摘要
目的探究能谱CT诊断股骨头缺血性坏死(ONFH)骨髓水肿的应用价值。方法收集2020年10月至2021年6月北京中医药大学第三附属医院收治的35例单侧ONFH骨髓水肿患者的临床资料,所有患者均行双侧髋关节能谱CT和磁共振成像(MRI)扫描。运用影像工作站(AW4.7)的重建/后处理软件GSI viewer,生成水基图与羟基磷灰石(HAP)基图。比较患侧与健侧股骨头MRI短时反转恢复(STIR)横断面图像与能谱CT图像,在骨髓水肿最明显区域选取一圆形感兴趣区(ROI),并在双侧正常髂腰肌同一层面选取相同大小ROI作为背景区域,分别测量并计算患侧、健侧与相应髂腰肌的水含量比值、HAP含量比值、STIR信号强度比值、能谱曲线斜率。结果患侧骨髓水肿最明显区STIR信号强度比值、水含量比值均高于健侧ROI[2.38(1.90,3.47)比0.28(0.22,0.34)、0.96(0.95,1.00)比0.89(0.88,0.91)](P<0.01),而HAP含量比值低于健侧ROI[9.62(5.06,19.42)比19.12(13.49,39.33)](P<0.05)。受试者工作特征曲线显示,STIR信号强度比值诊断ONFH骨髓水肿的曲线下面积为100.00%,灵敏度和特异度均为100.00%;水含量比值的灵敏度、特异度、阳性似然比、阴性似然比、诊断比值比分别为97.14%、91.43%、11.33、0.03、362.369;HAP含量比值与能谱曲线斜率的灵敏度、特异度、阳性似然比、阴性似然比、诊断比值比均为71.43%、77.14%、3.12、0.37、8.44。结论能谱CT成像对ONFH骨髓水肿的诊断效能较高,可用于临床ONFH继发骨髓水肿的诊断。
Objective To explore the application value of energy spectrum CT in the diagnosis of bone marrow edema in osteonecrosis of the femoral head(ONFH).Methods Clinical data of Thirty five patients with unilateral bone marrow edema in ONFH admitted to the Third Affiliated Hospital of Beijing University of Chinese Medicine from Oct.2020 to Jun.2021 were included.All the patients underwent bilateral hip joint energy spectrum CT and magnetic resonance imaging(MRI)scans of both lower limbs.The reconstruction/post-processing software GSI viewer of image workstation(AW4.7)was used to generate water base map and hydroxyapatite(HAP)base map.The MRI short time of inversion recovery(STIR)cross-sectional images and energy spectrum CT images of the affected side and the healthy side of the femoral head were compared.A circular region of interest(ROI)in the most obvious area of bone marrow edema was selected,and ROI of the same size on the same level of bilateral normal iliopsoas was selected as the background area.The water content ratio,the HAP content ratio,the STIR signal intensity and ratio,and the slope of energy spectrum curve of the affected side,the healthy side and the corresponding iliopsoas muscle were measured and calculated respectively.Results The ratio of STIR signal intensity and water content in the most obvious area of bone marrow edema on the affected side were higher than those of the ROI on the healthy side[2.38(1.90,3.47)vs 0.28(0.22,0.34),0.96(0.95,1.00)vs 0.89(0.88,0.91)](P<0.01),while the ratio of HAP content was lower than that on the healthy side[9.62(5.06,19.42)vs 19.12(13.49,39.33)](P<0.05).Receiver operating characteristic curve showed that the area under the curve of STIR signal intensity ratio for the diagnosis of ONFH bone marrow edema was 100.00%,and the sensitivity and specificity were 100.00%;the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio of water content ratio were 97.14%,91.43%,11.33,0.03 and 362.369 respectively;the sensitivity,specif
作者
申钿
冯莉莉
申艳光
郑仲奇
姬新珂
刘钢
刘凯
SHEN Tian;FENG Lili;SHEN Yanguang;ZHENG Zhongqi;JI Xinke;LIU Gang;LIU Kai(Department of Radiology,the Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《医学综述》
CAS
2022年第21期4338-4342,共5页
Medical Recapitulate
关键词
股骨头缺血性坏死
能谱CT
CT能谱成像
骨髓水肿
塌陷
Osteonecrosis of the femoral head
Energy spectrum CT
CT spectroscopy imaging
Bone marrow edema
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