TY  - JOUR
A1  - Cavallaro, Marco
A1  - D’Angelo, Tommaso
A1  - Albrecht, Moritz Hans Ernst
A1  - Yel, Ibrahim
A1  - Martin, Simon S.
A1  - Wichmann, Julian
A1  - Lenga, Lukas Fabian
A1  - Mazziotti, Silvio
A1  - Blandino, Alfredo
A1  - Ascenti, Giorgio
A1  - Longo, Marcello
A1  - Vogl, Thomas J.
A1  - Booz, Christian
T1  - Comprehensive comparison of dual-energy computed tomography and magnetic resonance imaging for the assessment of bone marrow edema and fracture lines in acute vertebral fractures
T2  - European radiology
N2  - Objectives: To compare dual-energy CT (DECT) and MRI for assessing presence and extent of traumatic bone marrow edema (BME) and fracture line depiction in acute vertebral fractures. Methods: Eighty-eight consecutive patients who underwent dual-source DECT and 3-T MRI of the spine were retrospectively analyzed. Five radiologists assessed all vertebrae for presence and extent of BME and for identification of acute fracture lines on MRI and, after 12 weeks, on DECT series. Additionally, image quality, image noise, and diagnostic confidence for overall diagnosis of acute vertebral fracture were assessed. Quantitative analysis of CT numbers was performed by a sixth radiologist. Two radiologists analyzed MRI and grayscale DECT series to define the reference standard. Results: For assessing BME presence and extent, DECT showed high sensitivity (89% and 84%, respectively) and specificity (98% in both), and similarly high diagnostic confidence compared to MRI (2.30 vs. 2.32; range 0–3) for the detection of BME (p = .72). For evaluating acute fracture lines, MRI achieved high specificity (95%), moderate sensitivity (76%), and a significantly lower diagnostic confidence compared to DECT (2.42 vs. 2.62, range 0–3) (p < .001). A cutoff value of − 0.43 HU provided a sensitivity of 89% and a specificity of 90% for diagnosing BME, with an overall AUC of 0.96. Conclusions: DECT and MRI provide high diagnostic confidence and image quality for assessing acute vertebral fractures. While DECT achieved high overall diagnostic accuracy in the analysis of BME presence and extent, MRI provided moderate sensitivity and lower confidence for evaluating fracture lines.
KW  - Radiology
KW  - Multidetector computed tomography
KW  - Magnetic resonance imaging
KW  - Spinal fractures
KW  - Retrospective study
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63588
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-635882
SN  - 1432-1084
SN  - 1613-3757
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 32
IS  - 1
SP  - 561
EP  - 571
PB  - Springer
CY  - Berlin ; Heidelberg
ER  -