Distal ekstremitelerde travmatik kemik iliği ödeminin dual enerji bt ile kalitatif ve kantitatif değerlendirilmesi
Küçük Resim Yok
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Distal ekstremite kemiklerinde travmatik kemik iliği ödeminin saptanmasında dual enerji bilgisayarlı tomografinin (DEBT) tanısal başarısını değerlendirmek. Gereç ve Yöntem: Bu prospektif çalışma Malatya İnönü Üniversitesi Bilimsel Araştırma ve Yayın Etiği Kurulu'nun 2017/74 karar no'lu izni ile gerçekleştirilmiştir. 2017 Mayıs-2018 Mart ayları arasında el ve ayak bileği travması nedeni ile başvuran 42 (20 el bileği, 22 ayak bileği) hasta çalışmaya dahil edildi. Tüm hastalara tıbbi endikasyon dahilinde DEBT ve manyetik rezonans görüntüleme (MRG) yapıldı. DEBT görüntüleri, MRG bulgularından habersiz ve birbirinden bağımsız iki radyolog tarafından kalitatif olarak renkli olarak kodlanmış kemik iliği haritasında değerlendirildi. MRG altın standart olarak kabul edildi. Son olarak birinci radyolog tarafından BT numaralarının belirlenmesi ile kantitatif değerlendirme yapıldı. Bu değerlerin kullanılması ile eşik (cut-off) değer hesaplandı. Bulgular: Kalitatif değerlendirmede duyarlılık %36,90, özgüllük %55, pozitif kestirim değeri %77,5, negatif kestirim değeri %17,18, doğruluk oranı %40,38, yanlış pozitiflik oranı %22,5, yanlış negatif oranı %82,81 olarak hesaplandı. Gözlemciler arası uyum k= 0,44 (orta) ile k= 0,74 (iyi) arasında değişmekte idi. Kantitatif değerlendirmede distal ekstremitelerdeki küçük kemiklerde ödemi ayırt edebilmek için duyarlılık; %94, özgüllük; %92 olmasını sağlayan cut-off değeri -61,4 HU olarak hesaplandı. Sonuç: Distal ekstremite yerleşimli küçük kemiklerde travma sonrası kemik iliği ödeminin gösterilmesinde kalitatif analizde DEBT'nin duyarlılık ve özgüllük oranları düşüktür. Ancak kantitatif değerlendirmede yapılan ROI öçümlerinden elde edilen eşik değeri anlamlı tanısal ilişkiler içinde olup kemik iliği ödeminin tespitinde kullanılabilir. Anahtar kelimeler: Dual Enerji Bilgisayarlı Tomografi, Kemik İliği Ödemi, Travma
Purpose: To evaluate the diagnostic success of dual energy computed tomography (DECT) in the detection of traumatic bone marrow edema in distal extremity bones. Materials and Methods: This prospective study was performed with permission Malatya Inonu University Research and Publication Ethics Board decision number 2017/74. 42 (20 wrists, 22 ankles) patients who applied for foot and ankle trauma between May 2017 and March 2018 were included in the study. All patients were scanned with DEBT and magnetic resonance imaging (MRI) within medical indications. DECT images were evaluated in a color-coded bone marrow map qualitatively in terms of abnormal bone density (bone marrow edema) by two independent radiologists unaware of MRI findings. MRI was accepted as gold standard. Finally, quantitative evaluation was performed by the first radiologist to determine the CT HU numbers. The cut-off value was calculated using these CT HU numbers. Findings: In qualitative evaluation, sensitivity was calculated as 36.90%, specificity as 55%, positive predictive value as 77.5%, negative predictive value as 17.18%, accuracy rate as 40.38%, false positive rate as 22.5%, false negative rate as 82.81%. The interobserver agreement was between k = 0.44 (medium) and k = 0.74 (good). The cut-off value, which allowed the sensitivity to be 94%and the specificity to be 92%, was calculated to be -61.4 HU in order to distinguish the edema in the small bones in the distal extremities in quantitative evaluation. Result: Sensitivity and specificity rates of DECT are low in qualitative analysis of post-traumatic bones marrow edema in small bones at distal extremities. However, the cut off value obtained from the quantitative ROI measuremants are diagnosticly significant and can be used to determine bone marrow edema. Keywords: Dual Energy Computerized Tomography, Bone Marrow Edema, Trauma
Purpose: To evaluate the diagnostic success of dual energy computed tomography (DECT) in the detection of traumatic bone marrow edema in distal extremity bones. Materials and Methods: This prospective study was performed with permission Malatya Inonu University Research and Publication Ethics Board decision number 2017/74. 42 (20 wrists, 22 ankles) patients who applied for foot and ankle trauma between May 2017 and March 2018 were included in the study. All patients were scanned with DEBT and magnetic resonance imaging (MRI) within medical indications. DECT images were evaluated in a color-coded bone marrow map qualitatively in terms of abnormal bone density (bone marrow edema) by two independent radiologists unaware of MRI findings. MRI was accepted as gold standard. Finally, quantitative evaluation was performed by the first radiologist to determine the CT HU numbers. The cut-off value was calculated using these CT HU numbers. Findings: In qualitative evaluation, sensitivity was calculated as 36.90%, specificity as 55%, positive predictive value as 77.5%, negative predictive value as 17.18%, accuracy rate as 40.38%, false positive rate as 22.5%, false negative rate as 82.81%. The interobserver agreement was between k = 0.44 (medium) and k = 0.74 (good). The cut-off value, which allowed the sensitivity to be 94%and the specificity to be 92%, was calculated to be -61.4 HU in order to distinguish the edema in the small bones in the distal extremities in quantitative evaluation. Result: Sensitivity and specificity rates of DECT are low in qualitative analysis of post-traumatic bones marrow edema in small bones at distal extremities. However, the cut off value obtained from the quantitative ROI measuremants are diagnosticly significant and can be used to determine bone marrow edema. Keywords: Dual Energy Computerized Tomography, Bone Marrow Edema, Trauma
Açıklama
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine
