Department of Radiology, the Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China; Department of Radiology, Zhuhai People's Hospital, Zhuhai, 519000, China.
Department of Radiology, the Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China.
Eur J Radiol. 2020 Dec;133:109385. doi: 10.1016/j.ejrad.2020.109385. Epub 2020 Nov 2.
The purpose of this study was to evaluate the diagnostic accuracy of different related contrast material (Rel.CM) values in dual-energy computed tomography (DECT) virtual non-calcium (VNCa) images for the detection of bone marrow edema (BME) in knee.
This prospective study was approved by the institutional research ethics board, and written informed consent was obtained from all participants. Twenty-three patients (24 knees) who underwent dual-energy CT and MRI within three weeks from July 2018 to June 2019 with a definite history of trauma were enrolled. Each knee was divided into 12 regions. First, MR images served as the reference standard, Receiver operating characteristic (ROC) curve was used and diagnostic accuracy of VNCa images corresponding to different Rel.CM values (1.25, 1.35, 1.45, 1.55, 1.65, 1.75) were analyzed, aimed to select an optimal Rel.CM value of VNCa images for detecting BME. Then, CT values of the normal areas and BME areas were measured on the VNCa images corresponding to the optimal Rel.CM value for preliminary quantitative analysis. The rank-sum test was used to compare the differences of CT values between BME areas and normal bone marrow areas on the VNCa images.
The 24 knees were divided into 288 areas. MR Imaging showed BME in 121 areas. The areas under the ROC curve with different Rel.CM values (1.25, 1.35, 1.45, 1.55, 1.65, and 1.75) were 0.633, 0.674, 0.882, 0.684, 0.651, and 0.649, respectively. On the VNCa images of Rel.CM = 1.45, the diagnostic accuracy was the highest (up to 89.2 %), the CT values of the BME area and the normal area were -67.9 (1.7∼-100.1) HU and -94.5 (-69.7∼-144.9) HU, respectively, with statistical significance (Z=-9.804, P < 0.05).
The VNCa images with a Rel.CM value of 1.45 is optimal for the detection of BME in knee.
本研究旨在评估双能 CT（DECT）虚拟非钙（VNCa）图像中不同相关对比剂（Rel.CM）值在膝关节骨髓水肿（BME）检测中的诊断准确性。
本前瞻性研究获得了机构研究伦理委员会的批准，并获得了所有参与者的书面知情同意。2018 年 7 月至 2019 年 6 月期间，23 例（24 膝）患者在 3 周内接受了双能 CT 和 MRI 检查，且均有明确外伤史。每只膝关节分为 12 个区域。首先，MR 图像作为参考标准，使用受试者工作特征（ROC）曲线分析对应不同 Rel.CM 值（1.25、1.35、1.45、1.55、1.65、1.75）的 VNCa 图像的诊断准确性，旨在为检测 BME 选择最佳的 VNCa 图像 Rel.CM 值。然后，在对应于最佳 Rel.CM 值的 VNCa 图像上测量正常区域和 BME 区域的 CT 值，用于初步定量分析。使用秩和检验比较 VNCa 图像上 BME 区域和正常骨髓区域的 CT 值差异。
24 个膝关节被分为 288 个区域。MR 成像显示 121 个区域有 BME。不同 Rel.CM 值（1.25、1.35、1.45、1.55、1.65 和 1.75）的 ROC 曲线下面积分别为 0.633、0.674、0.882、0.684、0.651 和 0.649。在 Rel.CM=1.45 的 VNCa 图像上，诊断准确性最高（高达 89.2%），BME 区域和正常区域的 CT 值分别为-67.9（1.7∼-100.1）HU 和-94.5（-69.7∼-144.9）HU，差异有统计学意义（Z=-9.804，P<0.05）。
对于膝关节 BME 的检测，Rel.CM 值为 1.45 的 VNCa 图像最佳。
