股骨远端CT值对髋部骨质疏松的诊断价值  

The diagnostic value of distal femur CT value in hip osteoporosis

作　　者：赵君禄[1] 刘斋[1] 任庆云[1] 赵德园 聂关伟[2] 韩康 ZHAO Junlu;LIU Zhai;REN Qingyun;ZHAO Deyuan;NIE Guanwei;HAN Kang(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9期1487-1490,共4页Journal of Practical Radiology

基　　金：河北省财政厅基金项目(LS201804)。

摘　　要：目的 探讨股骨远端CT值与髋部骨密度(BMD)的相关性及其对髋部骨质疏松的诊断效能.方法 选取因膝关节骨性关节炎进行膝关节CT扫描及同侧髋部双能 X 线吸收仪(DXA)检查的患者 152 例,测量股骨远端的 CT 值及同侧髋部 T-值与BMD,应用Pearson相关性检验分析股骨远端CT值与髋部T-值及BMD的相关性.使用受试者工作特征(ROC)曲线分析股骨远端CT值测量对骨质疏松的诊断效能.结果 股骨远端外侧区CT值与髋部股骨颈BMD及T-值呈明显正相关(r=0.678,P<0.01;r=0.671,P<0.01).基于髋部DXA BMD分类中,不同 BMD组间股骨远端外侧区 CT 值有显著性差异(P<0.01),BMD 正常组、骨量减少组及骨质疏松组平均CT值分别为 144.53 HU、91.78 HU和 58.70 HU.ROC曲线分析显示股骨远端外侧区 CT值诊断骨量正常及骨质疏松的曲线下面积(AUC)值分别为 0.872 及 0.827,诊断骨量正常及骨质疏松的理想阈值分别为 99.84 HU及 86.25 HU.结论 股骨远端外侧区CT值与髋部T-值及BMD明显相关,对髋部骨质疏松有较高的诊断效能,股骨远端 CT 值测量可作为预测髋部骨质疏松的一种方法.Objective To explore the correlation between CT value of distal femur and bone mineral density(BMD)of hip,and to evaluate the diagnostic efficacy of distal femur CT value for predicting hip osteoporosis.Methods A total of 152 patients with knee CT scan and ipsilateral hip dual-energy X-ray absorptiometry(DXA)examination were selected,the CT value of the distal femur and ipsilateral hip T-score and BMD were measured,and the correlation between CT value of the distal femur and hip T-score and BMD was analyzed by the Pearson correlation test.The diagnostic efficacy of osteoporosis was measured using the receiver operating char-acteristic(ROC)curve.Results The CT value in the lateral area of the distal femur had the good correlation with the BMD(r=0.678,P<0.01)and T-score(r=0.671,P<0.01)of the femoral neck,respectively.The mean CT value differed significantly(P<0.01)for the three DXA-defined BMD categories of osteoporosis(58.70 HU),of osteopenia(91.78 HU),and of normal individuals(144.53 HU).The ROC curve analysis showed that the area under the curve(AUC)in the lateral area of the distal femur for the diagnosis of nor-mal individuals and osteoporosis was 0.872 and 0.827,respectively,and the optimal threshold for the diagnosis of normal individuals and osteoporosis was 99.84 HU and 86.25 HU,respectively.Conclusion The CT value in the lateral area of the distal femur is sig-nificantly correlated with the T-score and BMD of the hip,which has a high diagnostic efficacy for hip osteoporosis,and the distal femur CT value can be used as a method for predicting hip osteoporosis.

关 键 词：骨质疏松 计算机体层成像 双能X线吸收仪 股骨远端 骨密度 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学] R681.6[医药卫生—临床医学]