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双层 CT 中对比剂对脊柱钙成像的影响。

The influence of contrast media on calcium-based imaging of the spine in dual-layer CT.

机构信息

Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.

Clinic of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany.

出版信息

Sci Rep. 2024 Aug 14;14(1):18898. doi: 10.1038/s41598-024-69743-3.

DOI:10.1038/s41598-024-69743-3
PMID:39143146
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11324893/
Abstract

This study aimed to evaluate the impact of contrast media application on CT attenuation of the bone using a novel calcium-only imaging technique (VCa) from dual-layer spectral detector CT (DLCT), which enables CT-based bone mineral density measurement unimpeded by soft tissue components. For this, true non-contrast (TNC) and venous phase images (VP) of n = 97 patients were acquired. CT attenuation of the first lumbar vertebra (L1) was measured in TNC-VCa, VP-VCa, and in virtual non-contrast images (VNC). CT attenuation was significantly higher in VP-VCa than in TNC-VCa (p < 0.001), although regression analyses revealed a strong linear association between these measures (R = 0.84). A statistical model for the prediction of TNC-VCa CT attenuation was established (TNC-VCa[HU] = - 6.81 + 0.87 × VP-VCa[HU]-0.55 × body weight[kg]) and yielded good agreement between observed and predicted values. Furthermore, a L1 CT attenuation threshold of 293 HU in VP-VCa showed a sensitivity of 90% and a specificity of 96% for detecting osteoporosis. The application of contrast media leads to an overestimation of L1 CT attenuation in VCa. However, CT attenuation values from VP-VCa can be used within CT-based opportunistic osteoporosis screening eighter by applying a separate threshold of 293 HU or by converting measured data to TNC-VCa CT attenuation with the given regression equation.

摘要

本研究旨在评估新型基于钙的单能量成像技术（VCa）对双层光谱探测器 CT（DLCT）中对比剂应用对 CT 衰减的影响，该技术可实现不受软组织成分影响的基于 CT 的骨矿物质密度测量。为此，对 n=97 例患者采集了真实非对比（TNC）和静脉期图像（VP）。在 TNC-VCa、VP-VCa 和虚拟非对比图像（VNC）中测量第一腰椎（L1）的 CT 衰减。VP-VCa 中的 CT 衰减明显高于 TNC-VCa（p<0.001），尽管回归分析显示这些测量之间存在很强的线性关联（R=0.84）。建立了一个用于预测 TNC-VCa CT 衰减的统计模型（TNC-VCa[HU]=-6.81+0.87×VP-VCa[HU]-0.55×体重[kg]），并且观察值和预测值之间具有良好的一致性。此外，VP-VCa 中 L1 CT 衰减阈值为 293 HU 时，对骨质疏松症的检测灵敏度为 90%，特异性为 96%。对比剂的应用导致 VCa 中 L1 CT 衰减的高估。然而，VP-VCa 中的 CT 衰减值可以通过应用单独的 293 HU 阈值或通过使用给定的回归方程将测量数据转换为 TNC-VCa CT 衰减，用于基于 CT 的机会性骨质疏松症筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/6535d78e7f15/41598_2024_69743_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/dcf55d9e644c/41598_2024_69743_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/344ef5f57b8e/41598_2024_69743_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/3682547e76ca/41598_2024_69743_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/3e698deff3b2/41598_2024_69743_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/6535d78e7f15/41598_2024_69743_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/dcf55d9e644c/41598_2024_69743_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/344ef5f57b8e/41598_2024_69743_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/3682547e76ca/41598_2024_69743_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/3e698deff3b2/41598_2024_69743_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d8/11324893/6535d78e7f15/41598_2024_69743_Fig5_HTML.jpg

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本文引用的文献

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3
Dual-energy estimates of volumetric bone mineral densities in the lumbar spine using quantitative computed tomography better correlate with fracture properties when compared to single-energy BMD outcomes.
使用定量计算机断层扫描对腰椎容积骨密度进行双能量估计与单能量 BMD 结果相比，与骨折特性相关性更好。
Bone. 2020 Jan;130:115100. doi: 10.1016/j.bone.2019.115100. Epub 2019 Oct 31.
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Osteoporosis.骨质疏松症。
Lancet. 2019 Jan 26;393(10169):364-376. doi: 10.1016/S0140-6736(18)32112-3.
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Evaluation of cross-sectional and longitudinal changes in volumetric bone mineral density in postmenopausal women using single- versus dual-energy quantitative computed tomography.采用单能与双能定量 CT 评价绝经后妇女容积骨密度的横断面与纵向变化。
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