Dual-energy CT virtual noncalcium imaging for detecting bone marrow edema in vertebrae / 中国医学影像技术

ABSTRACT

Objective: To observe the value of dual-energy virtual noncalcium (DE-VNCa) using dual-source CT in diagnosis of vertebral bone marrow edema under different relative contrast material ratio (RCMR). Methods Totally 37 patients with spinal trauma and low back pain who underwent dual-source CT dual-energy scan and MR examination were enrolled. Taken RCMR value as 1.28, 1.45, 1.75 and 1.85, respectively, the 4 groups of DE-VNCa images were reconstructed. The best RCMR value was obtained through calculating the effect of 4 groups of images in diagnosis of vertebral bone marrow edema taken MRI diagnosis as golden standards. CT value and fat content of lumbar vertebral bone marrow edema area and normal vertebral body were measured and compared on the optimal imaging. The efficacy of CT value and fat content in diagnosis of lumbar bone marrow edema were evaluated using ROC curve. Results: When RCMR value was 1.28, 1.45, 1.75 and 1.85, the Youden index in diagnosis of lumbar bone marrow edema was 0.02, 0.35, 0.82 and 0.73, respectively. DE-VNCa imaging had the highest diagnostic efficiency when RCMR value was 1.75. The difference of CT value and fat content between the edema area of lumbar vertebrae and normal vertebrae was statistically significant on images of RCMR=1.75 (both P<0.01). Taking CT value=10.25 HU and fat content=24.50% as the critical value, the AUC under ROC curves in diagnosis of lumbar bone marrow edema was 0.95 and 0.91, respectively (both P<0.01). Conclusion: DE-VNCa imaging of dual-source CT has high clinical value in diagnosis of vertebral bone marrow edema when RCMR is 1.75, and CT value and fat content are helpful to diagnosis of lumbar bone marrow edema.