健康老年妇女近段股骨骨密度和结构的定量CT研究  

The study of bone mineral density and structure in proximal femur by quantitative CT in elderly Chinese women

作　　者：程晓光[1] Li Jing 刘霞[1] 王予生[1] 李谨[1] 屈辉[1] H Genant T Lang 

机构地区：[1]北京积水潭医院放射科,100035 [2]Department of Radiology,University of California San Francisco, CA 94143-0628, USA

出　　处：《中华放射学杂志》2009年第2期126-130,共5页Chinese Journal of Radiology

基　　金：礼来妇女健康中心（Lilly center for women’s Health）国际研究基金资助项目志谢BMD体模由美国Image Analysis公司资助

摘　　要：目的采用定量CT（QCT）和双能X线吸收测量（DXA）仪对健康老年妇女近段股骨骨密度（BMD）和骨结构进行研究，并对2种测量方法的结果进行比较。方法对66名65岁以上健康妇女左侧髋关节进行DXA测量，计算出股骨颈和粗隆区BMD；对其双侧近段股骨进行QCT测量，计算出股骨颈、粗隆区和整体股骨ROI的皮质骨、松质骨和总体骨的BMD和体积；并将QCT三维图像模拟DXA的平面投影计算出模拟DXA股骨颈BMD和模拟DXA股骨粗隆区BMD。对所获数据进行配对t检验或非参数秩和检验，并用Pearson法分析DXA和QCT相对应ROI的相关性。结果用QCT可以对股骨近段不同ROI（股骨颈、粗隆区和整体股骨区）及不同骨成分（皮质骨、松质骨和总体骨）的BMD及体积等参数进行精确的定量分析。除右侧股骨颈皮质骨BMD[（0．52±0．04）g／cm^3]、股骨粗隆区皮质骨BMD[（0．49±0．03）g／cm^3]、股骨粗隆区综合骨BMD[（0．22±0．04）g／cm^3]大于左侧相应参数[分别为[（0．51±0．04）、（0．48±0．03）、（0．21±0．04）g／cm^3]，差异均有统计学意义（P值均〈0．05），但差别均〈3．3％；而模拟DXA股骨颈BMD、模拟DXA股骨粗隆区BMD、股骨颈皮质骨体积、股骨颈松质骨BMD、股骨颈松质骨体积、股骨颈综合骨BMD、股骨颈综合骨体积、股骨粗隆区皮质骨体积、股骨粗隆区松质骨BMD、股骨粗隆区松质骨体积、股骨粗隆区综合骨体积左侧参数分别为（0．52±0．10）g／cm^2、（0．78±0．13）g／cm^2、5．80cm^3、（0．06±0．03）g／cm^3、（5．19±1．40）cm^3、（0．25±0．04）g／cm^3、15．66cm^3、（21．74±3．43）cm^3、（0．08±0．03）g／cm^3、（34．27±6．09）cm^3、（76．12±11．11）cm^3，右侧分别为（0．52±0．10）g／cm^2、（0．78±0．13）g／cm^2、6．01cm^3、（0．06±0．02）g／cm^3、（5．17±1．27）cm^3、（0．25±0．04）g／cm^3、15．6Objective To evaluate the bone mineral density （BMD） and structure of proximal femur in elderly Chinese women by quantatitive computed tomography （QCT） and dual energy X-ray absorptiometry （DXA）, and to further compare the results of these two methods. Methods Sixty-six healthy Chinese women over 65 years old participated in this study. The left hips of all subjects were measured with DXA and the BMD of femoral neck and trochanteric region were calculated. With QCT, the BMD and tissue volume of cortical, trabecular and integral bone were calculated for femoral neck, trochanteric and total femur regions in both hips. Appropriate statistical analyses were performed with SPSS 11.5. Results The BMD and structural parameters in different regions and different compartments of the proximal femur could be precisely assessed with QCT technique. The BMD of cortical bone in femoral neck [ （ 0. 52 ± 0. 04 ） g/cm^3 ], BMD of cortical bone in trochanteric region [ （ 0. 49 ± 0.03 ） g/cm^3 ] and BMD of integral bone in trochanteric region[ （0. 22 ±0. 04） g/cm^3 ] were greater in the right than those in the left [ （0. 51±0. 04）, （0. 48 ±0.03）, （0. 21 ±0.04） g/cm^3 ]. The difference had statistical signification （P 〈0. 05）. However, the difference was less than 3.3%. In the left the parameters of analogue DXA BMD of femoral neck, analogue DXA BMD of troehanterie region, cortical bone volume of femoral neck, BMD of trabecular bone in femoral neck, trabecular bone volume of femoral neck, BMD of integral bone in femoral neck, integral bone volume of femoral neck, cortical bone volume of trochanteric region, BMD of trabeeular bone in trochanterie region, trabecular bone volume of troehanteric region and integral bone volume of troehanteric region were （ 0. 52 ± 0. 10 ） g/cm^2, （ 0. 78 ± 0. 13 ） g/cm^2, 5.80 cm^3, （ 0. 06 ± 0. 03 ） g/cm^3, （5.19±1.40）cm^3,（0.25 ±0.04）g/cm^3,15.66 cm^3, （21.74 ±3.43）cm^3,（0.08 ± 0. 03 ） g/cm^3, （ 34. 27 ± 6. 09 ） cm^

关 键 词：骨密度 体层摄影术 X线计算机 光密度测定法 X线 

分 类 号：R686[医药卫生—骨科学]