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Sensitivity of DECT in ACL tears. A prospective study with arthroscopy as reference method.

Ann-Sofi Björkman1,2, Håkan Gauffin3,4, Anders Persson1,2

  • 1Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.

Acta Radiologica Open
|March 17, 2022
PubMed
Summary

Dual-energy CT (DECT) shows promise for diagnosing anterior cruciate ligament (ACL) tears, with comparable accuracy to MRI. While sensitivity is slightly lower than MRI, DECT offers a high positive predictive value for ACL injury detection.

Keywords:
ACLKneedual energy CTligament teartrauma

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Area of Science:

  • Radiology
  • Orthopedics
  • Medical Imaging

Background:

  • Computed tomography (CT) is standard for knee trauma evaluation.
  • Diagnosing anterior cruciate ligament (ACL) injuries is crucial following knee trauma.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of dual-energy CT (DECT) for detecting ACL tears.
  • To assess DECT's effectiveness in acute and subacute knee injuries.

Main Methods:

  • Patients with suspected ACL tears underwent both DECT and MRI scans.
  • Radiologists independently interpreted blinded DECT images.
  • Arthroscopy served as the gold standard for ACL tear confirmation.

Main Results:

  • DECT demonstrated a sensitivity of 76.3% and a positive predictive value (PPV) of 93.5%.
  • MRI showed a sensitivity of 86.8% and a PPV of 91.7%.
  • No statistically significant difference in diagnostic performance was found between DECT and MRI (p = .223).

Conclusions:

  • DECT exhibits a high PPV for detecting ACL ruptures.
  • While DECT's sensitivity for ACL tears is lower than MRI, the difference is not statistically significant.
  • DECT is a viable imaging option for evaluating ACL injuries.