The diagnostic utility of CT attenuation values in detecting calcification within costal cartilage

Baohong Wang , Yiqing Dai , Lufan Chang , Yiyuan Li , Datao Li , Feng Xu , Zhicheng Xu , Qun Zhang , Hao Liu , Xia Chen , Ruhong Zhang
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Abstract

Background

To establish and verify diagnostic criteria for the identification of costal cartilage calcification based on computed tomography (CT) attenuation value.

Methods

360 chest CT slices of 120 patients were reviewed and annotated retrospectively and receiver operating characteristic curve was used to evaluate the diagnostic ability of CT attenuation value. Another 20 slices containing calcification were randomly selected and annotated by 4 doctors for further validation. hematoxylin and eosin and collagen type X (COLX) staining was performed on the residual costal cartilage.

Results

In total 355,129 voxels were detected and 187.5 was confirmed as the optimal CT attenuation value threshold, with a sensitivity of 98.6% and a specificity of 99.7%, for costal cartilage calcification diagnosis. Threshold-based identification of calcification demonstrated a similarity of nearly 80% with specialists’ assessments, and exhibited advantages in the identification of subtle calcifications in the further validation. We also observed that CT attenuation values among males demonstrated a centralized distribution, whereas those among females exhibited a bimodal distribution. Threshold-based identified calcification showed a positivity of COLX.

Conclusions

CT attenuation value could validly and reliably diagnose calcification within costal cartilage. Further investigations involving larger cohorts of patients are required to elucidate the risk factors and underlying mechanisms of costal cartilage calcification.
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CT 衰减值在检测肋软骨钙化方面的诊断效用。
背景:建立并验证基于计算机断层扫描(CT)衰减值的肋软骨钙化诊断标准:方法:对 120 例患者的 360 张胸部 CT 切片进行回顾性审查和标注,并使用接收器操作特征曲线评估 CT 衰减值的诊断能力。对残留的肋软骨进行苏木精、伊红和 X 型胶原(COLX)染色:结果:共检测出 355 129 个体素,187.5 被确认为诊断肋软骨钙化的最佳 CT 衰减值阈值,灵敏度为 98.6%,特异度为 99.7%。基于阈值的钙化鉴定与专家评估的相似度接近 80%,并在进一步验证中显示出鉴定细微钙化的优势。我们还观察到,男性的 CT 衰减值呈集中分布,而女性则呈双峰分布。基于阈值识别的钙化显示出 COLX 的阳性:CT衰减值可有效、可靠地诊断肋软骨内的钙化。要阐明肋软骨钙化的风险因素和潜在机制,还需要对更多患者进行进一步研究。
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来源期刊
CiteScore
3.10
自引率
11.10%
发文量
578
审稿时长
3.5 months
期刊介绍: JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.
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