金：张家港市科技支撑(社会发展)计划项目(ZKS1933)。

摘　　要：目的探讨双能量CT(DECT)虚拟去钙(VNCa)技术诊断骶髂关节炎骨髓水肿(BME)的可行性及准确性。方法前瞻性连续纳入骶髂关节炎患者31例。所有患者均行DECT和MRI检查。将每个骶髂关节分成4个区域,分别对每个区域在VNCa图像、MRI上是否存在BME进行分级。测量每个区域VNCa图像的骨髓CT值。结果VNCa图像诊断骶髂关节炎BME的准确性为78.6%。VNCa图像上阳性BME区域的CT值[髂骨(-7.7±24.9)HU;骶骨(1.0±26.9)HU]明显高于正常骨髓区域[髂骨(-51.4±20.5)HU;骶骨(-40.0±15.3)HU](P<0.0001)。VNCa图像诊断髂骨、骶骨区域BME的曲线下面积(AUC)均为0.913,最佳诊断界值分别为-29.9HU、-17.6HU。结论DECT VNCa图像可以诊断骶髂关节炎BME,与MRI相比,敏感性和特异性中等;对MRI上明显的BME,有较高的敏感性和极佳的阴性预测价值。Objective To investigate the feasibility and accuracy of dual-energy CT(DECT)virtual non-calcium(VNCa)technique in the diagnosis of bone marrow edema(BME)in sacroilitis.Methods Thirty-one patients with sacroilitis were enrolled prospectively and consecutively.All patients underwent DECT and MRI examination.Each sacroiliac joint was divided into four quadrants,and whether there was BME in each quadrant on VNCa image and MRI was graded.The bone marrow CT values of VNCa image in each quadrant were measured.Results The accuracy of VNCa image in diagnosing sacroilitis BME was 78.6%.The CT values of positive BME quadrants on VNCa images[ilium(-7.7±24.9)HU;sacrum(1.0±26.9)HU] were significantly higher than that of normal bone marrow quadrants[ilium(-51.4±20.5)HU;sacrum(-40.0±15.3)HU](P<0.0001).The area under the curve(AUC)of BME in ilium and sacrum diagnosed by VNCa image was 0.913,and the best diagnostic cutoff values were-29.9 HU and-17.6 HU,respectively.Conclusion DECT VNCa images can be used to diagnose sacroilitis BME,with moderate sensitivity and specificity compared with MRI;it has high sensitivity and good negative predictive value for distinct BME on MRI.

关 键 词：双能量CT 骶髂关节炎 骨髓水肿 磁共振成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R684.3[医药卫生—放射医学] R445.2[医药卫生—临床医学]