L3椎体平面骨骼肌和脂肪化程度与老年肌少症关系的CT定量研究  

Quantitative CT study on the relationship between skeletal muscle and fatty degree in L3 vertebral plane and sarcopenia in the elderly

作　　者：左玉强 柳青[2] 高志红[1] 王正 关兴 殷玉玲 杨旭 冯平勇[2] ZUO Yuqiang;LIU Qing;GAO Zhihong;WANG Zheng;GUAN Xing;YIN Yuling;YANG Xu;FENG Pingyong(Department of Health Examination,the 2nd Hospital of Hebei Medical University,Shijiazhuang 050000,China;不详)

机构地区：[1]河北医科大学第二医院体检中心,石家庄050000 [2]河北医科大学第二医院放射科,石家庄050000 [3]河北医科大学第二医院呼吸科,石家庄050000 [4]石家庄市人民医院体检中心,石家庄050000

出　　处：《实用医学杂志》2021年第11期1470-1475,共6页The Journal of Practical Medicine

基　　金：河北省2021年度医学科学研究课题(编号:20211544)。

摘　　要：目的采用CT定量测量方法探讨L3椎体平面骨骼肌和脂肪化程度与老年肌少症的关系。方法回顾性分析2020年1月至2020年8月期间于河北医科大学第二医院体检中心行上腹部CT平扫的200例老年体检者的CT影像及临床资料。采用GE ADW4.6工作站中“X Section”软件对L3椎体平面总骨骼肌、肌间隙脂肪进行定量测量并记录其面积、平均CT值,并将L3椎体平面骨骼肌面积(L3 skeletal muscle area,L3 SMA)与体表面积(body surface area,BSA)、L3椎体横截面积及身高进行不同方式标准化。统计分析不同方式标准化结果诊断老年肌少症的效能。结果200例老年体检者中共16例(8.00%)诊断为肌少症,其中男6例(3.00%),女10例(5.00%)。两组体检者性别、年龄间差异无统计学意义(均P>0.05);肌少症组BMI低于非肌少症组,差异有统计学意义(P<0.05)。非肌少症组体检者L3 SMA、L3椎体平面总骨骼肌平均密度和肌间隙脂肪面积均高于肌少症组,但仅L3 SMA在组间差异有统计学意义(P<0.05)。ROC曲线分析结果显示L3 SMA经BSA进行标准化(L3 SMB)诊断老年肌少症效能最高,曲线下面积为0.802、敏感度73.9%,特异度75.0%,其诊断男、女老年肌少症的最佳临界值分别为435.15、365.08 cm^(2)/m^(2)。结论CT定量测量骨骼肌可信度较高,L3 SMB诊断老年肌少症的效能较高。Objective Quantitative CT was used to investigate the relationship between skeletal muscle and fatty degree of L3 vertebral plane and sarcopenia in the elderly.Methods The CT images and clinical data of 200 patients who underwent abdominal CT scan in the 2nd Hospital of Hebei Medical University from January 2020 to August 2020 were retrospectively analyzed.According to the diagnostic criteria of Asian sarcopenia working group,they were divided into sarcopenia group(n=16)and non⁃sarcopenia group(n=184).“X Section”software of GE ADW4.6 workstation was used to quantitatively measure the skeletal muscle and intermuscular fat of L3 verte⁃bral plane,and the area and average CT value were recorded.The skeletal muscle area of L3 vertebral plane(L3 SMA),body surface area(BSA),L3 vertebral area and height were standardized in different ways.Chi⁃square test or Fisher′s exact test was used to compare the differences between enumeration data in the two groups.Independent sample t test or nonparametric rank sum test(Mann⁃Whitney U test)was used to compare the differences between the measurement data in two groups.Receiver operating characteristic(ROC)curve was used to analyze the skeletal muscle area of L3 vertebral plane and the effectiveness of different standardized results in the diagnosis of sarcope⁃nia.Results There were 16 cases(8.00%)diagnosed as sarcopenia,including 6 males(3.00%)and 10 females(5.00%).There was no significant difference in gender,age between the two groups(P>0.05).BMI in sarcope⁃nia group was lower than that in non⁃sarcopenia group,The difference was statistically significant(P<0.05).The L3 SMA,average density of total skeletal muscle in L3 vertebral plane(L3 SMD)and muscle space area of the non⁃sarcopenia group were higher than those of the sarcopenia group,but only L3 SMA had significant difference between the two groups(P<0.05).ROC curve analysis showed that L3 SMA was standardized by the BSA(L3 SMB)had the highest diagnostic efficiency for sarcopenia,with area under the curve

关 键 词：肌少症 老年 L3骨骼肌指数 CT 

分 类 号：R445.3[医药卫生—影像医学与核医学]