Semin Musculoskelet Radiol 2019; 23(S 01): S1-S6
DOI: 10.1055/s-0039-1687698
Scientific Presentations and Posters
Georg Thieme Verlag KG Stuttgart · New York

Single-Source Dual-Energy Computed Tomography Detects Disk Injury in Patients with Vertebral Fractures

Torsten Diekhoff
1   Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
,
Michael Fuchs
2   Department of Spine Surgery, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
3   Department of Orthopedic Surgery, University of Ulm, Germany
,
Nils Engelhard
1   Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
,
Kay-Geert A. Hermann
1   Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
,
Michael Putzier
2   Department of Spine Surgery, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
,
Marcus R. Makowski
1   Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
,
Bernd Hamm
1   Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
,
Matthias Pumberger
2   Department of Spine Surgery, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
28 March 2019 (online)

Also available at
 

Objectives: Dual-energy computed tomography (DECT) allows for the reconstruction of collagen-sensitive images using a three-material decomposition algorithm. The aim of this study was to evaluate the diagnostic accuracy of DECT for the detection of disk injuries in patients with vertebral fractures using magnetic resonance imaging (MRI) as the standard of reference.

Methods: Institutional review board approval was obtained. We consecutively and prospectively included patients older than 50 years with vertebral compression fractures who underwent DECT and MRI of the thoracic or lumbar spine. Images were assessed by three blinded readers independently using the Sanders score (0–3). Only disks at risk (adjacent to a fracture) were included in the analysis. Sensitivity and specificity as well as the interrater agreement (Fleiss’s κ) were calculated using MRI as the standard of reference. Region of interest measurements of the disks were performed.

Results: Overall, 67 patients with a total of 295 disks were included. DECT showed a sensitivity of 85% and a specificity of 75%. The sensitivity increased with increasing Sanders score (1: 80%; 2: 85%; and 3: 98%). Fleiss’s κ was 0.51 for DECT and 0.41 for MRI. The Hounsfield unit values in the collagen images were lower for disks with injury compared with normal disks (80.3 ± 35.2 versus 97.9 ± 41.0; p = 0.0002).

Conclusion: Disk injuries can be depicted using DECT. Therefore, DECT can add additional diagnostic information to a standard CT scan beyond its ability to display bone marrow edema.

Conflict of Interest: None declared.