基于定量CT对骨质疏松性椎体压缩骨折患者椎旁肌肉改变的研究  

Study of paravertebral muscle changes in patients with osteoporotic vertebral compression fractures based on quantitative CT

作　　者：胡佳慧 王建国[2] 庄顺达 房泽辉[2] 李平[2] HU Jiahui;WANG Jianguo;ZHUANG Shunda;FANG Zehui;LI Ping(Shandong University of Traditional Chinese Medicine,Ji'nan 250355,China;Department of Radiology,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan 250014,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院放射科,山东济南250014

出　　处：《实用放射学杂志》2023年第8期1318-1321,共4页Journal of Practical Radiology

摘　　要：目的基于定量CT(QCT)探讨骨质疏松性椎体压缩骨折(OVCFs)患者椎旁肌肉改变与骨折发生的关系。方法选取OVCFs患者43例(骨折组)行腰椎QCT检查。选取同期行QCT检查的健康成年人43例(无骨折组)作为对照。分别测量2组骨密度(BMD)、内脏脂肪面积(VFA)及皮下脂肪面积(SFA);于L3椎体正中层面分别测量2组椎旁后肌(竖脊肌和多裂肌)的肌肉面积、脂肪面积及CT值,计算肌肉脂肪浸润(MFI)程度;再于L4~L5椎间盘水平分别测量2组两侧腰大肌的上述指标。运用独立样本t检验和非参数秩和检验进行统计学分析。结果骨折组与无骨折组间性别、年龄、VFA及SFA差异均无统计学差异(P>0.05)。2组间椎旁后肌、两侧腰大肌肌肉面积无统计学差异(P>0.05)。2组间椎旁后肌、两侧腰大肌脂肪面积,MFI及CT值有显著统计学差异(P<0.01)。骨折组的椎旁后肌、两侧腰大肌脂肪面积、MIF明显高于无骨折组,与骨折的发生呈正相关;CT值低于无骨折组,与骨折发生呈负相关。结论OVCFs患者椎旁肌肉发生退变,与骨折的发生具有相关性。Objective e To investigate the relationship between paravertebral muscle changes and fracture occurrence in patients with osteoporotic vertebral compression fractures(OVCFs)based on quantitative computed tomography(QCT).Methods A total of 43 patients with OVCFs(fracture group)were selected,all patients underwent lumbar spine QCT.A total of 43 healthy adults(non-fracture group)who underwent QCT at the same time were also enrolled as the control group.Bone mineral density(BMD),visceral fat area(VFA)and subcutaneous fat area(SFA)of two groups were respectively measured.The muscle area,fat area and CT values of paravertebral posterior muscle(including erector spine muscle and multifidus muscle)were measured and then calculated the muscle fat infiltration(MFI)degree of two groups at the median level of lumbar 3 vertebral body,respectively.All indexes mentioned above of bilateral psoas major muscle of two groups were also measured at the 4-5 level of lumbar intervertebral disc.Statistical analysis was performed using independent sample t test and nonparametric rank sum test.Results There were no significant differences in gender,age,VFA and SFA between the fracture group and the non-fracture group(P>0.05).There were no significant differences in muscle area of paravertebral posterior muscle and bilateral psoas major muscle between the two groups(P>0.05).There were significantly differences in fat area of paravertebral posterior muscle and bilateral psoas major muscle,MFI and CT values between the two groups(P<0.O1).The fat area of paravertebral posterior muscle and bilateral psoas major muscle,MFI in the fracture group were significantly higher than the non-fracture group,which were positively correlated with the occurrence of fracture;The CT values in the fracture group were lower than that in the non-fracture group,which were negatively correlated with the occurrence of fracture.Conclusion The degeneration of paravertebral muscles in patient with OVCFs is associated with the occurrence of fracture.

关 键 词：计算机体层成像 骨质疏松 压缩性骨折 椎旁肌肉退变 

分 类 号：R814.42[医药卫生—影像医学与核医学] R681[医药卫生—放射医学] R683[医药卫生—临床医学]