Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Eur Radiol. 2022 Apr;32(4):2168-2177. doi: 10.1007/s00330-021-08354-2. Epub 2021 Nov 24.
To investigate the diagnostic accuracy of color-coded contrast-enhanced dual-energy CT virtual noncalcium (VNCa) reconstructions for the assessment of lumbar disk herniation compared to unenhanced VNCa imaging.
A total of 91 patients were retrospectively evaluated (65 years ± 16; 43 women) who had undergone third-generation dual-source dual-energy CT and 3.0-T MRI within an examination interval up to 3 weeks between November 2019 and December 2020. Eight weeks after assessing unenhanced color-coded VNCa reconstructions for the presence and degree of lumbar disk herniation, corresponding contrast-enhanced portal venous phase color-coded VNCa reconstructions were independently analyzed by the same five radiologists. MRI series were additionally analyzed by one highly experienced musculoskeletal radiologist and served as reference standard.
MRI depicted 210 herniated lumbar disks in 91 patients. VNCa reconstructions derived from contrast-enhanced CT scans showed similar high overall sensitivity (93% vs 95%), specificity (94% vs 95%), and accuracy (94% vs 95%) for the assessment of lumbar disk herniation compared to unenhanced VNCa images (all p > .05). Interrater agreement in VNCa imaging was excellent for both, unenhanced and contrast-enhanced CT (κ = 0.84 vs κ = 0.86; p > .05). Moreover, ratings for diagnostic confidence, image quality, and noise differed not significantly between unenhanced and contrast-enhanced VNCa series (all p > .05).
Color-coded VNCa reconstructions derived from contrast-enhanced dual-energy CT yield similar diagnostic accuracy for the depiction of lumbar disk herniation compared to unenhanced VNCa imaging and therefore may improve opportunistic retrospective lumbar disk herniation assessment, particularly in case of staging CT examinations.
• Color-coded dual-source dual-energy CT virtual noncalcium (VNCa) reconstructions derived from portal venous phase yield similar high diagnostic accuracy for the assessment of lumbar disk herniation compared to unenhanced VNCa CT series (94% vs 95%) with MRI serving as a standard of reference. • Diagnostic confidence, image quality, and noise levels differ not significantly between unenhanced and contrast-enhanced portal venous phase VNCa dual-energy CT series. • Dual-source dual-energy CT might have the potential to improve opportunistic retrospective lumbar disk herniation assessment in CT examinations performed for other indications through reconstruction of VNCa images.
探讨彩色对比增强双能 CT 虚拟非钙（VNCa）重建在评估腰椎间盘突出症方面的诊断准确性，与未增强 VNCa 成像相比。
回顾性评估了 91 例患者（65 岁±16 岁；43 名女性），这些患者于 2019 年 11 月至 2020 年 12 月期间在检查间隔内接受了第三代双源双能 CT 和 3.0-T MRI 检查，最长可达 3 周。在评估完未经增强的彩色编码 VNCa 重建以确定腰椎间盘突出症的存在和严重程度 8 周后，由同 5 名放射科医生独立分析相应的对比增强门静脉期彩色编码 VNCa 重建。磁共振成像系列由一名经验丰富的肌肉骨骼放射科医生进行额外分析，并作为参考标准。
磁共振成像在 91 例患者中显示了 210 个突出的腰椎间盘。与未增强 VNCa 图像相比，来自对比增强 CT 扫描的 VNCa 重建在评估腰椎间盘突出症方面具有相似的高总体敏感性（93%对 95%）、特异性（94%对 95%）和准确性（94%对 95%）（均 p>0.05）。未增强和增强 CT 的 VNCa 成像的观察者间一致性均非常好（κ=0.84 对 κ=0.86；p>0.05）。此外，在未增强和对比增强 VNCa 系列之间，诊断信心、图像质量和噪声的评分没有显著差异（均 p>0.05）。
与未增强 VNCa 成像相比，源自对比增强双能 CT 的彩色编码 VNCa 重建在腰椎间盘突出症的显示方面具有相似的诊断准确性，因此可能改善机会性回顾性腰椎间盘突出症评估，特别是在分期 CT 检查中。
源自门静脉期的彩色双源双能 CT 虚拟非钙（VNCa）重建在评估腰椎间盘突出症方面与未增强 VNCa CT 系列（94%对 95%）具有相似的高诊断准确性，磁共振成像作为参考标准。
未增强和对比增强门静脉期 VNCa 双能 CT 系列之间，诊断信心、图像质量和噪声水平没有显著差异。
双源双能 CT 可能通过 VNCa 图像重建，有潜力改善因其他适应症而进行的 CT 检查中的机会性回顾性腰椎间盘突出症评估。
