Keywords:
Diagnostic procedure, MR, CT-Quantitative, CT, Musculoskeletal system, Extremities, Bones
Authors:
G. Foti1, M. Catania2, S. Caia1, L. Romano1, G. Carbognin1; 1Negrar/IT, 2Verona/IT
DOI:
10.26044/essr2019/P-0029
Results
Clinical data of patients enrolled are summarized in table 1 (fig 3).
MRI revealed the presence of BME in 25/40 cases (62.5%).
BME was depicted in patients with recent trauma in 9/13 cases (69.2%),
and in 16/27 patients (59.2%) suffering from chronic pain.
The diagnostic accuracy values of DECT on a per-patient analysis are summarized in table 3 (fig 4).
Thirty-six of 40 (90.0%) patients were correctly diagnosed (Fig 5) with 2 false positive (fig 6) and 2 false negative (fig 7) findings.
The interobserver and intraobsever agreement were near perfect (k=0.87 and k=0.83,
respectively).
DECT numbers were significantly different between positive (mean -12.6 ± 29.6 HU) and negative cases (mean -64.2 ± 34.5 HU) with a p value <0.001.
The ROC curve analysis revealed an AUC of 0.896 (95% confidence interval: 0.764-0.942).
By using -20HU cutoff to identify bone marrow edema,
the sensitivity,
specificity,
PPV and NPV and accuracy of DECT were 88.0,
92.6,
95.7,
92.6 and 87.5%,
respectively.
Associated imaging findings were detected at MRI in 10/25 cases: in particular an OCL of the talus was imaged in 5 cases,
a meshed fracture in 2 cases and a stress fractures in 3 patients.