双能CT虚拟去钙技术评估骨髓损伤的应用研究

发布时间：2018-02-26 06:06

本文关键词： 双能CT 虚拟去钙骨髓水肿磁共振成像　出处：《中国中西医结合影像学杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的:探讨双能CT(dual energy CT,DECT)在评估骨髓损伤中的应用价值。方法:收集11例病史完整的急性关节损伤患者的MRI和DECT资料。由2位副高级职称的骨关节系统影像科医师(Z和X)采用双盲法对DECT虚拟去钙图像进行评级(4级法),以骨髓水肿作为骨髓损伤的图像指标,参照MRI平扫(含抑脂T2WI)图像,评级一致后纳入统计分析。结果:在11例中,纳入统计253个区域。将1级定为阳性,阅片人Z判定DECT图像对骨髓水肿诊断灵敏度、特异度、阳性预测值、阴性预测值分别为73.3%、93.8%、83.30%、89.2%,准确度为87.8%,K=0.681;阅片人X判定相应各值为67.9%、90.9%、76.8%、86.4%,准确度为83.8%,K=0.607。将1级和2级定为阳性,阅片人Z相应各值为55.7%、90.6%、83.1%、71.0%、74.7%,K=0.475;阅片人X相应各值为52.2%、88.4%、78.9%、68.9%、71.9%,K=0.418。测量各分区CT值,差异均有统计学意义(均P0.05)。使用CT值绘制ROC曲线,若将1级图像定为阳性,则胫骨上段及股骨下段AUC值分别为0.883和0.941。若将1级和2级图像定为阳性,则胫骨上段及股骨下段AUC值分别为0.786和0.943。结论:DECT虚拟去钙技术可去除骨中的钙质,直观显示骨髓水肿,提示骨髓损伤;CT值可作为骨髓水肿程度的定量参数。
[Abstract]:Objective: to evaluate the value of dual energy CT(dual energy CTECT in the evaluation of bone marrow injury. Methods: the data of MRI and DECT in 11 patients with acute joint injury with complete history were collected. The DECT virtual decalcification images were rated by 4 grades method with double blind method, and bone marrow edema was used as the image index of bone marrow injury. According to the MRI plain scan (T2WI) image, the same grade was included in the statistical analysis. Results: in 11 cases, 253regions were included. Grade 1 was regarded as positive. The diagnostic sensitivity and specificity of DECT images for bone marrow edema were determined by Z. The positive predictive value and the negative predictive value were 73.33.93.8and 83.30m, respectively, and the accuracy was 87.80.681.The corresponding value of the film reader X was 67.99.90.90.86.4. the accuracy was 83.8K0.607.The corresponding values of grade 1 and grade 2 were determined as positive, and the corresponding values of Z were 55.70.690.691.073.71.71.71.74.70.705; the corresponding values of X-ray were 52.28.48.48.48.78.97.78.9k180.4. the CT values of each subdivision were measured, and the corresponding values of the two grades were 55.70.93 and 83.71.0, respectively, and the corresponding values were 74.71.70.475.The corresponding values of X were 52.28.78.98.98.90.607. the corresponding values of the first and second grades were determined as positive, and the corresponding values of Z were 55.70.691 and 83.71.71.74.70.475.The corresponding values were 52.28.78.988. The difference was statistically significant (P 0.05). The AUC values of the upper tibia and the lower femur were 0.883 and 0.941 respectively, if the grade 1 images were positive, the first and second grade images were positive, if the CT value was used to draw the ROC curve, the AUC values of the upper tibia and the lower femur were 0.883 and 0.941, respectively. The AUC values of the upper tibia and the lower femur were 0.786 and 0.943 respectively. Conclusion the virtual decalcification technique can remove the calcium from the bone and show the bone marrow edema directly, suggesting that the CT value of bone marrow injury can be used as a quantitative parameter of the degree of bone marrow edema.
【作者单位】：武汉大学中南医院医学影像科;西门子中国有限公司;武汉大学中南医院检验科;武汉大学中南医院干部保健处;
【基金】：国家自然科学基金项目(81171315;81227902)
【分类号】：R651.2;R816.1

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