Detection of Bone Marrow Edema in Nondisplaced Hip Fractures: Utility of a Virtual Noncalcium Dual-Energy CT Application. 2017

Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
From the Department of Radiology, Vancouver General Hospital, University of British Columbia, 3350-950 W 10th Ave, Vancouver, BC, Canada V5Z 4E3.

Purpose To quantify the sensitivity and specificity of dual-energy computed tomographic (CT) virtual noncalcium images in the detection of nondisplaced hip fractures and to assess whether obtaining these images as a complement to bone reconstructions alters sensitivity, specificity, or diagnostic confidence. Materials and Methods The clinical research ethics board approved chart review, and the requirement to obtain informed consent was waived. The authors retrospectively identified 118 patients who presented to a level 1 trauma center emergency department and who underwent dual-energy CT for suspicion of a nondisplaced traumatic hip fracture. Clinical follow-up was the standard of reference. Three radiologists interpreted virtual noncalcium images for traumatic bone marrow edema. Bone reconstructions for the same cases were interpreted alone and then with virtual noncalcium images. Diagnostic confidence was rated on a scale of 1 to 10. McNemar, Fleiss κ, and Wilcoxon signed-rank tests were used for statistical analysis. Results Twenty-two patients had nondisplaced hip fractures and 96 did not have hip fractures. Sensitivity with virtual noncalcium images was 77% and 91% (17 and 20 of 22 patients), and specificity was 92%-99% (89-95 of 96 patients). Sensitivity increased by 4%-5% over that with bone reconstruction images alone for two of the three readers when both bone reconstruction and virtual noncalcium images were used. Specificity remained unchanged (99% and 100%). Diagnostic confidence in the exclusion of fracture was improved with combined bone reconstruction and virtual noncalcium images (median score: 10, 9, and 10 for readers 1, 2, and 3, respectively) compared with bone reconstruction images alone (median score: 9, 8, and 9). Conclusion When used as a supplement to standard bone reconstructions, dual-energy CT virtual noncalcium images increased sensitivity for the detection of nondisplaced traumatic hip fractures and improved diagnostic confidence in the exclusion of these fractures. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on March 17, 2017.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011857 Radiographic Image Interpretation, Computer-Assisted Computer systems or networks designed to provide radiographic interpretive information. Computer Assisted Radiographic Image Interpretation,Computer-Assisted Radiographic Image Interpretation,Radiographic Image Interpretation, Computer Assisted
D001853 Bone Marrow The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. Marrow,Red Marrow,Yellow Marrow,Marrow, Bone,Marrow, Red,Marrow, Yellow
D004487 Edema Abnormal fluid accumulation in TISSUES or body cavities. Most cases of edema are present under the SKIN in SUBCUTANEOUS TISSUE. Dropsy,Hydrops,Anasarca
D005260 Female Females
D006620 Hip Fractures Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES). Femoral Trochlear Fractures,Intertrochanteric Fractures,Subtrochanteric Fractures,Trochanteric Fractures,Trochlear Fractures, Femur,Femoral Trochlear Fracture,Femur Trochlear Fracture,Femur Trochlear Fractures,Fracture, Femoral Trochlear,Fracture, Femur Trochlear,Fractures, Femoral Trochlear,Fractures, Femur Trochlear,Fractures, Hip,Fractures, Intertrochanteric,Fractures, Subtrochanteric,Fractures, Trochanteric,Trochlear Fracture, Femoral,Trochlear Fracture, Femur,Trochlear Fractures, Femoral
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

Related Publications

Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
August 2022, Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
January 2019, Radiology,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
January 2014, Journal of computer assisted tomography,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
November 2019, Acta radiologica (Stockholm, Sweden : 1987),
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
December 2019, Skeletal radiology,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
August 2010, Radiology,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
June 2021, European journal of radiology,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
November 2013, Radiology,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
December 2012, Academic radiology,
Trenton T Kellock, and Savvas Nicolaou, and Sandra S Y Kim, and Sultan Al-Busaidi, and Luck J Louis, and Tim W O'Connell, and Hugue A Ouellette, and Patrick D McLaughlin
February 2015, Emergency radiology,
Copied contents to your clipboard!