【摘要】 目的:评估双能量CT(DECT)去钙成像技术对急性腕关节骨挫伤的诊断性能。方法 :35例急性腕关节损伤患者行DECT检查并在3 d内进行MRI检查。分别对VNCa图像和MRI进行评分,并测量VNCa图像中骨髓CT值。结果 :所有骨髓病变以MR图像作为参考标准、2~3级骨髓作为阳性结果,分析DECT图像尺桡骨远端骨髓病变敏感性83.33%,特异性91.30%,阳性预测值为83.33%,阴性预测值为91.30%。DECT去钙图像中骨挫伤病灶随着CT值增高,骨髓等级也逐渐增加。骨髓阳性区域与阴性区域的CT值有显著差异(P<0.001)。以骨髓VNCa图像的CT值做ROC曲线分析,尺桡骨远端的曲线下面积>0.5。结论:以MR成像作为参考标准,DECT的VNCa图像在检测腕关节骨挫伤病灶中具有良好的诊断价值,可能是磁共振成像禁忌症患者的一个潜在替代扫描方法。更多还原

【Abstract】 Objective: To evaluate the performance of virtual non-calcium images reconstructed from DECT for the diag-nosis of bone marrow lesions in patients with acute wrist joint trauma in comparison with MRI. Methods: Thirty-five patients underwent DECT(80 k Vp and 140 k Vp with tin filter) and MR imaging within 3 day following acute wrist trauma. Presence of traumatic bone bruise on MR and virtual non-calcium images were graded respectively by the readers using a four-point sys-tem(3=distinct bone marrow lesion, 0=no lesion), and CT values in virtual non-calcium images were calculated. Results: All bone marrow lesions used MR images as a reference standard. Bone marrow graded 2~3 was considered positive. The sensitiv-ity, specifity, negative predictive value and positive predictive value were 83.33%, 91.30%, 83.33% and 91.30% by analyzing DECT images of the distal ulnar radius bone marrow. In non-calcium images, the grades of bone marrow lesion gradually in-creased from 0 to 3(P <0.001) with increasing corresponding CT values. There were significant differences in CT values be-tween the positive and negative regions(P<0.001). CT numbers for distal ulna and radius bone marrow lesions were analyzed by ROC, revealing areas under the receiver operating characteristic curve greater than 0.5. Conclusion: Compared with MR images, bone bruises of the wrist joint can be diagnosed on virtual non-calcium images reconstructed from DECT with high specificity and excellent negative predictive value. DECT may be a potential alternative method to MRI contraindications.更多还原