The Judicial Identification Significance Of Dual-energy CT Virtual Noncalcium Technique For Vertebral Fracture Evaluation

Objective:To explore the judicial identification significance of dual-energy CT virtual noncalcium technique(VNCa)in the evaluation of vertebral fractures.Methods:Analysis of 100 normal adults and 101 patients with vertebral fractures who underwent dual-energy CT dual-energy(80Kv,Sn140Kv)and MRI scan.All patients underwent MPR?bone algorithm and soft tissue algorithm,VNCa pseudo-color map,fat suppression sequence and other post-processing techniques.To compare the diagnostic efficacy of dual-source CT and MRI for vertebral fracture,bone marrow edema and surrounding soft tissue injury,and to measure the CT value of vertebral bone marrow edema and the normal vertebral body of the same patient on VNCa image.Statistical analysis using?~2test and independent sample t test.Results:The data of this group showed that C2 and T12-L2 vertebral fractures were common,with L1(3.9%)being the most.CT and MRI found that the display rate of accessory fractures was 30.7%and 9.9%,CT showed more advantages for attachment fractures.CT and MR showed that the rates of disc injury and spinal cord injury and soft tissue swelling around the vertebral body were 6.9%and 10.8%,68.3%and 24.7%.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of VNCa images for bone marrow edema were 88.7%,98.3%,92.2%,97.4%,and 96.5%.The CT value of the VNCa image in the bone marrow edema area was higher than that of the normal vertebral body,and the difference was statistically significant(P<0.01);The dual-energy CT detection of vertebral height reduction of less than 40%bone marrow edema of Sen,Spe,PPV,NPV and Acc were 91.2%,98.4%,92.0%,98.3%,97.3%;The Sen,Spe,PPV,NPV and Acc of osteoporotic vertebral edema detected by dual-energy CT were 95.5%,98.7%,93.4%,99.2%and 98.3%,the Sen,Spe,PPV,NPV and Acc of non-osteoporotic vertebral edema were 80.3%,97.3%,90.5%,94.0%and 93.2%,the osteoporosis group has higher sensitivity and specificity than the non-osteoporosis group.Conclusion:Dual-energy CT VNCa has obvious advantages in fracture diagnosis,and can be used to visually and quantitatively analyze bone marrow edema,which can be used as an important examination method for judicial identification.The application of dual-source CT virtual decalcification technology provides a new examination for patients with MRI contraindications,reduces the examination process for patients,avoids the occurrence of complications,and can become a“stationary”examination method for spinal injuries.It is time to start treatment early.