绝经妇女腰椎及髋关节定量CT骨密度测量诊断骨质疏松的初步研究  

The comparison of spine and hip QCT BMD measurements in diagnosis of osteoporosis in the postmenopausal women

作　　者：邓德茂[1] 何欣[1] 李家言[1] 张建[1] 黄增超[1] 袁文昭[1] 孙伟杰[2] 王玲[2] 程晓光[2] 

机构地区：[1]广西中医药大学第一附属医院放射科,南宁530023 [2]北京积水潭医院放射科,北京100035

出　　处：《中国骨质疏松杂志》2012年第11期1008-1010,共3页Chinese Journal of Osteoporosis

摘　　要：目的比较绝经后妇女L2～L4椎体及髋关节两个部位的定量CT骨密度(BMD)测量诊断骨质疏松的效能。方法 175例绝经妇女,年龄48～96岁,平均年龄为69±9岁。同时QCT测量L2～L4椎体的平均体积骨密度及髋关节类DXA的面积骨密度,右股骨颈和全髋二个感兴趣区(ROI)。采用国际临床骨密度学会(ISCD)QCT骨质疏松诊断标准(<80 mg/cm3)和WHO髋关节DXA骨密度诊断标准即股骨颈或全髋感兴趣区的T值(-2.5 SD)进行骨质疏松诊断。比较二者诊断骨质疏松的效能。结果 175绝经后妇女中,QCT骨密度测量腰椎部位骨密度值骨质疏松的检出率是44%(77/175)。如果采用髋部检查股骨颈部位为11%(19/175),全髋部位为14%(24/175),或二者任一部位为18%(31/175)。如果只做腰椎,不做髋关节,有7人漏诊,而如果只做髋关节,不做腰椎会漏诊44人。结论采用QCT骨密度测量,绝经妇女腰椎检查骨质疏松检出率为44%,而髋部检查检出率为18%。采用QCT骨密度测量,测量腰椎一个部位就可以诊断骨质疏松。Objective To compare the efficacy of spinal and hip QCT BMD measurement in the diagnosis of osteoporosis of postmenopausal women. Methods 175 menopausal women aged 48 to 96 years old （69 ±9 years） were recruited in this study. The average volumetric bone density of L2 - 4 and DXA like area bone mineral density of the hip were measured by QCT. According to the international society for clinical densitometry （ISCD） QCT diagnosis criteria of osteoporosis （ 〈 80 mg/cm3 ） and WHO hip DXA BMD criteria, i. e. , the score of femoral neck or total hip ROI was below 2.5 SD, then the detecting rate of osteoporosis in the spine and hip was calculated and their performance in diagnosis of osteoporosis was analyzed by statics. Results The detecting rate of osteoporosis was 44% （77/175） in the lumbar spine by QCT in 175 postmenopausal women, and the number was 11% （19/175） for femoral neck, 14% （24/175） for total hip ROI, and 18% （31/175） for either of them, respectively. 7 cases would be missed only by the lumbar spine, but 44 cases would be missed only by the hip. Conclusions The detect rate of osteoporosis was 44% in the lumbar spine by QCT, and the rate was 18% by hip examination in the postmenopausal women. Measurement of BMD in the spine by QCT will be sufficient to diagnose osteoporosis.

关 键 词：骨质疏松 骨密度测量 定量 计算机体层摄影 

分 类 号：R815[医药卫生—放射医学] R68[医药卫生—临床医学]