Karaca Leyla, Yuceler Zeynep, Kantarci Mecit, Çakır Murteza, Sade Recep, Calıkoglu Cagatay, Ogul Hayri, Bayrakturan U Gulsum
1 Atatürk University, Medical School, Department of Radiology, Erzurum, Turkey.
2 Eregli State Hospital, Radiology Department, Zonguldak, Turkey.
Br J Radiol. 2016;89(1057):20150300. doi: 10.1259/bjr.20150300. Epub 2015 Nov 5.
To prospectively evaluate the ability of dual-energy CT (DECT), compared with MRI, to identify vertebral compression fractures in acute trauma patients.
This institutional review board-approved study included 23 consecutive patients with 32 vertebral fractures who underwent both DECT and MRI of the spine between February 2014 and September 2014. A total of 209 vertebrae were evaluated for the presence of abnormal bone marrow attenuation on DECT and signal on MRI by five experienced radiologists. The specificity, sensitivity, predictive values and intraobserver and interobserver agreements were calculated.
MRI revealed a total of 47 vertebrae (22.4% of all vertebrae) and DECT revealed 44 vertebrae (21.0% of all vertebrae) with oedema. Using MRI as the reference standard, DECT had sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of 89.3, 98.7, 95.4, 96.9 and 96.6%, respectively. With respect to establishing the presence of oedema, the interobserver agreement was almost perfect (k = 0.82), and the intraobserver agreement was substantial (k = 0.80).
Compared with MRI, DECT can provide an accurate demonstration of acute vertebral fractures and can be used as an alternative imaging modality for the assessment of vertebral fractures in patients with contraindications for MRI.
Distinguishing of acute and chronic vertebral compression fracture is important for treatment choices. DECT is very fast compared with MRI and is an alternative imaging modality for the assessment of vertebral fractures in patients with contraindications for MRI.
前瞻性评估双能CT（DECT）与MRI相比，在急性创伤患者中识别椎体压缩骨折的能力。
这项经机构审查委员会批准的研究纳入了2014年2月至2014年9月期间连续23例患有32处椎体骨折的患者，这些患者均接受了脊柱的DECT和MRI检查。五位经验丰富的放射科医生对总共209个椎体进行评估，以确定DECT上骨髓衰减异常及MRI上信号的情况。计算特异性、敏感性、预测值以及观察者内和观察者间的一致性。
MRI显示共有47个椎体（占所有椎体的22.4%）存在水肿，DECT显示44个椎体（占所有椎体的21.0%）存在水肿。以MRI作为参考标准，DECT的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为89.3%、98.7%、95.4%、96.9%和96.6%。在确定水肿的存在方面，观察者间一致性几乎完美（k = 0.82），观察者内一致性良好（k = 0.80）。
与MRI相比，DECT能够准确显示急性椎体骨折，可作为对MRI有禁忌证患者评估椎体骨折的替代成像方式。
区分急性和慢性椎体压缩骨折对治疗选择很重要。与MRI相比，DECT速度非常快，是对MRI有禁忌证患者评估椎体骨折的替代成像方式。
