Björkman Ann-Sofi, Gauffin Håkan, Persson Anders, Koskinen Seppo K
Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Acta Radiol Open. 2022 Mar 9;11(3):20584601221075799. doi: 10.1177/20584601221075799. eCollection 2022 Mar.
CT is often used for fracture evaluation following knee trauma and to diagnose ACL injuries would also be valuable.
To investigate the diagnostic accuracy of dual energy CT (DECT) for detection of ACL tears in acute and subacute knee injuries.
Patients with suspected ACL injury were imaged with DECT and MRI. Clinically blinded DECT images were independently read twice by two radiologists. ACL was classified as normal or abnormal. Arthroscopy served as reference method. Sensitivity and positive predictive value (PPV) were calculated, and diagnostic performance between DECT and MRI was assessed.
48 patients (26 M, 22 F, mean age 23 years, range 15-37 years) were imaged with a mean of 25 days following trauma. Of these, 21 patients underwent arthroscopy with a mean of 195 days after trauma. Arthroscopy revealed 19 ACL tears and 2 ACLs with no tear. The combined sensitivity was 76.3% (95% CI 66.8-85.9) and 86.8 (95% CI 71.9-95.6) for DECT and MRI, respectively. There was no statistically significant difference between these two methods ( = .223). The positive predictive value (PPV) was 93.5 (95% CI 84.3-98.2) and 91.7 (95% CI 77.5-98.3) for DECT and MRI, respectively.
DECT has lower sensitivity to detect an ACL rupture than MRI, but the difference is not statistically significant. The PPV is high in both methods.
CT常用于膝关节创伤后的骨折评估，而用于诊断前交叉韧带（ACL）损伤也具有重要价值。
探讨双能CT（DECT）在急性和亚急性膝关节损伤中检测ACL撕裂的诊断准确性。
对疑似ACL损伤的患者进行DECT和MRI检查。两名放射科医生在不知临床情况的前提下，独立对DECT图像进行两次阅片。将ACL分为正常或异常。关节镜检查作为参考方法。计算敏感性和阳性预测值（PPV），并评估DECT和MRI之间的诊断性能。
48例患者（男26例，女22例，平均年龄23岁，范围15 - 37岁）在创伤后平均25天接受检查。其中21例患者在创伤后平均195天接受关节镜检查。关节镜检查发现19例ACL撕裂，2例ACL未撕裂。DECT和MRI的联合敏感性分别为76.3%（95%可信区间66.8 - 85.9）和86.8%（95%可信区间71.9 - 95.6）。这两种方法之间无统计学显著差异（P = 0.223）。DECT和MRI的阳性预测值分别为93.5%（95%可信区间84.3 - 98.2）和91.7%（95%可信区间77.5 - 98.3）。
DECT检测ACL断裂的敏感性低于MRI，但差异无统计学意义。两种方法的PPV均较高。
