| 曹敏,谢倩云,蒋燕,丁燕萍,杨莹.基于双源CT定性及定量分析诊断下肢隐匿性骨折[J].中国医学影像技术,2024,40(12):1904~1908 |
| 基于双源CT定性及定量分析诊断下肢隐匿性骨折 |
| Qualitative and quantitative analyses of dual source CT for diagnosing occult fracture of lower extremity |
| 投稿时间：2024-06-24 修订日期：2024-10-28 |
| DOI：10.13929/j.issn.1003-3289.2024.12.021 |
| 中文关键词: 下肢骨 骨折,闭合性 体层摄影术,X线计算机 |
| 英文关键词:bones of lower extremity fractures, closed tomography, X-ray computed |
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| 中文摘要: |
| 目的 观察基于双源CT(DSCT)定性及定量分析诊断下肢隐匿性骨折的价值。方法 回顾性纳入120例疑诊下肢隐匿性骨折患者,根据MRI或随访结果将其分为隐匿性骨折组(简称骨折组,n=82)与非隐匿性骨折组(简称非骨折组,n=38)。采用Kappa检验评估常规CT及DSCT与MRI的诊断一致性;比较组间DSCT定量参数,绘制受试者工作特征曲线,计算曲线下面积(AUC),评估DSCT定性及定量诊断下肢隐匿性骨折的效能。结果 DSCT定性诊断下肢隐匿性骨折的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为90.24%(74/82)、86.84%(33/38)、93.67%(74/79)、80.49%(33/41)及89.17%(107/120)。DSCT诊断下肢隐匿性骨折与MRI的一致性较好(Kappa=0.755),而常规CT与MRI的一致性较差(Kappa=0.348)。骨折组损伤处虚拟去钙(VNCa)CT值高于、而脂肪百分比(FP)低于非骨折组(P均＜0.001);组间双能混合图像CT值、骨基质密度及骨矿物质含量差异均无统计学意义(P均＞0.05)。DSCT定性诊断下肢隐匿性骨折的AUC为0.885,与定量参数VNCa CT值(AUC为0.829)及FP(AUC为0.787)差异无统计学意义(P均＞0.05);DSCT定性联合定量诊断下肢隐匿性骨折的AUC为0.963,高于定性诊断及单一定量参数(Z=2.917~4.199,P均＜0.01)。结论 DSCT定性诊断下肢隐匿性骨折效能良好;联合定量参数可进一步提高其诊断效能。 |
| 英文摘要: |
| Objective To observe the value of qualitative and quantitative analyses of dual source CT (DSCT) for diagnosing occult fracture of lower extremity. Methods Totally 120 patients with suspected occult fracture of lower extremity were retrospectively enrolled. The patients were divided into occult fracture group (abbreviated as fracture group, n=82) and non-occult fracture group (abbreviated as non-fracture group, n=38) according to MRI findings or follow-up results. Kappa test was performed to evaluate the diagnostic consistency between conventional CT or DSCT and MRI, respectively. Quantitative DSCT parameters were compared between groups. Receiver operating characteristic curve was drawn, and the area under the curve (AUC) was calculated to evaluate the efficacy of qualitative and quantitative analyses of DSCT for diagnosing occult fracture of lower extremity. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of qualitative diagnosis of lower extremity occulted fracture based on DSCT was 90.24% (74/82), 86.84% (33/38), 93.67% (74/79), 80.49% (33/41) and 89.17% (107/120), respectively. The consistency between DSCT and MRI was good (Kappa=0.755), which was poor between conventional CT and MRI (Kappa=0.348). In fracture group, CT value of virtual non-calcium (VNCa) was higher, while the fat percentage (FP) was lower than those in non-fracture group (both P＜0.001). No significant difference of CT value of dual-energy hybrid images, bone matrix density nor bone mineral content was found between groups (all P＞0.05). AUC of DSCT in qualitative diagnosis of lower extremity occult fracture was 0.885, which was not significant difference with that of VNCa CT value (0.829) and FP (0.787) in quantitative parameters (all P＞0.05). AUC of qualitative combined with quantitative analyses of DSCT for diagnosing lower extremity occult fracture was 0.963, higher than that of qualitative diagnosis and quantitative parameter alone (Z=2.917—4.199, all P＜0.01). Conclusion DSCT was effective in qualitative diagnosis of lower limb occult fracture. Combining with quantitative parameters could further improve diagnostic efficacy of DSCT. |
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