From the Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology.
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Invest Radiol. 2021 Apr 1;56(4):207-214. doi: 10.1097/RLI.0000000000000734.
The aim of this study was to investigative the diagnostic accuracy of colored dual-energy computed tomography (CT) virtual noncalcium (VNCa) series for analyzing cervical disk herniation compared with standard gray-scale CT images, with magnetic resonance imaging (MRI) serving as standard of reference.
Data from 57 patients who underwent noncontrast dual-source CT and 3.0-Tesla (T) MRI within 2 weeks between January 2017 and December 2018 were retrospectively analyzed. Five radiologists analyzed standard gray-scale dual-energy CT scans for the presence and degree of cervical disk herniation and spinal nerve root impingement. Readers reassessed scans after 8 weeks using colored VNCa series. Two experienced radiologists set the reference standard in consensus MRI reading sessions. Primary indices of diagnostic accuracy for both CT approaches were sensitivity and specificity, which were compared by application of the McNemar test.
A total of 57 patients (mean age, 64 ± 11 years; 30 women) were evaluated (337 intervertebral disks). Magnetic resonance imaging indicated a total of 103 cervical disk herniations. The VNCa reconstructions had higher overall sensitivity compared with gray-scale CT (487/515 [95%; 95% confidence interval (CI), 91%-98%] vs 392/515 [76%; 95% CI, 70%-83%]), as well as higher specificity (1107/1170 [95%; 95% CI, 90%-99%] vs 906/1170 [77%; 95% CI, 72%-82%]) for assessing cervical disk herniation (all P < 0.001). The VNCa reconstructions had higher diagnostic accuracy for analyzing spinal nerve root impingement in comparison with gray-scale CT (sensitivity, 195/230 [85%; 95% CI, 79%-90%] vs 115/230 [50%; 95% CI, 40%-59%]; specificity, 1430/1455 [98%; 95% CI, 94%-100%] vs 1325/1455 [91%; 95% CI, 88%-98%]; accuracy, 1625/1685 [96%; 95% CI, 93%-99%] vs 1440/1685 [86%; 95% CI, 82%-90%]; all P < 0.001).
Color-coded VNCa series improved the diagnostic accuracy for assessing cervical disk herniation and spinal nerve root impingement compared with standard gray-scale CT.
本研究旨在探讨彩色双能 CT（CT）虚拟非钙（VNCa）系列在分析颈椎间盘突出症方面的诊断准确性，与磁共振成像（MRI）作为参考标准进行比较。
回顾性分析了 2017 年 1 月至 2018 年 12 月期间 57 例在两周内接受非增强双源 CT 和 3.0-T（T）MRI 检查的患者的数据。五位放射科医生分析了标准灰度双能 CT 扫描颈椎间盘突出症和脊神经根受压的存在和程度。在 8 周后，读者使用彩色 VNCa 系列重新评估了扫描结果。两位经验丰富的放射科医生在共识 MRI 阅读会议中设定了参考标准。两种 CT 方法的主要诊断准确性指标是敏感性和特异性，应用 McNemar 检验进行比较。
共评估了 57 例患者（平均年龄 64±11 岁；30 名女性）（337 个椎间盘）。MRI 显示共有 103 例颈椎间盘突出症。VNCa 重建与灰度 CT 相比，总体敏感性更高（487/515[95%；95%置信区间（CI），91%-98%]与 392/515[76%；95%CI，70%-83%]），特异性也更高（1107/1170[95%；95%CI，90%-99%]与 906/1170[77%；95%CI，72%-82%]），用于评估颈椎间盘突出症（均 P<0.001）。与灰度 CT 相比，VNCa 重建在分析脊神经根受压方面具有更高的诊断准确性（敏感性，195/230[85%；95%CI，79%-90%]与 115/230[50%；95%CI，40%-59%]；特异性，1430/1455[98%；95%CI，94%-100%]与 1325/1455[91%；95%CI，88%-98%]；准确性，1625/1685[96%；95%CI，93%-99%]与 1440/1685[86%；95%CI，82%-90%]；均 P<0.001）。
与标准灰度 CT 相比，彩色编码的 VNCa 系列提高了评估颈椎间盘突出症和脊神经根受压的诊断准确性。
