The Value Of Dual Energy CT In Detecting Anterior Cruciate Ligament Mucoid Degeneration In Knee Osteoarthritis Joint

Purpose: There is a correlation between mucinous degeneration of anterior cruciate ligament(ACL)and osteoarthritis(OA).Computed tomography(CT)can be used to assess bone condition and ligament lesions.In this study,magnetic resonance imaging(MRI)was used as a reference standard to evaluate the diagnostic value of dual-energy computed tomography(DECT)of anterior cruciate ligament mucinous degeneration(ACL).Materials and Methods: 32 patients with knee osteoarthritis a total of 37 knee joints were examined by DECT and MRI,the mean age was 59.2 years ± 8.2[standard deviation],age range was 43-76,including 19 females(mean age,63.0 years ± 5.9[standard deviation];age range,55-76 years)and 13 males(mean age,53.0 years ± 7.7[standard deviation];age range,43-68years).Patients underwent MRI as the standard for the diagnosis of ACL mucoid degeneration,and DECT examinations were performed within 24 hours,and the oblique sagittal and oblique coronal images were reconstructed for each knee joint.Two radiologists randomly scored 74 DECT reconstruction series(37 knee reconstructions)and two serial images,with a five-point scale(level 1 = definitely not mucoid degeneration,to level 5 = definitely mucoid degeneration)to assess ACL mucoid degeneration.Analyze the inter-observer consistency of DECT Tendon images.ROC curve analysis was used to compare the feasibility of DECT in the diagnosis of ACL mucoid degeneration and the diagnostic efficacy of different series.Evaluate the relationship between intercondylar notch stenosis and OA combined with ACL mucoid to aid diagnosis.Results: DECT Tendon and MRI showed good consistency(oblique position: Kappa=0.665;oblique coronal position: Kappa=0.415;comprehensive assessment: Kappa=0.603).When the 4-5 grade ACL changes the lesion as a positive result,the sensitivity,specificity,positive predictive value and negative predictive value of the DECT Tendon image for detecting ACL mucoid degeneration of knee osteoarthritis were 71.43 %,78.26 %,66.70 %,81.78 % respectively in the oblique sagittal position,35.00%,85.19%,46.00%,77.99% respectively in the oblique coronal position,71.43%,80.44%,69.05%,82.21% respectively in the comprehensive evaluation.The area under the ROC curve of DECT Tendon image detection ACL mucoid degeneration were 0.802 in the oblique sagittal position,and 0.792 in the comprehensive evaluation(all p value < 0.05).The Fisher's exact test of intercondylar notch shape between simple OA groups and OA complicated with ACL mucoid degeneration was p value < 0.05.The one-way ANOVA of NWI between simple OA groups and OA complicated with ACL mucoid degeneration,the F values of NWI-1,NWI-2,NWI-A were 11.828,12.875,7.619.Conclusion: Tendon images of DECT showed good diagnostic performance in the assessing of ACL mucoid degeneration of knee osteoarthritis,and it may become a complementary and practical imaging tool for evaluating ligament lesions in the future.