Disk injury in patients with vertebral fractures—a prospective diagnostic accuracy study using dual-energy computed tomography
| Autor: | Bernd Hamm, Kay-Geert A. Hermann, Nils Engelhard, Matthias Pumberger, Michael Putzier, Michael Fuchs, Torsten Diekhoff, Marcus R. Makowski |
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| Rok vydání: | 2019 |
| Předmět: |
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medicine.medical_specialty Thoracic Vertebrae 030218 nuclear medicine & medical imaging Radiography Dual-Energy Scanned Projection 03 medical and health sciences 0302 clinical medicine Hounsfield scale Fractures Compression Humans Medicine Radiology Nuclear Medicine and imaging In patient Prospective Studies Intervertebral Disc Prospective cohort study Aged Neuroradiology Lumbar Vertebrae medicine.diagnostic_test business.industry Tomography X-ray computed Ultrasound Reproducibility of Results Magnetic resonance imaging Dual-Energy Computed Tomography Interventional radiology General Medicine Middle Aged Magnetic Resonance Imaging Spine Musculoskeletal 030220 oncology & carcinogenesis Spinal Fractures Female Collagen Radiology business |
| Zdroj: | European Radiology |
| ISSN: | 1432-1084 0938-7994 |
| Popis: | Objectives Using magnetic resonance imaging (MRI) as the standard of reference, we aimed to evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) in assessing disk injuries in patients aged more than 50 years with vertebral fractures. Methods This prospective study was approved by the local ethics committee (EA1/372/14), and all patients gave written informed consent. Patients with suspected fractures underwent spinal DECTs and MRIs. Three readers scored DECT collagen maps for the presence or absence of disk injuries and also scored MR images according to the Sander classification (0–3). Only disks at risk (target disks) were included in the analysis. Sensitivity and specificity were calculated. Fleiss’s κ was used to evaluate interrater agreement. Attenuation, in Hounsfield units, was compared between affected and unaffected disks in DECT. Results Analyzing 295 disks in 67 patients, DECT was both sensitive (0.85) and specific (0.75). Sensitivity varied with the severity of disk damage, as assessed using the Sander scale (grade 1, 0.80; 2, 0.85; and 3, 0.98). Fleiss’s κ was 0.41 for MRI and 0.51 for DECT. In the DECT collagen maps, attenuation was lower in injured disks compared to that in normal disks (80.3 ± 35.2 vs. 97.9 ± 41.0, p |
| Databáze: | OpenAIRE |
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