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首页> 外文期刊>Acta Radiologica >Diagnostic accuracy of dual-energy CT for detection of bone marrow lesions in the subacutely injured knee with MRI as reference method
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Diagnostic accuracy of dual-energy CT for detection of bone marrow lesions in the subacutely injured knee with MRI as reference method

机译：用MRI将抑制膝关节骨髓病变检测的双能CT诊断准确性

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Background Dual-energy computer tomography (DECT) can detect post-traumatic bone marrow lesions. Prospective studies of the knee with large numbers of participants and intra-observer agreement assessment are limited. Purpose To investigate the diagnostic accuracy of DECT in detecting bone marrow lesions as well as estimating the bone marrow lesion volume in patients with suspected anterior cruciate ligament trauma with magnetic resonance imaging (MRI) as reference standard. Material and Methods Forty-eight consecutive patients with suspected anterior cruciate ligament injury were imaged bilaterally with DECT within a mean of 25 days (range 4-55 days) following injury and MRI within seven days of DECT. Two readers analyzed DECT virtual non-calcium-blinded images. Consensus MRI was reference standard. Intra- and inter-observer agreement were determined using weighted kappa statistics. Sensitivity, specificity, and negative and positive predictive values were calculated. Bone marrow lesion volumes were measured; for comparison, intra-class correlation coefficient was used. Results The 48 patients (26 men, 22 women; mean age 23 years, age range 15-37 years) were imaged bilaterally yielding 52 knees with bone marrow lesions, of which 44 were in the femur and 41 were in the tibia. Intra- and inter-observer agreement to detect bone marrow lesions was moderate and fair to moderate (kappa 0.54-0.66, 95% confidence interval [CI] 0.39-0.80 and 0.37-0.41, 95% CI 0.20-0.57) and overall sensitivity and specificity were 70.1% and 69.1%, respectively. Positive and negative predictive values were 72.9% and 66.1%, respectively. Bone marrow lesion volumes showed excellent intra- and inter-observer agreement (0.83-0.91, 95% CI 0.74-0.94 and 0.76-0.78, 95% CI 0.57-0.87). Conclusion The diagnostic performance of DECT to detect bone marrow lesions in the subacutely injured knee was moderate with intra- and inter-observer agreement ranging from moderate to substantial and fair to moderate. Bone marrow lesion volume correlation was excellent.
机译：背景技术双能计算机断层扫描（DECT）可以检测创伤后的骨髓病变。大量参与者和观察者内部协议评估的膝关节前瞻性研究有限。目的探讨DECT在检测骨髓病变中的诊断准确性，以及涉及磁共振成像（MRI）作为参考标准的涉及牵引韧带创伤患者骨髓病变体积。材料和方法48例连续疑似前令韧带损伤的患者在损伤后25天（范围4-55天的范围内）与DECT的平均值在DECT后的损伤和MRI之后的平均值。两个读者分析了DECT虚拟非钙盲的图像。共识MRI是参考标准。使用加权kappa统计确定和观察员间协议。计算灵敏度，特异性和消极和阳性预测值。测量骨髓病变量;为了比较，使用阶级内相关系数。结果48例患者（26名男子，22名女性;平均年龄23岁，年龄范围15-37岁）双侧屈服52膝关节，其中44位在股骨中，41人在胫骨中。检测骨髓病变的内部和观察者间的互联和公平适中（Kappa 0.54-0.66,95％置信区间[CI] 0.39-0.80和0.37-0.41,95％CI 0.20-0.57）和整体敏感性和特异性分别为70.1％和69.1％。阳性和阴性预测值分别为72.9％和66.1％。骨髓病变卷显示出优异的内部观察者和观察者间协议（0.83-0.91,95％CI 0.74-0.94和0.76-0.78,95％CI 0.57-0.87）。结论DECT以检测底部受伤的膝关节中骨髓病变的诊断性能与观察室内和观察员间协议的中等程度从中度到大量和公平到中等。骨髓病变体积相关性很好。

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