Assessment of the Diagnostic Value and Image Quality of Dual-source Computed Tomography in Lumbar Vertebral Fractures: Comparison with Magnetic Resonance Imaging

Abstract

The aim of this study was to assess the performance of virtual non-calcium images from dual-energy computed tomography (DECT), using dual-source CT (DSCT). Forty-one patients suspected of having traumatic vertebral fractures who underwent DSCT with virtual non-calcium imaging were included in this study. For comparison, radiation exposure was measured in 11 patients receiving DSCT with a radiation exposure reduction system, and in 14 patients receiving conventional multi-detector-row CT scans. Radiation exposure, detectability of fractures and visual image quality were assessed and compared between the groups. Radiation exposure was less with the non-calcium image than with the other methods. The CT number (x-ray absorption coefficient of a pixel in a CT) for the affected vertebrae was significantly higher than for normal vertebrae. When the threshold of the CT number was determined as -25.6 HU, the sensitivity was 100% and specificity was 92.6%. In most cases, the quality of the virtual non-calcium image was inferior to the fat-suppressed T2-weighted magnetic resonance images. The virtual non-calcium image technique obtained using DSCT can be a useful part of the clinical diagnosis of vertebral fractures.