胸部低剂量CT结合定量CT测量下段胸椎骨密度诊断骨质疏松  

Low-dose CT combined with quantitative CT measurement of bone mineral density of lower thoracic vertebri for diagnosing osteoporosis

作　　者：姜文蓁 张宇威 崔效楠 武雅琳 韩丽珠 叶兆祥 JIANG Wenzhen;ZHANG Yuwei;CUI Xiaonan;WU Yalin;HAN Lizhu;YE Zhaoxiang(Department of Radiology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin's Clinical Research Center for Cancer,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院放射科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室天津市恶性肿瘤临床医学研究中心,天津300060

出　　处：《中国医学影像技术》2022年第5期734-738,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察胸部低剂量CT(LDCT)结合定量CT(QCT)测量下段胸椎骨密度(BMD)诊断骨质疏松的效能。方法前瞻性收集接受胸部LDCT肺癌筛查联合QCT BMD检查的体检者,分别测量T9~L2各相邻2个椎体BMD的均值(BMD_(T9/T10)~BMD_(L1/L2)),分析BMD_(T9/T10)~BMD_(T12/L1)与BMD_(L1/L2)之间的相关性及其差异。以BMD_(L1/L2)结果为金标准,采用受试者工作特征曲线(ROC)评价BMD_(T9/T10)~BMD_(T12/L1)诊断骨质疏松的效能,分析其与BMD_(L1/L2)诊断结果的一致性。结果共纳入630例,骨质疏松患病率为28.25%(178/630)。胸腰椎BMD_(T9/T10)~BMD_(T12/L1)与BMD_(L1/L2)均呈正相关(r=0.927~0.984,P均<0.001),且自上而下相关系数逐渐增高,而BMD_(T9/T10)~BMD_(T12/L1)与BMD_(L1/L2)的差异逐渐减低(P均<0.001)。胸腰椎BMD_(T9/T10)~BMD_(T12/L1)诊断骨质疏松的曲线下面积(AUC)自上而下逐渐增大,除BMD_(T9/T10)与BMD_(T10/T11)外(Z=1.78,P=0.08),其余各BMD的AUC差异均有统计学意义(P均<0.05),尤以BMD_(T12/L1)诊断骨质疏松效能最高(AUC=0.990);BMD_(T9/T10)~BMD_(T12/L1)与BMD_(L1/L2)诊断骨质疏松的一致性中等至良好(Kappa为0.646~0.820,P均<0.001)。结论胸部LDCT结合QCT测量下段胸椎BMD诊断骨质疏松效能良好。Objective To observe the diagnostic performances of lower thoracic vertebrae bone mineral density(BMD)based on chest low-dose CT(LDCT)and quantitative CT(QCT)for diagnosing osteoporosis.Methods People who would undergo chest LDCT lung cancer screening and asynchronous QCT BMD examination were prospectively selected.The mean BMD of 2 consecutive vertebrae from T9—L2(BMD_(T9/T10)—BMD_(L1/L2))were measured.The correlations and differences of BMD_(T9/T10)—BMD_(T12/L1)and BMD_(L1/L2)were analyzed.Taken the diagnostic results of BMD_(L1/L2)as the gold standards,receiver operating characteristic(ROC)curve was used to analyze the efficacy of BMD_(T9/T10)—BMD_(T12/L1)for diagnosing osteoporosis,and their consistencies with results of BMD_(L1/L2)were analyzed.Results Totally 630 subjects were enrolled.The prevalence of osteoporosis was 28.25%(178/630).Thoracolumbar BMD_(T9/T10)—BMD_(T12/L1)were positively correlated with BMD_(L1/L2)(r=0.927-0.984,all P<0.001),and from top to bottom,the correlation coefficients gradually increased,while the differences of BMD_(T9/T10)—BMD_(T12/L1)and BMD_(L1/L2)gradually decreased(all P<0.001).The area under the curve(AUC)of thoracolumbar BMD_(T9/T10)—BMD_(T12/L1)for diagnosis of osteoporosis gradually increased from top to bottom,and there were significant differences between them(all P<0.05)except for BMD_(T9/T10)and BMD_(T10/T11)(Z=1.78,P=0.08).Among them,BMD_(T12/L1)had the highest efficacy for diagnosing osteoporosis(AUC=0.990).The diagnostic consistencies of BMD_(T9/T10)—BMD_(T12/L1)and BMD_(L1/L2)for diagnosing osteoporosis were moderate to good(Kappa=0.646-0.820,all P<0.001).Conclusion Chest LDCT combined with QCT measurement of BMD of lower thoracic vertebrae had good diagnostic efficacy of osteoporosis.

关 键 词：骨质疏松 胸椎 骨密度 体层摄影术 X线计算机 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学]