ArticleQuantitative imaging in medicine and surgery2025
Diagnostic accuracy of virtual non-calcium dual-energy computed tomography in the detection of acute occult ankle and calcaneus fractures.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- What you don't see matters: dual-energy CT in emergency radiology.Japanese journal of radiology · 2026Review
- Enhanced subfibular ossicle diagnosis: CT-MRI integration of morphology and ligament attachments.Insights into imaging · 2025Article
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5 authors.
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Abstract
Background: Individuals with acute occult ankle and calcaneus fractures usually need to undergo additional magnetic resonance imaging (MRI) to confirm the diagnosis. In some cases, dual-energy computed tomography (DECT) is more convenient and efficient than MRI. This study aimed to assess the diagnostic accuracy of virtual non-calcium (VNCa) DECT in detecting acute occult ankle and calcaneus fractures. Methods: From January 2022 to February 2024, adult patients presenting with ankle and calcaneal trauma but showing negative or inconclusive results on radiographs were enrolled in this prospective study. Ankle and calcaneus imaging was performed using DECT and MRI. Bone marrow edema (BME) was assessed by consolidating the MRI scan readings. Concurrently, the identification of fractures was conducted by consolidating the DECT and MRI scan readings. The computed tomography (CT) numbers corresponding to BME, fractures, and normal bone marrow in the VNCa images were compared. To determine the optimal cut-off CT number for ascertaining the presence or absence of BME and fractures, a receiver operating characteristic (ROC) curve analysis was conducted. Results: The cohort comprised 180 participants (average age: 43±14 years; 92 male). In terms of BME detection, DECT had a sensitivity of 92% (96/104) and a specificity of 88% (67/76). In terms of fracture detection, DECT and MRI had a sensitivity of 95% (110/116) and 93% (108/116), respectively, and a specificity of 91% (58/64) and 92% (59/64), respectively. The optimal cut-off CT number for differentiating fractures from normal bone was 26.7 Hounsfield units (HU), which had a sensitivity of 97.3% (144/148) and a specificity of 100% (572/572). Conclusions: Compared with MRI, VNCa imaging was found to be exceptionally accurate in diagnosing acute occult ankle and calcaneus fractures.
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