定量CT评价股骨近段骨皮质厚度及骨密度  

Quantitative computed tomography on assessment of proximal femoral cortical bone thickness and bone mineral density

作　　者：王玲[1] 张勇[1] 程晓光[1] 全显跃[2] 曹宇鹏[1] 李文[1] 赵伟[1] 吴远[3] 危杰[4] 伊辰 

机构地区：[1]北京积水潭医院放射科,北京100035 [2]南方医科大学珠江医院放射科,广东广州510282 [3]重庆医科大学附属第一医院神经内科,重庆400016 [4]北京积水潭医院创伤骨科,北京100035

出　　处：《中国医学影像技术》2015年第10期1461-1465,共5页Chinese Journal of Medical Imaging Technology

基　　金：北京市卫生系统高层次卫生技术人才培养项目(2009-02-03);首都卫生发展科研专项自主创新项目(2014-2-112);首都临床特色应用研究项目(z141107002514072);南方医科大学"科研启动计划"青年科技人员培育项目(PY2014N067)

摘　　要：目的初步探讨采用定量CT(QCT)骨结构分析系统(BIT)测量股骨近段骨皮质的信度和可重复性。方法收集30例髋部低能量骨折患者,正常侧股骨用于测量,采集髋部QCT扫描数据,于QCT分析工作站上BIT自动选定垂直于股骨颈中段长轴最狭窄处横断面,将该横断面分为4个象限,即上前象限(SA),下前象限(IA),下后象限(IP),上后象限(SP),BIT自动估算各象限骨皮质厚度(C.Th),由3名测量者分别进行测量,比较测值的差异及一致性。结果 3名测量者测得的股骨颈最狭窄处横断面平均C.Th及SA、SP、IA象限C.Th和骨密度差异均无统计学意义(P均>0.05),一致性均较好,其中平均C.Th的ICC值最高,为0.883。而3名测量者测得的IP象限C.Th和骨密度差异均有统计学意义(P均<0.05)。结论 BIT能够实现获取股骨近段骨密度结果的同时获得骨结构信息,测得的股骨颈横断面上象限及前下象限C.Th及骨密度具有很好的重复性。Objective To assess the reproducibility of bone investigational toolkit（BIT）measuring the proximal femoral cortical bone.Methods Totally 30 patients with low energy hip fracture were enrolled in the study.Quantitative computed tomography（QCT）data of non-fracture hip was transferred to the QCT analysis work station for further analysis.With the BIT module of QCT PRO software,the narrowest portion of the mid-femoral neck cross-section perpendicular to the femoral neck axis being identified automatically,this slice was used to measure cortical thickness in four anatomic quadrants of the femoral neck,i.e.superoanterior（SA）quadrants,inferoanterior（IA）quadrants,inferoposterior（IP）quadrants and superoposterior（SP）quadrants.The proximal femoral cortical bones of 30 subjects were measured by 3radiologists independently to assess the differences and similarity.Results There was no significant differences of the average cortical thickness,SA,SP,IA quadrants cortical thickness and cortical bone mineral density among 3radiologists（all P〈0.05）,which inter-observer agreement were well,and the best reproducible measurement was average cortical thickness（ICC0.883）.Nevertheless,the difference of IP quadrants cortical thickness and cortical bone mineral density among 3radiologists were significantly different（both P〈0.05）.Conclusion The cortical bone structural information and bone mineral density can be measured simultaneously from BIT software,which is reproducible in the evaluation of cortical thickness and bone mineral density at superior quadrants and IA quadrants.

关 键 词：体层摄影术 X线计算机 股骨 骨结构 骨皮质 

分 类 号：R814.42[医药卫生—影像医学与核医学] R274.12[医药卫生—放射医学]