Traumatic bone marrow lesions in dual-energy computed tomography

Abstract

Traumatic bone marrow lesions (TBMLs) are considered to represent a range of concealed bone injuries, including haemorrhage, infarction, and localised oedema caused by trabecular microfracture occurring in the cancellous bone. If TBMLs are not managed timeously, they potentially cause a series of complications that can lead to irreversible morbidity and prolonged recovery time. This article reviews interesting image findings of bone marrow lesions in dual-energy computed tomography (DECT). In addition to combining the benefits of traditional CT imaging, DECT also reveals and identifies various structures using diverse attenuation characteristics of different radiographic spectra. Therefore, DECT has the capacity to detect TBMLs, which have traditionally been diagnosed using MRI. Through evaluating DECT virtual non-calcium maps, the detection of TBMLs is rendered easier and more efficient in some acute accidents.

Dual-energy CT virtual non-calcium: an accurate method for detection of knee osteoarthritis-related edema-like marrow signal intensity

“…We have previously reported that DECT VNCa has good diagnostic performance in the detection of carpal joint contusion and is a potential alternative scanning method for patients with contraindications to MRI [ 37 ]. Currently, most investigators use VNCa images to detect trauma-associated ELMSI, and qualitative and quantitative analysis of DECT VNCa images has had high diagnostic performance for these lesions [ 38 – 40 ].…”

Accuracy of dual-energy computed tomography for bone marrow edema in the sacroiliac joint: A systematic review and meta-analysis

“…This systematic review and meta-analysis evaluated the overall diagnostic performance of VNCa and mass decomposition imaging techniques in DECT. [2,3,5,11,12] 2. Methods Systematic review: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in March 2023.…”

Bioanalytical evaluation of wound depth and musculoskeletal injuries: Synergizing focused assessment with sonography for trauma with computed tomography/magnetic resonance imaging in orthopaedic trauma care

“…Speed and high‐resolution imaging capabilities render it an indispensable instrument in acute trauma contexts. In addition to providing enhanced soft tissue contrast, which is critical for assessing ligament, tendon and muscle injuries, MRI further refines the delineation of lesion depth 14–16 …”

“…In addition to providing enhanced soft tissue contrast, which is critical for assessing ligament, tendon and muscle injuries, MRI further refines the delineation of lesion depth. [14][15][16] When combined with CT and MRI, FAST improves the accuracy of diagnoses and directs the development of effective treatment plans in orthopaedic trauma care. It facilitates more comprehensive comprehension of the injury, which is essential when determining whether surgical intervention or conservative management is warranted.…”

“…12,13 In contrast, CT scans yield intricate visualizations of soft tissue and bone, facilitating the comprehensive evaluation of skeletal irregularities such as dislocations of joints, fractures and other injuries. 14 Speed and highresolution imaging capabilities render it an indispensable instrument in acute trauma contexts. In addition to providing enhanced soft tissue contrast, which is critical for assessing ligament, tendon and muscle injuries, MRI further refines the delineation of lesion depth.…”