股骨近端CT值测量对骨质疏松症的诊断价值  

Clinical study on the proximal femur CT value for diagnosis of osteoporosis

作　　者：赵君禄[1] 任庆云[1] 聂关伟[2] 刘斋[1] 韩康 赵德园 ZHAO Junlu;REN Qingyun;NIE Guanwei;LIU Zhai;HAN Kang;ZHAO Deyuan(Department of Radiology,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China;Operating Room,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院放射科,河北石家庄050031 [2]河北医科大学第一医院手术室,河北石家庄050031

出　　处：《实用放射学杂志》2023年第2期278-282,共5页Journal of Practical Radiology

基　　金：河北省财政厅基金项目(LS201804)。

摘　　要：目的探讨常规腹盆部CT扫描中股骨近端CT值测量对髋部骨质疏松症的诊断价值。方法217例因临床需要进行常规腹盆腔CT检查包括股骨近端扫描范围的患者,同时进行股骨近端定量CT(QCT)测量,应用Pearson相关性检验分析股骨头、股骨颈、股骨近端及股骨粗隆CT值与股骨颈、股骨粗隆及股骨粗隆间骨密度(BMD)值的相关性。应用单样本t检验分析左、右两侧股骨近端不同BMD组间CT值有无显著性差异,使用受试者工作特征(ROC)曲线分析股骨近端CT值测量对骨质疏松症的诊断效能。结果股骨近端CT值与髋部BMD值相关性最高(r=0.842,P<0.01)。基于QCT BMD分类中,骨量正常组左侧及右侧股骨近端平均CT值分别为310.30 HU及314.59 HU,骨量减少组平均CT值分别为250.37 HU及251.59 HU,骨质疏松组平均CT值分别为198.56 HU及195.47 HU,3组间股骨近端CT值有显著性差异(P<0.01)。ROC曲线分析显示左侧及右侧股骨近端CT值诊断骨质疏松症的曲线下面积(AUC)分别为0.940及0.931,诊断骨质疏松症的阈值分别为左侧232.4 HU、右侧241.1 HU。结论股骨近端CT值与QCT测量的髋部BMD值呈明显相关,腹盆部CT检查中股骨近端CT值对于骨质疏松症有较高的诊断效能,可作为髋部骨质疏松症筛查的一种方法。Objective To explore the diagnostic value of proximal femur CT value measurement in routine abdominal and pelvic CT scan for hip osteoporosis.Methods Totally 217 patients who underwent routine abdominal and pelvic CT examination including the scanning range of the proximal femur due to clinical needs were also subjected to quantitative CT(QCT)measurement of the proximal femur.The Pearson correlation test was used to analyze the correlation of CT values of the femoral head,femoral neck,proximal femur and femoral trochanter with bone mineral density(BMD)values of femoral neck,femoral trochanter,and intertrochanteric femur.Single sample t test was used to analyze the CT values of the left and right proximal femur with different BMD.The diagnostic performance of CT value measurement of proximal femur for osteoporosis was analyzed using receiver operating characteristic(ROC)curve.Results The CT value of the proximal femur had the highest correlation with the BMD value of the hip(r=0.842,P<0.01).The mean CT value of proximal femur in the left and right side were 310.30 HU vs 314.59 HU,250.37 HU vs 251.59 HU,and 198.56 HU vs 195.47 HU for the normal individual,osteopenia and osteoporosis groups,respectively,there were significant differences in CT value of proximal femur among three groups based on QCT BMD measurement(P<0.01).The area under the curve(AUC)to diagnosis osteoporosis in the left and right proximal femur CT values were 0.940 and 0.931,respectively.The cut off values for diagnosis of osteoporosis were 232.4 HU and 241.1 HU for in the left and right proximal femur,respectively.Conclusion The proximal femur CT value is significantly correlated with the hip BMD values measured by QCT,and the proximal femur CT value in the abdominal-pelvic CT examination has a high diagnostic efficacy for osteoporosis,which can be used as a method for hip osteoporosis screening.

关 键 词：骨质疏松症 计算机体层成像 骨密度 髋部 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学] R223.7[医药卫生—临床医学]