摘要
目的探讨双能量CT骨髓成像诊断脊柱转移瘤的诊断准确性及临床应用价值。方法选取我院32例经病理穿刺活检或临床随访确诊的脊柱转移瘤患者,行双能量CT及MRI脊柱扫描并进行回顾性分析。以MRI为参考标准,由两名放射科医师对图像进行主观评估,比较双能量CT骨髓成像、常规CT图像对脊柱转移瘤的诊断准确性。根据骨质破坏类型,将转移椎体分成溶骨型和成骨型两组,分别比较转移瘤椎体与正常椎体双能量CT骨髓成像、常规CT定量值差异。通过ROC曲线分析比较双能量CT骨髓成像与常规CT对脊柱转移瘤的诊断效能。结果最终32例患者共215个转移瘤椎体纳入研究。两观察者在双能量CT骨髓成像及常规CT图像上一致性很好,Kappa值分别为0.885、0.866。双能量CT骨髓成像对脊柱转移瘤的诊断准确性明显高于常规CT(90.1%vs 83.8%)。在双能量CT骨髓成像上,脊柱溶骨型转移瘤明显高于相邻正常椎体CT值,存在差异有统计学意义(P<0.001),而成骨型转移瘤定量值无明显差异。双能量CT骨髓成像诊断脊柱溶骨型转移瘤的AUC值大于常规CT(0.71 vs 0.55)。结论相较于常规CT,双能量CT骨髓成像能更好地显示脊柱转移瘤内骨髓情况,提高脊柱转移瘤的诊断准确性,其对脊柱溶骨型转移瘤拥有更好的诊断效能。
Objective To study the diagnostic accuracy and clinical value of dual-energy CT bone marrow edema imaging in spinal metastases.Methods A total of 32 patients with spinal metastases diagnosed by pathological biopsy or clinical follow-up were retrospectively analyzed and underwent DECT and MRI examinations.With MRI as the gold standard,two radiologists performed subjective evaluation and analysis of the images to compare the diagnostic accuracy of dual-energy bone marrow edema imaging and conventional CT images in spinal metastases.According to the type of metastasis,vertebral metastases were divided into two groups osteolytic metastases and osteoblastic metastases.The differences between the two groups of vertebral metastases and adjacent normal vertebral bodies were compared with dual-energy CT bone marrow imaging and conventional CT quantitative values.ROC curve analysis was used to compare the diagnostic performance of dual-energy CT bone marrow imaging and conventional CT for spinal metastases.Results A total of 215 vertebral metastases were analyzed in 32 patients.The subjective scores on dual-energy CT bone marrow edema and conventional CT images were consistent(Kappa value 0.885 vs 0.866),and the diagnostic accuracy was significantly higher than conventional CT(90.1%vs 83.8%).On dual-energy CT bone marrow imaging,the CT quantitative values of spinal osteolytic metastases were significantly higher than those of adjacent normal vertebral bodies(P<0.001),and there were no significant differences between osteoblastic metastases and adjacent normal vertebral bodies.ROC curve showed that the AUC value of dual-energy CT bone marrow imaging in the diagnosis of spinal osteolytic metastases was higher than conventional CT(0.71 vs 0.55).Conclusion Compared with conventional CT,Dual-energy CT bone marrow imaging can effectively evaluate bone marrow edema in spinal metastases,thereby improving the diagnostic accuracy of spinal metastases,and spinal osteolytic metastases has better diagnostic performance in dual-energy C
作者
徐驰杰
孔玲玲
曹国平
邓小毅
崔磊
XU Chijie;KONG Lingling;CAO Guoping;DENG Xiaoyi;CUI Lei(Department of Radiology, Jiangsu University Affiliated Aoyang Hospital, Zhangjiagang 215600, P.R.Chian;Department of Radiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, P.R.China)
出处
《医学影像学杂志》
2021年第7期1232-1236,1264,共6页
Journal of Medical Imaging
基金
江苏大学临床医学科技发展基金项目(编号:JLY20180151)
江苏省张家港市科技局项目(编号:ZKS1933)。
