摘要
目的旨在探讨双能量CT虚拟单能量成像在脊柱溶骨型转移瘤所致恶性压缩性骨折与良性压缩性骨折中的鉴别诊断价值。方法纳入我院2018年3月至2019年8月期间经手术、病理穿刺活检或临床随访证实的51例脊柱压缩性骨折患者,行双能量CT脊柱扫描。根据发病原因将压缩性骨折椎体分为溶骨型转移瘤所致恶性压缩性骨折组(共计21例、50个椎体)、良性压缩性骨折组(共计30例、37个椎体)。采用t检验分析脊柱良恶性压缩性骨折在虚拟单能量不同能级下CT值及单能量曲线斜率之间差异性。作ROC曲线分析,评价双能量CT虚拟单能量成像对脊柱良恶性压缩性骨折的鉴别诊断效能。结果脊柱良、恶性压缩性骨折单能量曲线斜率均随着Kev值的增加而降低且脊柱恶性压缩性骨折斜率低于良性压缩性骨折,两者存在显著统计学差异(P<0.001)。ROC曲线显示,当虚拟单能量曲线斜率K=2.20时,AUC值最高为0.792,相应敏感性为89%。脊柱恶性压缩性骨折在虚拟单能量不同能级下(40 Kev~120Kev)CT值低于良性压缩性骨折,两者存在显著统计学差异(P<0.001)。ROC曲线显示,在120Kev能级下AUC值最高为0.882,相应敏感性为95%。结论双能量CT虚拟单能量成像能作为评估脊柱良恶性压缩性骨折新的辅助手段,帮助放射科医生更好地进行鉴别诊断,具有较好的临床应用价值。
Objective To explore the value of dual-energy virtual monoenergetic imaging in differential diagnosis of spinal malignant compression fractures caused by spinal osteolytic metastases and benign compression fractures.Methods A total of 51 patients with spinal compression fractures from March 2018 to August 2019 were enrolled in our hospital and underwent dual-energy CT scans.All patients were finally confirmed by surgery,pathological biopsy or clinical follow-up.According to the cause of the diseases,the patients were divided into two groups:malignant compression fractures caused by spinal osteolytic metastases and benign compression fractures.Among them,there were 21 patients(50 vertebrae)with malignant compression fractures caused by spinal osteolytic metastases and 30 patients(37 vertebrae)with spinal benign compression fracture.The CT values and the slope of the monoenergetic curve at different virtual monoenergetic levels were analyzed by t-test.ROC curve was used to compare the diagnostic performance of virtual monoenergetic imaging in the diagnosis of malignant compression fractures caused by spinal osteolytic metastases and benign compression fractures.Results The slope of the virtual monoenergetic curve in spinal malignant compression fractures caused by spinal osteolytic metastases and benign compression fracture decreased with the increase of Kev value,the slope of the virtual monoenergetic curve of spinal malignant compression fractures caused by spinal osteolytic metastases were lower than those of spinal benign compression fractures,with statistically significant differences(P<0.001).ROC curve showed that the AUC value at the slope of the virtual monoenergetic curve K=2.20 was 0.792,and the corresponding sensitivity was 89%.The CT values of spinal malignant compression fractures caused by spinal osteolytic metastases at different virtual monoenergetic levels were lower than those of benign compression fractures,with statistically significant differences(P<0.001).ROC curve showed that the AUC value at
作者
徐驰杰
孔玲玲
赵承勇
邓小毅
孙旭
朱斌
XU Chi-jie;KONG Ling-ling;ZHAO Cheng-yong;DENG Xiao-yi;SUN Xu;ZHU Bin(Department of Radiology,Jiangsu University Affiliated AoYang Hospital,Zhangjiagang 215600,Jiangsu Province,China;Department of Vertebrate Surgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China;Department of Radiology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2022年第12期150-152,共3页
Chinese Journal of CT and MRI
基金
国家自然科学基金资助项目(81772422,81401848)
张家港市科技支撑计划(社会发展)(ZKS2042)。
关键词
虚拟单能量
双能量CT
虚拟单能量曲线
Virtual Monoenergetic Imaging
Dual-Energy CT
The Slope of Virtual Monoenergetic Curve.
