Study on Diagnostic Performance of Dual-Energy CT Virtual Non-Calcium Imaging for
Displaying Bone Marrow Edema in Patients with Rheumatoid Arthritis of Wrist
LIU Xiang1,CHEN Yingmin1,ZHENG Hongming2,WANG Yuhang1,LI Ling3,BAI Wenyue1
1. Department of Medical Imaging, Hebei General Hospital, Shijiazhuang Hebei 050001, China丨
2. Department of Nuclear Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang Hebei 050061, China丨
3. MRI Room, Shaanxi Provincial People’s Hospital, Xi’an Shaanxi 710068, China
Abstract:Objective To evaluate the diagnostic performance of dual-energy CT (DECT) virtual non-calcium (VNCa) images
in displaying bone marrow edema (BME) in wrist joints in participants with rheumatoid arthritis (RA). Methods From July to
December 2019, 13 RA patients with clinical symptoms such as wrist swelling and pain received by the department of rheumatology
and immunology in our hospital were collected, and a total of 122 bones were included in the study. Two physicians independently
visually assessed all bones for BME (0=no abnormal bone marrow density, 1=BME) on color-coded images by using binary
classification. Using MRI as the reference standard, calculated the sensitivity, specificity, accuracy, positive predictive value (PPV)
and negative predictive value (NPV) of the subjective analysis results of VNCa images in the diagnosis of BME丨 compared whether
there were differences in CT values of bone marrow edema and normal bone marrow, and used receiver operating characteristic
curve analysis to test the best cut-off CT value of BME. Results MRI showed 39 bones with BME and 83 bones without BME. The
sensitivity, specificity, accuracy, PPV and NPV of DECT showed that the BME of RA patients was 87%, 95%, 93%, 89%, 94%,
and 87%, 89%, 89%, 79%, 94%, respectively. The CT values of BME in the quantitative determination of VNCa image was higher
than that of no BME area (P<0.01). When the cut-off value of image diagnosis of BME was -34 HU, the sensitivity, specificity and
accuracy were 92.3%, 92.7%, and 92.6%, respectively. Conclusion The third-generation DECT VNCa technology can be used to
display the BME of the wrist of RA patients, and has a good diagnostic performance.
刘向1,陈英敏1,郑泓明2,王宇航1,李玲3,白文月1. 双能CT虚拟去钙技术对类风湿性关节炎腕关节骨髓水肿诊断效能的研究[J]. 中国医疗设备, 2021, 36(10): 84-89.
LIU Xiang1,CHEN Yingmin1,ZHENG Hongming2,WANG Yuhang1,LI Ling3,BAI Wenyue1. Study on Diagnostic Performance of Dual-Energy CT Virtual Non-Calcium Imaging for
Displaying Bone Marrow Edema in Patients with Rheumatoid Arthritis of Wrist. China Medical Devices, 2021, 36(10): 84-89.