Affiliation:
1. Department of
Radiology, Zhuhai People’s Hospital, Zhuhai Hospital affiliated with Jinan University, Zhuhai, 519000, China
2. Department of Radiology, Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, 519000, China
Abstract
Background:
Early and accurate diagnosis is vital for avoiding the development of nondisplaced
fractures to displaced fractures. Dual-energy CT (Computed Tomography) can detect bone
marrow edema (BME), which may help to detect non-displaced fractures.
Aim:
To evaluate the value of DECT (Dual-Energy Computed Tomography) VNCa (Virtual noncalcium)
images for improving diagnostic performance and confidence in acute non-displaced knee
fractures.
Methods:
125 patients with clinical suspicion of knee fractures underwent both DECT and MR. Conventional
linear-blended CT and VNCa images were obtained from DECT. First, five readers with
varying levels of experience evaluated the presence of fractures on conventional linear-blended CT
and graded their diagnostic confidence on a scale of 1 to 10. Then BME with VNCa images was evaluated
and compared with MR. Finally, the VNCa images combined with conventional linear-blended
CT images were used to reassess the presence of fractures and diagnostic confidence. Diagnostic performance
and matched pair analyses were performed.
Results:
20 non-displaced knee fractures were detected. The consistency test of VNCa images and MR
by five radiologists showed Kappa values are 0.76, 0.79, 0.81,0.85,and 0.90,respectively. The diagnostic
performance of all readers was improved when using VNCa images combined with conventional
linear-blended CT compared with that with conventional linear-blended CT alone. Diagnostic confidence
was improved with combined conventional linear-blended CT and VNCa images (median
score:8,8,9,9, and 10, respectively) compared with conventional linear-blended CT alone (median
score:7,7,8,9, and 9).
Conclusion:
DECT VNCa images could improve the radiologists' diagnostic performance and confidence
with varying levels of experience in the detection of non-displaced knee fractures.
Publisher
Bentham Science Publishers Ltd.
Subject
Radiology, Nuclear Medicine and imaging