Abstract
Dual-energy computed tomography (DECT) has been reported to successfully identify bone marrow oedema (BME) in various traumatic settings. DECT has multiple strengths, including the availability of both a 3D view of the anatomical area studied and of high-resolution dual energy specific maps super-imposed onto conventional grayscale morphological images. Windowing can be used to enhance the visualization of BME by increasing the level of the super-imposed images. Conversely, by decreasing the level of the super-imposition of color-coded images, it is possible to progressively enhance the visualization of fine anatomical details, which is useful for diagnosing associated imaging findings. Importantly, bone sclerosis may represent an important pitfall for DECT, potentially generating both false positive and false negative findings by locally altering CT numbers. The aim of this paper was to evaluate the strengths and limitations of DECT in accurately detecting traumatic BME, by considering practical approaches to imaging at several anatomical sites.
Highlights
Bone marrow oedema (BME) represents a common clinical problem amongst the adult population [1]
While Dual-energy computed tomography (DECT) images can be used to identify bone marrow oedema (BME), standard Computed tomography (CT) images can help in identifying subtle morphological changes that could prove key for diagnosis, increasing the reliability and reading confidence amongst less experienced readers, and reducing the overall reading time in general [14]
This paper will describe the role of DECT in the assessment of post-traumatic BME, highlighting specific problems regarding the acquisition and interpretation of DECT images that could prove relevant to clinical practice
Summary
Bone marrow oedema (BME) represents a common clinical problem amongst the adult population [1]. BME is typically a response to an injury such as a fracture or conditions such as osteoarthritis. It occurs when fluid builds up in the bone marrow. While DECT images can be used to identify BME, standard CT images can help in identifying subtle morphological changes that could prove key for diagnosis, increasing the reliability and reading confidence amongst less experienced readers, and reducing the overall reading time in general [14]. This paper will describe the role of DECT in the assessment of post-traumatic BME, highlighting specific problems regarding the acquisition and interpretation of DECT images that could prove relevant to clinical practice
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