定量CT测量胸椎骨密度诊断骨质疏松的初步研究  

A preliminary study on the diagnosis of osteoporosis based on quantitative CT measurement of thoracic spine bone mineral density

作　　者：滕剑 彭飞[1] 张羽[1] 刘许慧 傅迎霞 张宗军 吴飞云[2] TENG Jian;PENG Fei;ZHANG Yu;LIU Xuhui;FU Yingxia;ZHANG Zongjun;WU Feiyun(Department of Radiology,the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 21002S,China;Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属中西医结合医院放射科,江苏南京210028 [2]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《实用放射学杂志》2022年第4期621-624,共4页Journal of Practical Radiology

基　　金：江苏省老年健康科研项目(LK2021013).

摘　　要：目的探讨胸椎(T7~T9)与腰椎(L1~L3)椎体骨密度(BMD)的差异与相关性,以及T7~T9BMD诊断骨质疏松的最佳临界值.方法测量同时行胸腹部CT检查的278例检查者的T7~T9和L1~L3椎体BMD数据,分析两者间的差异与相关性;并以L1+L2为诊断标准,通过受试者工作特征(ROC)曲线分析分别依据T7+T8、T7+T9、T8+T9诊断骨质疏松的最佳临界值.结果不论男女,T7~T9和L1~L3椎体BMD均与年龄呈负相关.在T7~L3方向,6个椎体BMD呈逐渐减低趋势(P<0.05),且BMD均存在显著相关性(r=0.78~0.99,P<0.01).ROC曲线分析显示依据T7+T8、T7+T9、T8+T9诊断骨质疏松的最佳临界值分别为107mg/cm^(3)、106mg/cm^(3)、100mg/cm^(3),对应的敏感度分别为87.5%、86.5%、85.4%,特异度分别为87.9%、87.9%、91.8%.结论T7~T9BMD均高于L1~L3,存在显著的正相关性.胸椎BMD诊断骨质疏松的参考值高于腰椎的诊断标准值,定量CT测量胸椎BMD诊断骨质疏松应依据胸椎的诊断阈值为参考.Objective To investigate the differences and correlation between the bone mineral densities(BMD)of thoracic vertebrae(T7-T9)and lumbar vertebrae(L1-L3),and the optimal cutoff T7-T9 BMD values for the diagnosis of osteoporosis.Methods The BMD of the T7-T9 and L1-L3 vertebral bodies of 278 subjects who underwent simultaneous thoracic and abdominal CT examinations were measured,and their differences and correlations were analyzed.The receiver operating characteristic(ROC)curve analysis was used to determine the optimal cutoff BMD values for the diagnosis of osteoporosis based on T7+T8,T7+T9,a nd T8+T9,with L1+L2 as the diagnostic standard.Results Regardless of sex,the BMD of T7-T9 and L1-L3 were negatively correlated with age.The BMD of the 6 vertebral bodies from T7 to L3 exhibited a gradual decrease(P<0.05),with a significant correlation(r=0.78-0.99,P<0.01).The ROC curve analysis revealed that the optimal cutoff BMD values for the diagnosis of osteoporosis based on T7+T8,T7+T9,and T8+T9 were 107 mg/cm^(3),106 mg/cm^(3),and 100 mg/cm^(3),respectively,with corresponding sensitivities and specificities of 87.5%and 87.9%,86.5%and 87.9%,85.4%and 91.8%,respectively.Conclusion The BMD of T7-T9 is higher than that of L1-L3,with a significant positive correlation.The reference value of thoracic spine BMD for the diagnosis of osteoporosis is higher than that of lumbar spine BMD.Quantitative CT measurement of thoracic spine BMD for the diagnosis of osteoporosis should be based on the diagnostic cutoff value of thoracic spine BMD.

关 键 词：骨质疏松 骨密度 腰椎 胸椎 计算机体层成像 

分 类 号：R681[医药卫生—骨科学] R681.5[医药卫生—外科学] R814.42[医药卫生—临床医学]