定量CT对股骨头松质骨骨密度的测量  

Measurement of cancellous bone mineral density of femoral head by quantitative CT

作　　者：李现龙 许乐洋[1] 范永前[1] LI Xianlong;XU Yueyang;FAN Yongqian(Department of Orthopaedics,Huadong Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院骨科

出　　处：《中国骨质疏松杂志》2019年第7期936-941,共6页Chinese Journal of Osteoporosis

基　　金：上海市科学技术委员会科研计划项目(15411951500);上海市卫生计生系统重要薄弱学科-老年医学项目(2015ZB00)

摘　　要：目的探讨利用定量CT(quantitative computed tomography,QCT)中"3D Spine Exam Analysis"软件分析模块测量股骨头松质骨的骨密度的可重复性,以及患者双侧股骨头松质骨骨密度的差异性。方法回顾性研究330名(女性239人,男性91人)受试者的股骨头松质骨骨密度,对其中因各种原因仅可获得一侧髋关节图像的受试者149人进行可重复性研究;对其余的受试者181人进行双侧股骨头松质骨骨密度的差异性研究。利用QCT Pro软件中"3D Spine Exam Analysis"软件分析模块将股骨头划分为上、中、下3个层面:靠近股骨颈上部皮质、经股骨颈中心、靠近股骨颈下部皮质,并对各个层面进行测量。结果2名不同操作者测量同一股骨头的相同层面松质骨骨密度值的差异无统计学意义(P上=0.148> 0.05,P中=0.05,P下=0.097>0.05)。同一患者双侧股骨头相对应层面的松质骨骨密度之间具有良好相关性。在上层,两侧股骨头的松质骨骨密度之间的差异无统计学意义(P上=0.445>0.05);而在中层与下层,两侧股骨头的松质骨骨密度之间的差异有统计学意义(P中=0.000<0.05,P下=0.000<0.05)。结论利用QCT中"3D Spine Exam Analysis"软件分析模块进行股骨头松质骨的骨密度测量具有较好的可重复性。患者双侧股骨头不同层面松质骨的骨密度具有良好的相关性,并且左侧股骨头的中层与下层的松质骨骨密度显著大于右侧。Objective To evaluate the reproducibility of measuring cancellous bone mineral density of femoral head and the differences in cancellous bone mineral density of bilateral femoral heads in patients using"3D Spine Exam Analysis"module in quantitative computed tomography( QCT). Methods 330 subjects( 239 females and 91 males) were selected for this retrospective study. The reproducibility test was performed in 149 subjects who only had QCT of one hip. The bilateral differential evaluation was performed in the other 181 subjects. The QCT data of hip were transferred to the QCT analysis work station. Using the "3D Spine Exam Analysis"module of QCT Pro software,the femoral head was divided into the upper,middle and lower layers: 3 planes parallel to the long axis of the femoral neck,which were located close to the upper part of the femoral neck,the center of the femoral neck,and the lower part of the femoral neck. And the volumetric bone mineral density of the 3 layers was measured by two experienced operators. Results There was no statistical difference in the cancellous bone mineral density at the different layers of the same femoral head measured by two different operators( Pupper = 0. 148>0. 05,Pmiddle = 0. 05,Plower = 0. 097>0. 05). There was a good correlation between the cancellous bone density at the same layer of bilateral femoral heads in the same patient. In the upper layer,there was no statistical difference between cancellous bone density of the femoral heads on both sides( Pupper = 0. 445 > 0. 05). In the middle and lower layers,there was a statistically significant difference between cancellous bone density at both femoral heads( Pmiddle = 0. 000<0. 05,Plower = 0. 000<0. 05). Conclusion Cancellous bone density of femoral head measured by " 3D Spine Exam Analysis" module in QCT showed good reproducibility. The cancellous bone mineral density of the same layer of bilateral femoral heads was correlated,and the cancellous bone mineral density of the middle and lower layers of the left femoral head was signifi

关 键 词：骨密度 定量CT 股骨头 松质骨 

分 类 号：R683.42[医药卫生—骨科学]