Exploration of the Application Value of Dual Energy CT in the Diagnosis and Phase ⅡA Display of Talar Osteochondrial Injury
MENG Xianghua
CUI Xuefeng
CHEN Yingmin
MA Guangjun
WANG Yanfen
MA Li
ZHAI Zechuan
SHEN Chaona
Abstract：Objective:To investigate the diagnostic value of dual-energy computed tomography(DECT)for Stage ⅡA talar osteochondral injuries,with magnetic resonance imaging(MRI)as the reference standard.Methods:Thirty consecutive patients admitted to the orthopedics department of our hospital from January 2023 to December 2023,with long-term ankle pain and diagnosed with an osteochondral lesion of the talus through clinical and MRI examinations,were enrolled.DECT was performed on the patients within 24 hours after the MRI examination.Doctor A diagnosed and staged the 30 MRI images based on the modified MRI staging criteria by Hepple et al.Doctors B and C,independently and blindly,performed visual assessment and staging of the DECT images after post-processing to generate virtual non-calcium images.Doctor D quantitatively assessed images from the patients with a Stage ⅡA injury using the virtual non-calcium technique,based on the MRI results.With MRI as the reference standard,the qualitative assessments of DECT were statistically analyzed by Doctors B and C.Doctor D quantitatively assessed whether there was a statistical difference in CT attenuation values in the lesion area in patients with Stage ⅡA injuries compared with the controls.Results:The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of DECT qualitative diagnosis by Doctors B and C were 84％,91％,89％,83％,and 90％and 85％,89％,88％,83％,91％,respectively(Kappa values of 0.771 and 0.758).The sensitivity and specificity of qualitative assessment of Stage ⅡA lesions by Doctors B and C were 85％,94％,and 84％,93％,respectively(Kappa values of 0.807 and 0.801).The quantitative diagnosis by Doctor D showed a statistical difference,with an optimal cutoff value of-21.85 HU(sensitivity and specificity:92％and 98.9％).Conclusion:DECT and virtual non-calcium imaging techniques have significant diagnostic value for patients with Stage ⅡA talar osteochondral injuries.
Keywords：dual-energy CTvirtual non-calcium techniqueOLTbone marrow edemaphase ⅡA
Publication Date：2025-11-30
Online Publishing Date：2025-12-19(First online date of this platform, not the publication date of the document)
Pages：9( 1173-1181 )