Clinical Utility of Dual-Energy CT Analysis of Bone Marrow Edema in Acute Wrist Fractures

AJR. American Journal of Roentgenology
Ismail T AliSavvas Nicolaou

Abstract

The purpose of this study is to determine the utility of dual-energy CT (DECT) for assessing carpal fractures and to obtain an attenuation value cutoff (in Hounsfield units) to identify bone marrow edema due to an acute carpal fracture. In this retrospective study, 24 patients who presented with wrist fractures from September 3, 2014, through March 9, 2015, underwent imaging with DECT (80 and 140 kVp). Using the three-material decomposition algorithm specific for virtual noncalcium to construct images, two radiologists identified carpal fractures and associated bone marrow edema. Readers noted the attenuation at areas with and without bone marrow edema. The cutoff value was obtained by ROC analysis and was internally validated on 13 separate patients with suspected wrist fractures. A p < 0.05 was considered statistically significant. CT attenuation was significantly higher in areas of bone marrow edema than in areas without it (p < 0.0001, t test). A cutoff of 5.90 HU allows detection of bone marrow edema associated with acute wrist fractures with 100% sensitivity and 99.5% specificity, compared with visual DECT interpretation. In the 13 validation cases, the cutoff of 5.90 HU identified bone marrow edema with 100% accuracy, co...Continue Reading

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Citations

Feb 12, 2020·AJR. American Journal of Roentgenology·Veronique C M L TimmerAlida A Postma
May 5, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Babina GosangiBharti Khurana
Aug 22, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Prabhakar RajiahShuai Leng
Jan 11, 2021·Seminars in Roentgenology·Francis I Baffour, Katrina N Glazebrook
Apr 21, 2021·European Journal of Radiology·Felix C MüllerMikael Boesen
Jan 18, 2020·The Indian Journal of Radiology & Imaging·Luca SabaSerge Agostini
Sep 7, 2020·Clinical Radiology·A J N WongK K Lau
Sep 4, 2021·European Radiology Experimental·Tommaso D'AngeloChristian Booz

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