Domin Na1, Suk-Joo Hong2, Min A Yoon1, Kyung-Sik Ahn3, Chang Ho Kang3, Baek Hyun Kim4, Yeonggul Jang5. 1. Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea. 2. Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea. Electronic address: hongsj@korea.ac.kr. 3. Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. 4. Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea. 5. Severance Biomedical Science Institute, Yonsei University Health System, Seoul, Republic of Korea.
Abstract
RATIONALE AND OBJECTIVES: The study aimed to evaluate the usefulness of dual-energy computed tomography (DECT) before and after calcium subtraction in the diagnosis of spinal bone bruise. MATERIALS AND METHODS: Among the patients who visited our emergency department between January 2013 and July 2014 who underwent both spinal DECT and magnetic resonance imaging, 38 patients (men:women = 25:13; mean age: 55.6 years, range: 28-82) were included. The patients were divided into two groups, those with and without acute spinal compression fracture, based on magnetic resonance imaging findings. In the fracture group (n = 22), the ratio of Hounsfield unit (HU) values was calculated between the fracture level and the next normal inferior vertebra in the DECT before and after calcium subtraction. In the non-fracture group (n = 16), the ratios of HU values were calculated between two normal adjacent vertebrae. The mean HU ratios were compared between the two groups. RESULTS: The mean HU ratio was higher in the fracture group (calcium subtraction: before: 1.57 and 1.59; after: 1.74 and 1.76) than the non-fracture group (before: 1.07 and 1.08; after: 1.07 and 1.07) (P < 0.001). The mean HU ratio between before and after calcium subtraction images was different only in the fracture group (P < 0.05). There was no significant difference in the area under the curve, sensitivity, specificity, positive and negative predictive values, and accuracy (before: 0.846, 87.5%, 81.2%, 87.5%, 81.2%, 85%; after: 0.865, 91.7%, 81.2%, 88%, 86.7%, 87.5% in high energy) between the images before and after calcium subtraction. CONCLUSION: The HU ratio between the fractured and next normal vertebra was diagnostic for spinal bone bruise on DECT images both before and after calcium subtraction.
RATIONALE AND OBJECTIVES: The study aimed to evaluate the usefulness of dual-energy computed tomography (DECT) before and after calcium subtraction in the diagnosis of spinal bone bruise. MATERIALS AND METHODS: Among the patients who visited our emergency department between January 2013 and July 2014 who underwent both spinal DECT and magnetic resonance imaging, 38 patients (men:women = 25:13; mean age: 55.6 years, range: 28-82) were included. The patients were divided into two groups, those with and without acute spinal compression fracture, based on magnetic resonance imaging findings. In the fracture group (n = 22), the ratio of Hounsfield unit (HU) values was calculated between the fracture level and the next normal inferior vertebra in the DECT before and after calcium subtraction. In the non-fracture group (n = 16), the ratios of HU values were calculated between two normal adjacent vertebrae. The mean HU ratios were compared between the two groups. RESULTS: The mean HU ratio was higher in the fracture group (calcium subtraction: before: 1.57 and 1.59; after: 1.74 and 1.76) than the non-fracture group (before: 1.07 and 1.08; after: 1.07 and 1.07) (P < 0.001). The mean HU ratio between before and after calcium subtraction images was different only in the fracture group (P < 0.05). There was no significant difference in the area under the curve, sensitivity, specificity, positive and negative predictive values, and accuracy (before: 0.846, 87.5%, 81.2%, 87.5%, 81.2%, 85%; after: 0.865, 91.7%, 81.2%, 88%, 86.7%, 87.5% in high energy) between the images before and after calcium subtraction. CONCLUSION: The HU ratio between the fractured and next normal vertebra was diagnostic for spinal bone bruise on DECT images both before and after calcium subtraction.