Dual-energy CT in the diagnosis of occult acute scaphoid injury: a direct comparison with MRI
- PDF / 610,309 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 35 Downloads / 185 Views
MUSCULOSKELETAL
Dual-energy CT in the diagnosis of occult acute scaphoid injury: a direct comparison with MRI Cheng Xie 1
&
Sarim Ather 1 & Ramy Mansour 2 & Fergus Gleeson 3 & Rajat Chowdhury 2
Received: 23 June 2020 / Revised: 9 November 2020 / Accepted: 4 December 2020 # The Author(s) 2020
Abstract Objectives Scaphoid injuries occult on plain radiography often require further imaging for definitive diagnosis. We investigate the utility of dual-energy computed tomography (DECT) for the detection of acute bone marrow oedema and fracture of scaphoid compared to MRI. Materials and methods Twenty patients who presented acutely (without prior injury) to the emergency department with clinically suspected occult scaphoid fracture and had MRI of the wrist were prospectively recruited to have DECT (GE Revolution CT). Material decomposition images of the water-calcium base pair were generated and assessed in conjunction with the monochromatic images to permit correlation of marrow signal changes with any cortical disruption for fracture confirmation. The assessment was performed by two musculoskeletal radiologists blinded from MRI results. The statistical difference of MRI and reviewers’ detection of acute bone oedema (1 = present, 0 = absent) was performed using the Friedman test (SPSS v.16). Results MRI showed acute scaphoid fracture and/or bone marrow oedema in 14/20 patients of which 6 also had cortical disruption. On DECT, reviewer A identified oedema in 13 and cortical disruption in 10 patients while reviewer B identified oedema in 10 and cortical disruption in seven of the 14 MRI positive patients. No statistically significant difference in oedema detection on MRI and reviewers of DECT (p value 0.61) but DECT was more sensitive at detecting cortical disruption. Conclusion DECT has the capability to detect acute scaphoid oedema in addition to cortical fractures. However, compared to MRI, DECT has lower contrast resolution and less sensitive in the detection of mild oedema. Key Points • Dual-energy CT is able to detect acute traumatic scaphoid marrow oedema. • Dual-energy CT has greater detection rate of scaphoid fractures than MRI. • Dual-energy CT is an alternative to MRI for occult scaphoid injury. Keywords Wrist injuries . Scaphoid bone . Bone marrow . Edema . Radiography
Joint first authors and equal contributions of Cheng Xie and Sarim Ather. * Cheng Xie [email protected] 1
2
3
Department of Radiology, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, OX3 9DU Oxford, UK Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Headington, OX3 7HE Oxford, UK Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Old Road, Headington, OX3 7LE Oxford, UK
Abbreviations CT Computed tomography DECT Dual-energy computed tomography FOOSH Fall on an outstretched hand MRI Magnetic resonance imaging VNC Virtual non-calcium
Introduction After a fall on to an o
Data Loading...
