Department of Radiology, First Affiliated Hospital of Hunan University of Chinese Medicine, 95 Shaoshan Middle Road, Yuhua District, Changsha, 410007, People's Republic of China.
GE Healthcare (Shanghai) Co., Ltd, Shanghai, 201203, People's Republic of China.
Arch Osteoporos. 2021 Jun 3;16(1):85. doi: 10.1007/s11657-021-00948-z.
The vertebral compression fractures (VCFs) represent an incidental finding on thoracic and abdominal dual-energy CT examinations (which use STND reconstruction kernel), which are associated with increased mortality. While the BONE reconstruction kernel shows a superior diagnostic accuracy to find fractures. This study showed STND and BONE reconstruction kernel both had excellent diagnostic performance to detect abnormal edema in acute VCFs.
To investigate whether different reconstruction kernels (STND V.S. BONE) affect the diagnostic performance of dual-energy CT virtual noncalcium technique (VNCa) for identifying acute and chronic vertebral compression fractures (VCFs).
This retrospective study included 31 consecutive patients with 79 VCFs who underwent both a dual-energy CT and a 3-T MR examination of the spine between August 2018 and March 2019. MR images served as the reference standard. Two independent and blinded radiologists evaluated all vertebral bodies for the presence of abnormal edema on color-coded overlay VNCa images. Two additional radiologists performed a quantitative analysis on VNCa images by calculating water content of vertebral bodies. Receiver operating characteristic curve (ROC) analysis was conducted. Area under the curve (AUC) was calculated.
MR imaging depicted 44 edematous and 35 nonedematous VCFs. In visual analysis, the AUC and AUC were 0.932 and 0.943. In quantitative analysis, water content results were significantly different between vertebrae with and without bone marrow edema on MR (P < 0.001). And the AUC and AUC were 0.851 and 0.850 respectively.
Visual and quantitative analysis of dual-energy CT VNCa technique had excellent diagnostic performance for identifying acute and chronic compression fractures; different reconstruction kernels did not matter.
研究不同重建核（STND 与 BONE）是否会影响双能 CT 虚拟非钙技术（VNCa）对急性和慢性椎体压缩性骨折（VCF）的诊断性能。
这是一项回顾性研究，纳入了 2018 年 8 月至 2019 年 3 月期间连续 31 例共 79 个 VCF 患者，所有患者均行双能 CT 与 3-T 脊柱磁共振检查。MR 图像作为参考标准。2 位独立的、盲法的放射科医生在彩色编码叠加 VNCa 图像上评估所有椎体是否存在异常水肿。另外 2 位放射科医生通过计算椎体的含水量对 VNCa 图像进行定量分析。进行受试者工作特征曲线（ROC）分析。计算曲线下面积（AUC）。
MR 成像显示 44 个水肿性 VCF 和 35 个非水肿性 VCF。在视觉分析中，AUC 和 AUC 分别为 0.932 和 0.943。在定量分析中，MR 上骨髓水肿与无骨髓水肿的椎体之间的水含量结果有显著差异（P < 0.001）。AUC 和 AUC 分别为 0.851 和 0.850。
双能 CT VNCa 技术的视觉和定量分析对识别急性和慢性压缩性骨折具有极好的诊断性能；不同的重建核没有影响。
