| Objective:To evaluate the diagnostic value of spectral CT calcium Suppression(CaSupp)technique in acute and chronic thoracolumbar compression fractures.Methods:A total of 31 patients with thoracolumbar compression fractures were given spectral CT and MRI scans.Physicians A and B subjectively evaluated the Casupp diagram by dichotomy.Kappa test was used to evaluate the diagnostic consistency between the two,and ROC curve was used to analyze the diagnosis results.CT values of fractured vertebra and adjacent normal vertebra were measured on conventional CT and CaSupp graphs respectively,and the CT value difference between fractured vertebra and adjacent vertebra was calculated.Independent sample T-test was used to compare the conventional CT value and CT value difference,CaSupp CT value and CT value difference between acute and chronic fractured vertebra.ROC curve was used to analyze the diagnostic efficacy of each measured value.Results:The number of vertebral bodies in acute and chronic compression fractures diagnosed by MRI were 48 and 11 respectively.The scores of doctors A and B were highly consistent(Kappa=0.782),and the AUC,sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the diagnosis results were 0.882 and0.857,85.4% and 89.6%,90.9% and 81.8%,86.4% and 88.1%,97.6% and 95.6%,58.8%and 64.3%,respectively.The differences of conventional CT value,CaSupp CT value and CaSupp CT value between acute and chronic compression fractures were statistically significant(P<0.05),and the AUC values of conventional CT value,CaSupp CT value difference and CaSupp CT value difference were 0.824,,0.930 and 0.934,respectively.Conclusion:The two-layer detector spectral CT CaSupp technique has high diagnostic value in differentiating acute and chronic thoracolumbar compression fractures and provides a new method for clinicians. |
