• Xin Li, Jianguo Wang, Ping Li, Shunda Zhuang, Shun Jiang, and Wenqian Liu.
• Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
• Medicine (Baltimore). 2024 Jan 5; 103 (1): e36708e36708.

BackgroundThis systematic literature review and meta-analysis aimed to assess the accuracy, sensitivity, and specificity of dual-energy computed tomography (DECT) of the sacroiliac joint. Bone marrow edema (BME) of the sacroiliac joint is an early manifestation of some diseases, such as ankylosing spondylitis, and is usually examined by nuclear magnetic resonance imaging (MRI); however, MRI can be intolerable for some patients; hence, numerous studies have analyzed DECT examinations.MethodsWe searched PUBMED, CNKI, and EMBASE in 2023 for articles containing the following terms (DECT) or (DE-CT) or (dual-energy CT) or "dual-energy CT" or (dual-energy computed tomography) and ((sacroiliac joint) or (ankylosing spondylitis) or (sacroiliac arthritis) or (sacroiliitis)). An initial search identified 444 articles, of which 7 met the criteria. Data were extracted to calculate the sensitivity, specificity, and diagnostic odds for analysis using R software.ResultsOut of 291 patients and 577 sacroiliac joints, 429 (74.35%) exhibited BME. All studies used magnetic resonance as the control group. The overall sensitivity and specificity of DECT were 79%, and 92%, respectively, with positive prediction rate of 92.55% and negative prediction rate of 83.73%.ConclusionDECT appears to be a promising diagnostic tool for detecting BME in the sacroiliac joint and can be used as an alternative examination method for patients in whom MRI is contraindicated.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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