实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (4): 411-414.doi: 10.3969/j.issn.1003-9198.2025.04.018

• 临床研究 • 上一篇    下一篇

双能量CT虚拟去钙技术用于老年骨质疏松性新鲜椎体压缩性骨折诊断的精确性研究

黄鑫鹏, 秦虎, 黄越, 岳鼎, 刘军, 唐庆昆   

  1. 210011 江苏省南京市, 南京医科大学第二附属医院骨科
  • 收稿日期:2024-06-18 出版日期:2025-04-20 发布日期:2025-04-22

Clinical study on the accuracy of virtual non-calcium technique based on dual energy CT to evaluate fresh osteoporotic vertebral compression fractures in the elderly

HUANG Xinpeng, QIN Hu, HUANG Yue, YUE Ding, LIU Jun, TANG Qingkun   

  1. Department of Othopedics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
  • Received:2024-06-18 Online:2025-04-20 Published:2025-04-22

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摘要： 目的 评估双能量CT虚拟去钙技术用于老年骨质疏松性新鲜椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)诊断的精确性,探讨其作为MRI替代检查的可行性。 方法 回顾性收集133例2022年1月至2024年3月南京医科大学第二附属医院符合入选标准的病人的影像学资料,年龄65～88岁,平均(75.3±7.2)岁,其中男48例,女85例。入选病人均接受双能量CT检查及MRI检查,由资深影像科医师判断是否存在骨质疏松性新鲜椎体压缩性骨折。使用Spearman相关分析评估基于MRI、双能量CT图像诊断以及双能量CT成像后虚拟去钙技术进一步处理后诊断结果的一致性,然后使用卡方检验评估双能量CT原始图像及虚拟去钙技术处理后图像诊断的精准性差异以及错误诊断产生的原因。 结果 双能量CT组与虚拟去钙技术组诊断OVCF的敏感度分别为89.0%和97.3%,特异度分别为62.7%和79.7%,准确率分别为77.4%和89.5%。2组间诊断敏感度差异有统计学意义,特异度差异没有统计学意义。双能量CT组因陈旧性椎体骨折及骨赘干扰造成误诊例数显著高于虚拟去钙技术组(P<0.05)。 结论 双能量CT虚拟去钙技术是一种能够替代MRI诊断老年骨质疏松性新鲜胸腰椎骨折的影像学技术,适用于存在MRI检查相关禁忌证的病人。但既往接受椎体内骨水泥注射及金属内固定病史的病人应审慎选择此项检查。

关键词: 双能量CT, 虚拟去钙技术, 新鲜骨质疏松性椎体压缩性骨折, 诊断准确性

Abstract: Objective To investigate the accuracy of virtual non-calcium technique based on dual energy CT for the diagnosis of fresh osteoporotic vertebral compression fractures(OVCF) in the elderly, and to evaluate the possibility of an alternative examination for magnetic resonance imaging (MRI). Methods The imaging data from the patients who met the inclusion criteria were retrospectively collected from January 2022 to March 2024. A total of 133 elderly patients with a mean age of 75.3±7.2 years were enrolled in this study,with 48 males and 85 females. All patients underwent virtual non-calcium technique based on dual energy CT examination and MRI. The diagnosis was performed by senior imaging physicians. Spearman correlation analysis was used to evaluate the consistency of diagnosis among MRI, dual energy CT and virtual non-calcium technique based on dual energy CT, and then chi-square test was adopted to evaluate the differences in diagnostic accuracy.Finally,the reasons for misdiagnosis of dual energy CT and virtual non-calcium technique based on dual energy CT was analyzed. Results The sensitivity, specificity and accuracry of dual energy CT in diagnosing fresh OVCF were 89.0%, 62.7% and 77.4%, compared with 97.3%, 74.7% and 89.5% of virtual non-calcium technique. The virtual non-calcium technique group had significantly less misdiagnosis cases due to old vertebral fractures and osteophytes than dual energy CT group(P<0.05). Conclusions Virtual non-calcium technique based on dual energy CT is a novel imaging technique that can replace MRI in diagnosing fresh osteoporotic vertebral compression thoracolumbar fractures, especially for the patients with MRI-related contraindications. However, this examination should be carefully prescribed for the patients with bone cement injection and metal fixation history.

Key words: dual energy CT, virtual non-calcium technique, fresh osteoporotic vertebral compression fractures, diagnostic accuracy

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