CT定量测量骨骼肌脂肪浸润程度预测老年肌少症价值分析  

The Value of CT Quantitative Measurement of Skeletal Muscle Fat Infiltration in Predicting Sarcopenia in the Elderly

作　　者：左玉强 柳青[2] 关兴 高志红[1] 殷玉玲 杨旭 冯平勇[2] ZUO Yuqiang;LIU Qing;GUAN Xing(Department of Health Examination,the 2nd Hospital of Hebei Medical University,Shijiazhuang 050000,P.R.China)

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]石家庄市人民医院体检中心,050000

出　　处：《临床放射学杂志》2021年第11期2173-2177,共5页Journal of Clinical Radiology

摘　　要：目的探讨骨骼肌脂肪浸润(MFI)程度预测老年肌少症的效能。方法回顾性分析河北医科大学第二医院体检中心284例老年体检者的临床及CT影像资料。由两名影像科主治医师分别利用GE ADW 4.6工作站中“X Section”软件定量测量L_(3)椎体平面总骨骼肌、椎后肌群及腰大肌骨骼肌面积、密度及肌间隙脂肪面积,并计算骨骼肌指数(SMI)及MFI程度;使用组内相关系数(ICC)检验两名测量者间CT定量测量一致性。利用受试者工作特征(ROC)曲线分析SMI及不同骨骼肌MFI预测老年肌少症的效能。结果284例老年体检者中有22例肌少症患者,发病率7.75%。老年肌少症组与非肌少症组性别构成比、年龄、体质指数(BMI)间差异均无统计学意义(P均>0.05)。两名测量者CT定量测量结果间一致性良好(ICC均>0.75)。SMI、L_(3)平面总骨骼肌MFI程度、椎后肌群MFI程度及椎后肌群平均密度能有效预测老年肌少症,其中椎后肌群MFI程度预测老年肌少症效能最高,曲线下面积(AUC)为0.859,敏感度90.0%,特异度74.7%,最佳截断值0.135。结论老年肌少症发病率较高,CT定量测量L_(3)椎体平面总骨骼肌及脂肪组织信度较高,椎后肌群MFI程度较SMI预测老年肌少症效能更高,椎后肌群平均密度亦为预测老年肌少症的可靠指标。Objective To explore the effectiveness of skeletal muscle fat infiltration(MFI)in predicting sarcopenia in the elderly.Methods The clinical and CT imaging data of 284 elderly patients undergoing annual physical examination were retrospectively analyzed.Two radiologist used the"X section"software in GE ADW 4.6 workstation to measure the area and density of skeletal muscle in L_(3) vertebral plane,paravertebral muscle and psoas major muscle and the fatty area of the muscle space,calculated the skeletal muscle index(SMI)and the degree of skeletal muscle fat infiltration.The interobserver agreement regarding quantitative measurements were evaluated by using intraclass correlation coeffient(ICC).Receiver operating characteristic(ROC)curve was used to analyze the efficacy of SMI and different skeletal muscle degree of MFI in predicting sarcopenia in the elderly.Results Among the 284 elderly people,22 were diagnosed with sarcopenia,and the incidence rate of sarcopenia was 7.75%.There were no significant differences in sex ratio,age and BMI between the elderly sarcopenia group and the non-sarcopenia group(all P>0.05).The interobserver agreement regarding CT quantitative features wasexcellent(ICC all>0.75).SMIdegree of L_(3) plane total skeletal muscle MFI,degree of native muscle MFI and native muscle average density can effectively predict sarcopenia in the elderly.The degree of paravertebral muscle MFI is the most effective in predicting sarcopenia in the elderly,with area under the curve(AUC)of 0.859,sensitivity of 90.0%,specificity of 74.7%,and the best cut-off value of 0.135.Conclusion The incidence rate of sarcopenia is high in the elderly.CT quantitative measurement of skeletal muscle and adipose tissue has high reliability.The degree of native muscles MFI degree is more effective than SMI in predicting sarcopenia in the elderly.The average density of native muscles is also a reliable index for predicting sarcopenia in the elderly.

关 键 词：老年 肌少症 体层摄影术 X线计算机 脂肪浸润 效能 

分 类 号：R685[医药卫生—骨科学] R816.8[医药卫生—外科学]