椎体CT值联合腰椎MRI椎体骨质量评分筛查绝经后女性骨量异常的诊断价值  

Diagnostic value of vertebral CT value combined with lumbar MRI vertebral bone mass score for screening bone mass abnormalities in postmenopausal women

作　　者：魏其鹏 廖培基 范宇澄 郭伟俊[1] 詹锦祥 蔡东岭[1,2] WEI Qi-peng;LIAO Pei-ji;FAN YU-cheng;GUO Wei-jun;ZHAN Jin-xiang;CAI Dong-ling(Department of Orthopedics and Traumatology,Panyu District Traditional Chinese Medicine Hospital,Guangzhou,Guangdong,511400,China;Guangzhou University of Traditional Chinese Medicine,Guangzhou,Guangdong,510006,China)

机构地区：[1]广州市番禺区中医院骨伤三科,广东广州511400 [2]广州中医药大学,广东广州510006

出　　处：《颈腰痛杂志》2023年第6期994-998,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：番禺区科技计划重大医疗卫生项目(编号:2022-Z04-112);番禺区医学重点学科(2022-2024年)。

摘　　要：目的探讨椎体CT值、腰椎MRI椎体骨质量评分(VBQ评分)对绝经后女性骨量异常的诊断价值。方法回顾性分析2018年1月~2022年8月在广州中医药大学附属番禺区中医院骨科收治的210例绝经后女性患者临床资料,根据双能X线骨密度仪的股骨颈T值,将研究对象分为骨量异常组(骨量减少、骨质疏松,n=166)及骨量正常组(n=44),并测量出各组的CT值以及VBQ评分。采用受试者工作特征曲线(receiver operating curve,ROC)计算曲线下面积(area under the curve,AUC),分析筛查方法的诊断价值,确定诊断截断值,同时计算出不同联合方式筛查方法相应的灵敏度、特异度及约登指数。结果单独运用CT值、VBQ评分作为筛查标准时,AUC分别是0.79、0.777,cut-off值分别是116.75 HU、3.24,其约登指数分别是0.520、0.45,具有一定的诊断价值。CT值联合VBQ评分作为筛查标准时,AUC是0.822,灵敏度是75.9%,特异度为75%,约登指数为0.509;CT值与VBQ评分并联(CT值≤116.75 HU或VBQ评分≥3.24)诊断骨量异常时,其灵敏度为95.26%,特异性为49.16%,约登指数为0.444;串联(CT值≤116.75 HU且VBQ评分≥3.24)诊断骨量异常时,其灵敏度为60.73%,特异性为91.73%,约登指数为0.524,具有较高的诊断价值。结论单独或联合运用CT值、VBQ评分对筛查绝经后女性骨量异常均具有一定的诊断价值,可作为筛查绝经后女性骨量异常的补充方法。Objective To investigate the diagnostic value of vertebral CT value and vertebral body bone quality score(VBQ score)of lumbar MRI in postmenopausal women with abnormal bone mass.Methods The clinical data of 210 postmenopausal women admitted to the Department of Orthopedics of Panyu District Hospital of Traditional Chinese Medicine affiliated to Guangzhou University of Traditional Chinese Medicine from January 2018 to August 2022 were analyzed retrospectively.According to the T value of femoral neck of dual energy X-ray bone density(DXA),the subjects were divided into the abnormal bone mass group(osteopenia,osteoporosis,n=166)and the normal bone mass group(n=44),and the CT values and VBQ scores of each group were measured.The area under the curve(AUC)was calculated with the subject’s work curve(ROC),the diagnostic value of the screening method was analyzed,and the diagnostic cut-off point value was determined.At the same time,the sensitivity,specificity and Yoden index corresponding to different combinations of the screening method were calculated.Results When CT value and VBQ score were used as screening criteria alone,AUC was 0.79 and 0.777 respectively,cut-off value was 116.75 HU and 3.24 respectively,and Yoden index was 0.520 and 0.45 respectively,which had certain diagnostic value.When CT value combined with VBQ score was used as screening criteria,AUC was 0.822,sensitivity was 75.9%,specificity was 75%,and Yoden index was 0.509.When the CT value and VBQ score were parallel(CT value≤116.75 HU or VBQ score≥3.24),the sensitivity was 95.26%,specificity was 49.16%,and Yoden index was 0.444.When series(CT value≤116.75 HU and VBQ score≥3.24)was used to diagnose abnormal bone mass,its sensitivity was 60.73%,specificity was 91.73%,and Yoden index was 0.524,which had high diagnostic value.Conclusion Single or combined use of CT value and VBQ score has certain diagnostic value in screening postmenopausal women with abnormal bone mass,which can be used as a complementary method for screening postmenopausal wom

关 键 词：绝经后骨质疏松 椎体CT值 椎体骨质量评分 磁共振成像 

分 类 号：Q593.6[生物学—生物化学]