双能量CT对腕关节骨挫伤的诊断价值

doi:10.12117/jccmi.2018.07.014

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Abstract Objective: To evaluate the performance of virtual non-calcium images reconstructed from DECT for the diagnosis of bone marrow lesions in patients with acute wrist joint trauma in comparison with MRI. Methods: Thirty-five patients underwent DECT(80 kVp and 140 kVp 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 system(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 sensitivity, 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 increased from 0 to 3(P<0.001) with increasing corresponding CT values. There were significant differences in CT values between 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.

Key words： Wrist injuries Tomography, X-ray computed Magnetic resonance imaging

Received: 08 September 2017

PACS:	Ｒ684
	Ｒ681.7
	Ｒ814.42
	Ｒ445.2

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http://www.jccmi.com.cn/EN/10.12117/jccmi.2018.07.014 OR http://www.jccmi.com.cn/EN/Y2018/V29/I7/505

[1]Disseldorp DJ, Hannemann PF, Poeze M, et al. Dorsal or volar plate fixation of the distal radius: does the complication rate help us to choose?[J]. J Wrist Surg, 2016, 5(3): 202-210.
[2]Chin YC, Wijaya R, Chongle R, et al. Bone bruise patterns in knee injuries: where are they found?[J]. Eur J Orthop Surg Traumatol, 2014, 24(8): 1481-1487.
[3]Hoch JM, Mattacola CG. The effect of bone-bruise lesions on pain in patients with traumatic knee injury[J]. J Sport Rehabil, 2012, 21(1): 79-82.
[4]Eriksen EF. Treatment of bone marrow lesions(bone marrow edema)[J]. Bonekey Rep, 2015, 25(4): 755.
[5]Pathria MN, Chung CB, Resnick DL. Acute and stress-related injuries of bone and cartilage: pertinent anatomy, basic biomechanics, and imaging perspective[J]. Radiology, 2016, 280(1): 21-38.
[6]Muratovic D, Cicuttini F, Wluka A, et al. Bone marrow lesions detected by specific combination of MRI sequences are associated with severity of osteochondral degeneration[J]. Arthritis Res Ther, 2016, 24(18): 54.
[7]Mandalia V, Fogg AJ, Chari R, et al. Bone bruising of the knee[J]. Clin Radiol, 2005, 60(6): 627-636.
[8]Mutlu S, Mutlu H, Kmb B, et al. Magnetic resonance imaging-based diagnosis of occult osseous injuries in traumatic knees[J]. Open Orthop J, 2015, 31(1): 84-88.
[9]赵新玉，仵志强，刘玉，等. MSCT在微小骨折诊断中的应用[J]. 中国临床医学影像杂志，2013，24（10）：751-752.
[10]陈婷婷，刘白鹭. 双源CT VNC技术在诊断隐匿性骨折中的应用进展[J]. 中国临床医学影像杂志，2016，27（1）：66-68.
[11]曹建新，孔祥泉，王一民，等. 膝关节双能量CT低剂量扫描对虚拟去钙图像质量及骨挫伤诊断的影响[J]. 临床放射学杂志，2015，34（10）：1673-1678.
[12]黄伟，徐益明，卢道延，等. 双源CT去钙成像评价椎体骨髓水肿[J]. 医学影像学杂志，2015，25（3）：386-390.
[13]Ai S, Qu M, Glazebrook KN, et al. Use of dualenergy CT and virtual non-calcium techniques to evaluate post-traumatic bone bruises in knees in the subacute setting[J]. Skel Radiol, 2014, 43(9): 1289-1295.
[14]Guggenberger R, Gnannt R, Hodler J, et al. Diagnostic performance of dual-energy CT for the detection of traumatic bone marrow lesions in the ankle: comparison with MR imaging[J]. Radiology, 2012, 264(1): 164-173.
[15]Pache G, Krauss B, Strohm P, et al. Dual-energy CT virtual noncalcium technique: detecting posttraumatic bone marrow lesions-feasibility study[J]. Radiology, 2010, 256(2): 617-624.
[16]Seo SH, Sohn YJ, Lee CH, et al. Dual-energy CT for detection of traumatic bone bruises in the knee joint[J]. J Kor Soc Radiol, 2013, 69(6): 487-494.
[17]Cao JX, Wang YM, Kong XQ, et al. Good interrater reliability of a new grading system in detecting traumatic bone marrow lesions in the knee by dual energy CT virtual non-calcium images[J]. Eur J Radiol, 2015, 84(6): 1109-1115.
[18]Rrkli DA, Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function. A preliminary report of 20 cases[J]. J Bone Joint Surg Br, 1996, 78(4): 588-592.
[19]Kaewlai R, Avery LL, Asrani AV, et al. Multidetector CT of carpal injuries: anatomy, fractures, and fracture-dislocations[J]. Radiographics, 2008, 28(12): 1771-1784.
[20]Papp S. Carpal bone fractures[J]. Hand Clin, 2010, 26(1): 119-127.
[21]Friedrich KM, Komowski A, Tratinig S. 7T imaging of the wrist[J]. Semin Musculoskelet Radiol, 2012, 16(2): 88-92.