腰椎体积CT值对诊断骨质疏松症的应用价值  

Application value of lumbar spine volume CT value in the diagnosis of osteoporosis

作　　者：周凤云 闫东[2] 王玲[2] 耿健 张雯双 刘艳东 马康康 顾大龙 张薇[2] 程晓光 ZHOU Fengyun;YAN Dong;WANG Ling;GENG Jian;ZHANG Wenshuang;LIU Yandong;MA Kangkang;GU Dalong;ZHANG Wei;CHENG Xiaoguang(School of Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712083,Shaanxi;Department of Radiology,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]陕西中医药大学医学技术学院,陕西咸阳712083 [2]北京积水潭医院放射科,北京100035

出　　处：《中国骨质疏松杂志》2023年第9期1272-1277,共6页Chinese Journal of Osteoporosis

基　　金：北京市医院管理中心临床医学发展专项(ZYLX202107)。

摘　　要：目的评估基于双层光谱CT腰椎扫描获得的椎体体积HU值在骨质疏松诊断中的应用价值。方法回顾性收集2022年10月至2023年3月北京积水潭医院脊柱外科门诊患者91例。所有患者均接受过腰椎双层光谱CT扫描,包括QCT。同时测量纳入患者L1和L2椎体的体积HU值和基于QCT扫描的体积骨密度值。依据腰椎QCT骨密度诊断骨质疏松症的标准将研究对象分为骨量正常组、低骨量组和骨质疏松组,比较3组患者的一般情况,分析体积HU值与QCT测量的体积骨密度的关系。使用ROC曲线分别计算体积HU值诊断骨量减少和骨质疏松最佳诊断阈值以及使用逻辑回归模型确定性别、年龄和体积HU值与骨质疏松发生的关系。结果L1和L2的平均体积HU值与QCT测量的BMD之间有极好的相关性(r=0.941,P<0.001);ROC诊断骨量减少和骨质疏松的最佳阈值分别为154.73 HU(灵敏度为92.9%)和106.52 HU(灵敏度为86.6%);年龄和基于双层光谱CT测量的体积HU值与骨质疏松的发生显著相关(P<0.001),OR值分别为1.172和0.928。结论基于双层光谱CT测量的体积HU值和QCT测量的体积BMD之间有较好的相关性;基于腰椎体积HU值的阈值能准确预测骨量异常减低和骨质疏松,因此,体积HU值可以作为临床机会性筛查骨质疏松的补充手段。Objective To evaluate the application value of HU value of vertebral volume obtained from dual-layer spectral CT lumbar spine scanning in the diagnosis of osteoporosis.Methods A total of 91 outpatients in the Department of Spine Surgery,Beijing Jishuitan Hospital from October 2022 to March 2023 were retrospectively collected.All the patients underwent a dual-layer spectral CT scan of the lumbar spine,including QCT.Volumetric HU values of L1 and L2 vertebral bodies and volumetric bone mineral density values based on QCT scans were measured at the same time.The subjects were divided into normal bone mass group,osteopenia group,and osteoporosis group according to the standard of lumbar bone mineral density measured with QCT.The general conditions of the three groups were compared.The relationship between volumetric HU value and volumetric bone mineral density measured with QCT was analyzed.ROC curve was used to calculate the optimal diagnostic threshold of HU value for osteopenia and osteoporosis.Logistic regression model was used to determine the relationship between gender,age,HU value,and osteoporosis.Results There was an excellent correlation between the average volume HU values of L1 and L2 and BMD measured with QCT(r=0.941,P<0.001).The optimal thresholds of ROC for diagnosing osteopenia and osteoporosis were 154.73HU(sensitivity 92.9%)and 106.52HU(sensitivity 86.6%),respectively.Age and HU value measured with dual-layer spectral CT were significantly correlated with the occurrence of osteoporosis(p<0.001),with OR values of 1.172 and 0.928,respectively.Conclusion There is a good correlation between volumetric HU value measured with dual-layer spectral CT and volumetric BMD measured with QCT.The threshold of HU value based on the volume of lumbar spine accurately predicts abnormal bone mass loss and osteoporosis.Therefore,HU value can be used as a supplementary method for clinical screening of osteoporosis.

关 键 词：体积HU值 骨质疏松 腰椎CT 

分 类 号：R681.5[医药卫生—骨科学]