Assessment of bone marrow edema on dual-energy CT scans in people with diabetes mellitus and suspected Charcot neuro-osteoarthropathy.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Skeletal Radiology Pub Date : 2026-01-01 Epub Date: 2024-06-04 DOI:10.1007/s00256-024-04714-3

Carlijn M B Bouman, Marieke A Mens, Ruud H H Wellenberg, Geert J Streekstra, Sicco A Bus, Tessa E Busch-Westbroek, Max Nieuwdorp, Mario Maas

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Abstract

Objective: This study aimed to quantitatively assess the diagnostic value of bone marrow edema (BME) detection on virtual non-calcium (VNCa) images calculated from dual-energy CT (DECT) in people with diabetes mellitus and suspected Charcot neuro-osteoarthropathy (CN).

Materials and methods: People with diabetes mellitus and suspected CN who underwent DECT of the feet (80kVp/Sn150kVp) were included retrospectively. Two blinded observers independently measured CT values on VNCa images using circular regions of interest in five locations in the midfoot (cuneiforms, cuboid and navicular) and the calcaneus of the contralateral or (if one foot was available) the ipsilateral foot. Two clinical groups were formed, one with active CN and one without active CN (no-CN), based on the clinical diagnosis.

Results: Thirty-two people with diabetes mellitus and suspected CN were included. Eleven had clinically active CN. The mean CT value in the midfoot was significantly higher in the CN group (-55.6 ± 18.7 HU) compared to the no-CN group (-94.4 ± 23.5 HU; p < 0.001). In the CN group, the difference in CT value between the midfoot and calcaneus was statistically significant (p = 0.003); this was not the case in the no-CN group (p = 0.357). The overall observer agreement was good for the midfoot (ICC = 0.804) and moderate for the calcaneus (ICC = 0.712). Sensitivity was 100.0% and specificity was 71.4% using a cutoff value of -87.6 HU.

Conclusion: The detection of BME on VNCa images has a potential value in people with diabetes mellitus and suspected active CN.

Abstract Image

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通过双能 CT 扫描评估糖尿病和疑似 Charcot 神经骨关节病患者的骨髓水肿。

研究目的本研究旨在定量评估双能 CT（DECT）计算出的虚拟非钙（VNCa）图像上骨髓水肿（BME）检测对糖尿病和疑似 Charcot 神经骨关节病（CN）患者的诊断价值：回顾性纳入接受足部 DECT（80kVp/Sn150kVp）检查的糖尿病和疑似 CN 患者。两名盲人观察者使用脚中部（楔形、立方体和舟骨）和对侧或（如果有一只脚）同侧脚的小方块五个位置的圆形感兴趣区，独立测量 VNCa 图像上的 CT 值。根据临床诊断结果分成两个临床组，一个是有活动性 CN，另一个是无活动性 CN（无 CN）：结果：共纳入 32 名疑似 CN 的糖尿病患者。其中 11 人有临床活动性 CN。与无 CN 组（-94.4 ± 23.5 HU; p）相比，CN 组足中部的平均 CT 值（-55.6 ± 18.7 HU）明显较高：在 VNCa 图像上检测 BME 对糖尿病和疑似活动性 CN 患者具有潜在价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Skeletal Radiology 医学-核医学

CiteScore

4.40

自引率

9.50%

发文量

253

审稿时长

3-8 weeks

期刊介绍： Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.