Department of Radiology and Nuclear Medicine, University of Maryland School of Medicine and Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.
Emerg Radiol. 2020 Jun;27(3):285-292. doi: 10.1007/s10140-020-01753-w. Epub 2020 Jan 25.
To determine whether dual energy CT (DECT) scanning can aid in the differentiation between acute traumatic and pathologic fractures of the pelvis and long bones.
Retrospective review of 11 patients with 15 pathologic fractures proven by biopsy and/or other advanced imaging modalities. Age- and sex-matched patients with non-pathologic traumatic fractures were used as controls. Studies were reviewed by two readers on syngo.via software before and after the creation of virtual bone marrow color maps. Hounsfield units (HU) of the marrow space at the level of the fracture were recorded on both reviews. Differences between the HU of the bone marrow of traumatic and pathologic fractures were compared using two-tailed unpaired t-test.
A statistically significant difference was found in the HU of the affected bone marrow on DECT virtual noncalcium bone marrow color maps between the pathologic group (mean HU:4.89) and the non-pathologic group (mean HU: - 286.2) (p = 0.0177). HU measurements on the mixed kVp images were 150.4 for the pathologic and 94.1 for the non-pathologic fracture groups, respectively, with no statistical significance (p = 0.272).
DECT scanning can aid in the differentiation between hematoma at acute traumatic fracture sites and neoplasm at pathologic fracture sites. HU of the bone marrow is higher for pathologic fractures, and the difference in bone marrow attenuation is more evident on the virtual bone marrow color maps.
确定能区分急性创伤性和病理性骨盆及长骨骨折的双能 CT（DECT）扫描。
回顾性分析 11 例经活检和/或其他高级影像学证实的 15 例病理性骨折患者。选择年龄和性别匹配的非病理性创伤性骨折患者作为对照组。由两名读者在 syngo.via 软件上分别在创建虚拟骨髓彩色图谱之前和之后对研究进行回顾。记录骨折水平骨髓空间的 HU 值。使用双尾非配对 t 检验比较创伤性和病理性骨折骨髓的 HU 值差异。
在 DECT 虚拟非钙骨髓彩色图谱上，病理性组（平均 HU：4.89）和非病理性组（平均 HU：-286.2）的受累骨髓 HU 值存在统计学差异（p=0.0177）。混合 kVp 图像上的 HU 值分别为病理性骨折组 150.4 和非病理性骨折组 94.1，无统计学意义（p=0.272）。
DECT 扫描有助于区分急性创伤性骨折部位的血肿和病理性骨折部位的肿瘤。病理性骨折的骨髓 HU 值较高，在虚拟骨髓彩色图谱上骨髓衰减的差异更为明显。
