肩双重能量 CT 关节造影与磁共振关节造影在评估肩盂唇撕裂中的比较。
Evaluation of glenoid labral tears: comparison between dual-energy CT arthrography and MR arthrography of the shoulder.
机构信息
Department of Radiology, IRCCS Sacro Cuore Hospital, Negrar, Italy.
Department of Preventive Medicine Public Health Trust, Trento, Italy.
出版信息
Radiol Med. 2020 Jan;125(1):39-47. doi: 10.1007/s11547-019-01083-z. Epub 2019 Sep 20.
OBJECTIVE
To compare the diagnostic accuracy of dual-energy computed tomography arthrography (DE-CTA) and magnetic resonance arthrography (MRA) of the shoulder in depicting glenoid labral tears.
METHODS
This prospective institutional review board-approved study included 47 consecutive patients (28 males, 19 females; mean age of 34.2 years) studied between January 2017 and October 2018. All patients underwent DE-CTA and MRA the same day. Two radiologists (25 and 11 years of experience, respectively), blinded to clinical data, evaluated the presence labral tears on virtual-blended 120 kV standard CTA and on DE-CTA images. A third radiologist (18 years of experience) evaluated the MRA images. Diagnostic accuracy values were calculated by using surgery as standard of reference. Inter-observer and intra-observer agreements were calculated with k statistics. A value of p < 0.05 was considered statistically significant.
RESULTS
Surgery revealed the presence of labral tears in 38/47 patients (80.9%). Sensitivity and specificity values in diagnosing labral tears were 84.2% and 77.8% for MRA (Reader 3), 84.2% and 77.8% for CTA (Reader 1), 84.2% and 88.9% for CTA (Reader 2), 89.5% and 88.9% for DE-CTA (Reader 1), and 92.1% and 88.9% for DE-CTA (Reader 2). A nonsignificant increase in AUC values with respect to MRA was obtained by reading the CTA (p = 0.470) and DE-CTA dataset (p = 0.217), respectively. Inter-observer agreements were near perfect for CTA (k = 0.84) and substantial for DE-CTA reading (k = 0.76). Intra-observer agreements were near perfect both for CTA (k = 0.88) and for DE-CTA reading (k = 0.82).
CONCLUSION
DE-CTA and MRA were not different in terms of diagnostic performance.
目的
比较双能 CT 关节造影术（DE-CTA）和磁共振关节造影术（MRA）在肩关节评估盂唇撕裂中的诊断准确性。
方法
本前瞻性机构审查委员会批准的研究纳入了 2017 年 1 月至 2018 年 10 月期间连续 47 例患者（男 28 例，女 19 例；平均年龄 34.2 岁）。所有患者均在同一天行 DE-CTA 和 MRA 检查。两名放射科医师（分别具有 25 年和 11 年的经验）在不了解临床数据的情况下，评估虚拟混合 120 kV 标准 CTA 和 DE-CTA 图像上的盂唇撕裂。第三名放射科医师（具有 18 年的经验）评估 MRA 图像。使用手术作为参考标准计算诊断准确性值。使用 K 统计量计算观察者间和观察者内的一致性。p 值<0.05 被认为具有统计学意义。
结果
手术显示 47 例患者中有 38 例（80.9%）存在盂唇撕裂。MRA（Reader 3）诊断盂唇撕裂的敏感性和特异性值分别为 84.2%和 77.8%，CTA（Reader 1）分别为 84.2%和 77.8%，CTA（Reader 2）分别为 84.2%和 88.9%，DE-CTA（Reader 1）分别为 89.5%和 88.9%，DE-CTA（Reader 2）分别为 92.1%和 88.9%。与 MRA 相比，分别读取 CTA（p=0.470）和 DE-CTA 数据集（p=0.217）时，AUC 值略有增加，但无统计学意义。CTA （k=0.84）和 DE-CTA （k=0.76）的观察者间一致性接近完美。CTA （k=0.88）和 DE-CTA （k=0.82）的观察者内一致性均接近完美。
结论
DE-CTA 和 MRA 在诊断性能方面无差异。
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