用雙能電腦斷層造影偵測脊椎壓迫性骨折之水腫

使用磁振造影(MR)影像當作標準對照，評估雙能電腦斷層(DECT)造影的虛擬無鈣影像，是否能診斷脊椎壓迫性骨折的骨髓水腫;並分析DECT造影的虛擬無鈣影像，對脊椎壓迫性骨折，椎體形態上的分類，及雙能電腦斷層數值(CT number)的改變等參數，與骨髓水腫的相關性。以普查的方式，收集因脊椎壓迫性骨折而執行MR及DECT造影的志願病患，在排除掉因感染及腫瘤的案例後，共收集了六十八例志願病患，共對126節椎體進行分析。去除其中12節脊椎因嚴重的壓迫性骨折，使得椎體的高度小於4公厘而無法分析；另去除有2節因呼吸過速造成假影，使得雙能電腦斷層掃描無法取得正確的電腦斷層數值。共對112節椎體進行分析 (包含1,患者：病史、年齡、性別。2,傳統X光攝影：壓迫程度。3,DECT：影像、數值、骨折程度。4,MR：骨髓水腫、水腫型態、骨折程度、積水、積氣) 。 DECT造影與MR成像之間的平均時間約為1.13天（範圍0-13天）。依MR影像顯示，112節椎體中，有46節含椎體骨髓水腫（急性壓迫性骨折）；66節椎體未見椎體骨髓水腫（陳舊性壓迫性骨折）病變。使用DECT虛擬無鈣造影，在診斷骨髓水腫，於T檢定中，P值是< 0.0001***，具有統計學上的意義。因此DECT虛擬無鈣造影，有助於評估椎體骨折內的骨髓，使得因故無法接受MR造影的患者（如裝有心臟節律器、腦部或其他部位有金屬夾、幽閉恐懼症，•••等。）有其他更便宜的選擇。關鍵詞:雙能電腦斷層

關鍵字

雙能電腦斷層

並列摘要

Magnetic Resonance (MR) imaging can be the contrast of standard. It evaluates whether the Dual Energy (DE) imaging virtual non-calcium technique can diagnose compression fracture of lumbar spine with marrow edema. Moreover, we analysis the DE imaging virtual non-calcium technique with MR image, and analyze the relationship between bony marrow edema, the classification of the vertebral body shape, the change of CT number from DECT. Collecting volunteers who have been executed DECT and MR are compression fracture of the spine by using general survey. A total of 68 voluntary patients, with analyzing 126 vertebral bodies, are collected as cases, excluding the cases of infection and neoplasm. The 12 vertebral bodies are eliminated due to compression fracture, and it is unanalyzable that the body height is less than 4mm. In addition, the 2 vertebral bodies are excluded due to artifact by breathing too fast, and it makes DECT obtain incorrect CT number. A total of 112 vertebral bodies has been analyzed (including 1, patient: history, age, gender, 2, traditional X-ray: vertebral body high. 3, DECT: area, CT number, cortical defect, sclerosis. 4, MR：bone marrow edema, pattern of edema, cortical defect, air and fluid accumulation). The average time between the DECT virtual non-calcium technique and MR image is about 1.13 days (range: from 0 to 13 days). A total of 112 vertebral bodies were revealed, 46 vertebral bodies with bone marrow edema (acute compression fracture) and 66 vertebral bodies with no bone bruise (old compression fracture) by MR imagines. In the diagnosis of acute vertebral body compression fracture, the DECT virtual non-calcium technique is significant in statistics (the P value <0.0001***) and it is useful to evaluate the vertebral fractures with the bone marrow edema. In addition, the patients who can not take the examination of MR due to some reason (for example, with cardiac pacemakers, with the metal clips of brain or other parts and with claustrophobia, etc…) could have another inexpensive choice. Key word: DECT

並列關鍵字

DECT

參考文獻

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用雙能電腦斷層造影偵測脊椎壓迫性骨折之水腫

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