Dual-energy CT in sacral fragility fractures: defining a cut-off Hounsfield unit value for the presence of traumatic bone marrow edema in patients with osteoporosis

Autor: Jan-Peter Grunz, Lukas Sailer, Patricia Lang, Simone Schüle, Andreas Steven Kunz, Meinrad Beer, Carsten Hackenbroch
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Musculoskeletal Disorders, Vol 23, Iss 1, Pp 1-7 (2022)
Druh dokumentu: article
ISSN: 1471-2474
DOI: 10.1186/s12891-022-05690-2
Popis: Abstract Background Demographic change entails an increasing incidence of fragility fractures. Dual-energy CT (DECT) with virtual non-calcium (VNCa) reconstructions has been introduced as a promising diagnostic method for evaluating bone microarchitecture and marrow simultaneously. This study aims to define the most accurate cut-off value in Hounsfield units (HU) for discriminating the presence and absence of bone marrow edema (BME) in sacral fragility fractures. Methods Forty-six patients (40 women, 6 men; 79.7 ± 9.2 years) with suspected fragility fractures of the sacrum underwent both DECT (90 kVp / 150 kVp with tin prefiltration) and MRI. Nine regions-of-interest were placed in each sacrum on DECT-VNCa images. The resulting 414 HU measurements were stratified into “edema” (n = 80) and “no edema” groups (n = 334) based on reference BME detection in T2-weighted MRI sequences. Area under the receiver operating characteristic curve was calculated to determine the desired cut-off value and an associated conspicuity range for edema detection. Results The mean density within the “edema” group of measurements (+ 3.1 ± 8.3 HU) was substantially higher compared to the “no edema” group (-51.7 ± 21.8 HU; p
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