caa a22 4500 606171134 CHVBK 20210128100721.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s10140-014-1249-6 doi (NATIONALLICENCE)springer-10.1007/s10140-014-1249-6 Detection of occult, undisplaced hip fractures with a dual-energy CT algorithm targeted to detection of bone marrow edema [Elektronische Daten] [T. Reddy, P. McLaughlin, P. Mallinson, A. Reagan, P. Munk, S. Nicolaou, H. Ouellette] The purpose of this study is to describe our initial clinical experience with dual-energy computed tomography (DECT) virtual non-calcium (VNC) images for the detection of bone marrow (BM) edema in patients with suspected hip fracture following trauma. Twenty-five patients presented to the emergency department at a level 1 trauma center between January 1, 2011 and January 1, 2013 with clinical suspicion of hip fracture and normal radiographs were included. All CT scans were performed on a dual-source, dual-energy CT system. VNC images were generated using prototype software and were compared to regular bone reconstructions by two musculoskeletal radiologists in consensus. Radiological and/or clinical diagnosis of fracture at 30-day follow-up was used as the reference standard. Twenty-one patients were found to have DECT-VNC signs of bone marrow edema. Eighteen of these 21 patients were true positive and three were false positive. A concordant fracture was clearly seen on bone reconstruction images in 15 of the 18 true positive cases. In three cases, DECT-VNC was positive for bone marrow edema where bone reconstruction CT images were negative. Four patients demonstrated no DECT-VNC signs of bone marrow edema: two cases were true negative, two cases were false negative. When compared with the gold standard of hip fracture determined at retrospective follow-up, the sensitivity of DECT-VNC images of the hip was 90%, specificity was 40%, positive predictive value was 86%, and negative predictive value was 50%. Our initial experience would suggest that DECT-VNC is highly sensitive but poorly specific in the diagnosis of hip fractures in patients with normal radiographs. The value of DECT-VNC primarily lies in its ability to help detect fractures which may be subtle or undetectable on bone reconstruction CT images. American Society of Emergency Radiology, 2014 Dual-energy computed tomography nationallicence Virtual non-calcium images nationallicence Bone marrow edema nationallicence Hip fracture nationallicence Reddy T. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut McLaughlin P. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut Mallinson P. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut Reagan A. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut Munk P. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut Nicolaou S. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut Ouellette H. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut Emergency Radiology Springer Berlin Heidelberg 22/1(2015-02-01), 25-29 1070-3004 22:1<25 2015 22 10140 https://doi.org/10.1007/s10140-014-1249-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-014-1249-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Reddy T. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- McLaughlin P. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Mallinson P. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Reagan A. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Munk P. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Nicolaou S. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Ouellette H. Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, V5Z 1M9, Vancouver, BC, Canada aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/1(2015-02-01), 25-29 1070-3004 22:1<25 2015 22 10140