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Use of dual-energy CT and virtual non-calcium techniques to evaluate post-traumatic bone bruises in knees in the subacute setting

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Abstract

Objective

The purpose of this study was to determine the ability of dual-energy computed tomography (DECT) and virtual non-calcium (VNCa) imaging to detect magnetic resonance imaging (MRI)-demonstrated bone bruises several weeks after unilateral knee injury.

Materials and methods

Patients with unilateral knee injury and MRI-confirmed bone bruises who had undergone a DECT scan of both knees were retrospectively identified. Two radiologists evaluated VNCa images for bruises in four regions per knee without knowing the MRI results. The mean CT numbers were calculated for the lesion-positive and lesion-negative regions of the injured knee, and the contralateral knee.

Results

Fourteen patients with a total of 36 regions positive for bone bruises on MRI were identified. The median delay between injury and DECT was 37 days (range, 11–99 days). The mean CT numbers in VNCa images for lesion-positive and lesion-negative regions were –7.6 ± 24.9 HU and –58.2 ± 19.5 HU, respectively. There were no significant differences in mean CT number between the lesion-negative regions in the injured knee and the contralateral knee. No resolution of bruising was seen before week 5, and bone bruising was still identifiable in one out of the two patients scanned at 10 weeks following injury.

Conclusions

DECT and VNCa images can identify bone bruising for at least 10 weeks after injury.

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Acknowledgments

The authors thank Dr. Diane L. Dahm and Dr. Michael J. Stuart for providing the cases, Dr. Yunhong Shu for providing technical support on MRI information, and Ms. Amy Nordstrom for assistance with manuscript submission. Dr. Naomi L. Ruff assisted with preparing the manuscript, for which she was paid by Mayo Clinic. Songtao Ai’s research was supported by the National Natural Science Foundation of China (81301260).

Conflict of interest

Cynthia H. McCollough receives research support from Siemens Healthcare. The other authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Songtao Ai, Mingliang Qu, Katrina N. Glazebrook, Yu Liu, Shuai Leng & Cynthia H. McCollough

  2. Department of Orthopedics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Peter C. Rhee

  3. Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai, China

    Songtao Ai

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  1. Songtao Ai
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  2. Mingliang Qu
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  3. Katrina N. Glazebrook
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  4. Yu Liu
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  5. Peter C. Rhee
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  6. Shuai Leng
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  7. Cynthia H. McCollough
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Correspondence to Cynthia H. McCollough.

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Ai, S., Qu, M., Glazebrook, K.N. et al. Use of dual-energy CT and virtual non-calcium techniques to evaluate post-traumatic bone bruises in knees in the subacute setting. Skeletal Radiol 43, 1289–1295 (2014). https://doi.org/10.1007/s00256-014-1913-7

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  • DOI: https://doi.org/10.1007/s00256-014-1913-7

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