单源双能量CT虚拟去钙成像对脊柱压缩性骨折骨髓水肿的诊断价值研究  

Diagnostic value of VNCa imaging of single-source DECT for bone marrow edema of patients with spinal compression fracture

作　　者：李微[1] 王毅[1] 周宇[1] 韩雪[1] 王丹 Li Wei;Wang Yi;Zhou Yu;Han Xue;Wang Dan(Department of Radiology,Wang Jing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院放射科,北京100102

出　　处：《中国医学装备》2024年第12期61-65,共5页China Medical Equipment

摘　　要：目的:探讨利用单源双能量CT(DECT)的虚拟去钙(VNCa)成像在脊柱压缩性骨折骨髓水肿诊断准确性的价值。方法:回顾性分析2021年1月至2022年6月期间于中国中医科学院望京医院就诊的60例胸椎及腰椎椎体压缩性骨折患者的临床及影像资料。两名医生在未知MRI结果前提下,主观评估VNCa图像,计算对骨折椎体骨髓水肿的诊断灵敏度、特异度及准确率;以MRI结果为参考标准,比较水肿椎体与正常椎体CT值的差异,运用受试者工作特征(ROC)曲线分析虚拟去钙图的CT值对脊椎骨髓水肿的诊断价值。结果:60例患者中共观察451个椎体,其中胸椎238个,腰椎213个,MRI诊断椎体骨髓水肿83个,正常椎体368个。以MRI检查为参考标准,阅片者使用VNCa图像进行诊断脊椎压缩性骨折骨髓水肿的灵敏度为87.95%,特异度为98.91%,准确率为96.90%。使用VNCa图像定量测定骨髓水肿的平均CT值(-13.82±24.97)HU高于正常椎体(-51.67±23.78)HU,差异具有统计学意义(t=12.98,P<0.05)。定量测定ROC曲线下面积为0.867,骨髓水肿的截断值设定为-26.90 HU,灵敏度、特异度及准确率分别为78.30%、84.50%和86.7%。结论:DECT的VNCa图像视觉和定量分析均可以有效诊断椎体压缩性骨折骨髓水肿。Objective:To investigate the value of Virtual Non-Calcium(VNCa)imaging of single-source dualenergy computed tomography(DECT)in the diagnostic accuracy for bone marrow edema of spinal compression fracture.Methods:The clinical and image data of a total of 60 patients with vertebral compression fracture on thoracic and lumbar vertebrae,who admitted to Wang Jing Hospital of China Academy of Chinese Medical Sciences from January 2021 to June 2022,were retrospectively analyzed.Two doctors conducted subjective assessment for VNCa images under the premise that they did not know results of magnetic resonance imaging(MRI).Then,the diagnostic sensitivity,specificity and accuracy of that for bone marrow edema of fractured vertebral body were calculated.The MR results were used as reference standard to compared whether existed differences in the CT values between edema vertebrae and normal vertebrae.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of CT values of VNCa images for spinal bone marrow edema.Results:A total of 451 vertebral bodies were observed in 60 patients,which included 238 thoracic vertebrae and 213 lumbar spine.MRI diagnosis confirmed 83 vertebral bone marrow edema and 368 normal vertebral body.MRI examination was used as reference standard,and the sensitivity,specificity and accuracy of using VNCa images by doctors were respectively 87.95%,98.91%and 96.90%in diagnosing bone marrow edema of spinal compression fracture.The average CT value of using VNCa image was(-13.82±24.97)HU in determining bone marrow edema,which was significantly higher than that(-51.67±23.78)HU of normal vertebrae,and the differences were significant(t=12.98,P<0.05).The area under curve(AUC)value of ROC curve that was quantitatively determined was 0.867,and the cut-off value of diagnosing bone marrow edema was set at-26.90 HU,and the sensitivity,specificity and accuracy were respectively 78.30%,84.50%and 86.7%.Conclusion:The vision and quantitative analysis of VNCa images of single-source DECT can e

关 键 词：单源双能量CT 磁共振成像(MRI) 虚拟去钙(VNCa) 脊椎压缩性骨折 骨髓水肿 

分 类 号：R816.8[医药卫生—放射医学]