定量CT计算机辅助诊断系统3D半自动测量法对骨质疏松症的诊断价值  

Diagnostic Value of Three-Dimensional Semi-Automatic Measurements in Quantitative CT Computer-Aided Diagnosis System for Osteoporsis

作　　者：高睿 王新文[2] 郭雅君 郝丽娇 田弢[3] GAO Rui;WANG Xinwen;GUO Yajun;HAO Lijiao;TIAN Tao(Department of Radiology,Second Hospital of Shanxi Medical University,Taiyuan 030001,China;不详)

机构地区：[1]山西医科大学医学影像学院,山西太原030000 [2]山西医科大学第二医院影像科,山西太原030001 [3]山西医科大学第二医院院感科,山西太原030001

出　　处：《中国医学影像学杂志》2023年第4期400-404,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨计算机辅助诊断系统在诊断骨质疏松症中的应用价值。资料与方法回顾性收集2020年9月—2021年2月于山西医科大学第二医院行腰椎正位双能X线吸收法(DXA)和全腰椎CT的207例患者的影像学资料,按年龄(50~59岁、60~69岁、70~80岁)分为3组。通过无体模定量CT的3D半自动测量法和2D自定义测量法分别对3组进行骨密度测量。比较3组间骨密度的差异,分析两种方法对各年龄组骨质疏松症的诊断效能差异,分析两种方法对各年龄组的骨密度测值与DXA测值的相关性。结果50~59岁、60~69岁、70~80岁组使用3D半自动测量法[(150.29±24.23)mg/cm^(3)、(113.63±14.64)mg/cm^(3)、(108.18±37.19)mg/cm^(3)]、2D自定义测量法[(121.32±21.83)mg/cm^(3)、(102.50±11.41)mg/cm^(3)、(92.41±17.37)mg/cm^(3)]测得的骨密度比较,差异有统计学意义(F=136.84、178.65,P均<0.05)。50~59岁组和60~69岁组使用3D半自动测量法与2D自定义测量法的诊断效能相同(AUC50~59-3D=0.90,AUC50~59-2D=0.93;AUC60~69-3D=0.89,AUC60~69-2D=0.89,P均>0.05);70~80岁组使用3D半自动测量法的诊断效能优于2D自定义测量法(AUC70~80-3D=0.93,AUC70~80-2D=0.89,P<0.05)。3D半自动测量法和2D自定义测量法在不同年龄组的骨密度测量结果均与DXA测值呈正相关(r50~59-3D=0.89、r60~69-3D=0.86、r70~80-3D=0.85,r50~59-2D=0.87、r60~69-2D=0.85、r70~80-2D=0.84,P均<0.05)。结论定量CT计算机辅助诊断系统对骨质疏松症的诊断效能与人工相似,甚至优于人工,具有较高的应用价值。Purpose To explore the diagnostic value of three dimensional(3D)semi-automatic measurements in quantitative CT(QCT)computer-aided diagnosis system for osteoporosis.Materials and Methods The imaging data of 207 patients who underwent lumbar orthogonal dual-emission X-ray absorptiometry(DXA)and total lumbar spine CT at the Second Hospital of Shanxi Medical University from September 2020 to February 2021 were retrospectively collected,and all subjects were divided into three groups according to age(50-59,60-69,and 70-80 years).Bone mineral density(BMD)measurements were performed by 3D semi-automatic and 2D custom measurements in QCT without external reference phantom among the three groups.The differences of BMD among the three groups were compared,and the differences in diagnostic efficacy of the two methods for osteoporosis among three groups and the correlation between BMD measurements and DXA measurements in each group via the two methods were analyzed.Results The differences among the 50-59,60-69,and 70-80 years groups via 3D semi-automatic measurements[(150.29±24.23)mg/cm^(3),(113.63±14.64)mg/cm^(3),(108.18±37.19)mg/cm^(3)]and 2D custom measurements[(121.32±21.83)mg/cm^(3),(102.50±11.41)mg/cm^(3),(92.41±17.37)mg/cm^(3)]were statistically significant(F=136.84,178.65,both P<0.05).In the 50-59 year and 60-69 year groups,3D semi-automatic measurement had the almost same diagnostic performance as 2D custom measurements(AUC50-59-3D=0.90,AUC50-59-2D=0.93;AUC60-69-3D=0.89,AUC60-69-2D=0.89;all P>0.05);while 3D semi-automatic measurements had better diagnostic performance than 2D custom measurements in the 70-80 year group(AUC70-80-3D=0.93,AUC70-80-2D=0.89;P<0.05).BMD measurements via 3D semi-automated and 2D custom measurements in different age groups were all positively correlated with DXA(r50-59-3D=0.89,r60-69-3D=0.86,r70-80-3D=0.85;r50-59-2D=0.87,r60-69-2D=0.85,r70-80-2D=0.84;all P<0.05).Conclusion Computer-aided diagnostic systems exhibits almost similar and even better diagnostic efficacy than manual ones,wi

关 键 词：骨质疏松 诊断 计算机辅助 骨密度 体层摄影术 X线计算机 

分 类 号：R681[医药卫生—骨科学] R445.3[医药卫生—外科学]