基于胸部CT图像成年男性骨质疏松的定量评估  

Quantitative evaluation of osteoporosis in adult men based on chest CT images

作　　者：董文惠 鄂林宁 武志峰 DONG Wenhui;E Linning;WU Zhifeng(Department of Radiology,College of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;Department of Radiology,Shanxi Bethune Hospital)

机构地区：[1]山西医科大学医学影像学院放射教研室,太原030001 [2]山西白求恩医院放射科

出　　处：《山西医科大学学报》2022年第5期640-645,共6页Journal of Shanxi Medical University

基　　金：山西省自然基金面上项目(201801D121200)。

摘　　要：目的基于胸部CT图像,探讨成年男性胸椎椎体CT值评估骨质疏松(osteoporosis,OP)的价值。方法回顾性分析山西白求恩医院2020年9-11月均接受胸部螺旋CT扫描和双能X线光吸收法(dual energy X ray absorptiometry,DXA)骨密度(bone mineral density,BMD)检查(两项检查时间差为1个月内),男性患者93例,年龄22~96岁,平均年龄(61±15)岁。利用DXA作为参考标准,通过测量胸1至胸12椎体CT值来探讨胸椎椎体CT值评估BMD的可行性并确定CT值诊断骨量减少或骨质疏松的最佳测量椎体。所有研究对象均采集一般临床资料及利用西门子医疗系统有限公司(AI-Rad Companion Chest CT,原型机ver.4.3.3)软件测量胸1椎体至胸12椎体的CT值。以DXA测量的骨密度T-score为标准,将93例患者分为骨密度正常组(n=47)、骨量减少组(n=30)和骨质疏松组(n=16),采用方差分析分别比较各组间胸1至胸12各椎体CT均值的差异;用Pearson相关分析每一椎体CT值与DXA测得的腰椎BMD的相关性;采用受试者工作特征(ROC)曲线分析胸1至胸12椎体CT值对骨质疏松的诊断价值从而确定评估骨质疏松的最佳椎体,并且通过计算约登指数来确定最佳椎体评估骨量减少或骨质疏松的临界CT值。结果骨质疏松组胸1椎体至胸12各椎体的CT均值明显低于骨密度正常组及骨量减少组(P<0.05)。胸1至胸12椎体CT值与DXA测得的T-score均呈正相关(r>0,P<0.05),且胸9椎体的相关系数最大(0.617)。胸9椎体的AUC值最大,并且胸9椎体CT值下降至153 HU以下,高度提示骨量减少或骨质疏松。结论基于患者胸部CT扫描图像测量的胸椎椎体CT值,可以对OP患者进行早期识别及定量评估,为改善患者生活质量和预后提供更多的支撑信息。Objective To explore the value of thoracic vertebral CT values in adult males in evaluating osteoporosis(OP)based on chest CT images.Methods Chest CT and dual-energy X-ray absorptiometry(DXA)bone mineral density(BMD)of 93 male patients aged 22-96 years,with an average age of 61±15 years were performed within one month in Shanxi Bethune Hospital from September to November 2020 and retrospectively analyzed.With DXA as a reference standard,the thoracic vertebral body CT was measured to evaluate the feasibility of thoracic vertebral CT value in evaluation of BMD and determine the best measurement of vertebral body in the diagnosis of osteopenia or osteoporosis.General clinical data were collected and CT values from T1 to T12 were measured using Siemens Companion Chest CT(Prototype ver4.3.3)software.All 93 patients were divided into normal BMD group(n=47),osteopenia group(n=30)and osteoporosis group(n=16)based on BMD T-score measured by DXA.The CT mean values from T1 to T12 were compared between groups by ANOVA.The correlation between CT value of each vertebral body and lumbar BMD measured by DXA was analyzed by Pearson correlation.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of CT values of thoracic vertebrae 1 to 12 and determine the best vertebral body in the evaluation of osteoporosis,and the critical CT value of the best vertebral body in the evaluation of osteopenia or osteoporosis was determined by calculating the Jorden index.Results The mean CT values from T1 to T12 in osteoporosis group were significantly lower than those in normal BMD group and osteopenia group(P<0.05).CT values from T1 to T12 were positively correlated with T-score measured by DXA(r>0,P<0.05),and the correlation coefficient of T9 vertebral body was the largest(0.617).The AUC value of thoracic 9 vertebral body was the highest,and the CT value of thoracic 9 vertebral body decreased to less than 153 HU,which highly suggests osteopenia or osteoporosis.Conclusion The CT value of thoracic vertebral body m

关 键 词：骨质疏松 椎体CT值 骨密度 双能X线光吸收法 

分 类 号：R445.3[医药卫生—影像医学与核医学]