基于能谱CT物质分离技术预测骨质疏松性椎体骨折术后骨折再发的价值  

Value of material separation technique based on energy spectrum CT in predicting recurrence of osteoporotic vertebral fractures after operation

作　　者：隋愿[1] 董备[1] 李依明[1] 李玉舟[1] 郑吟诗[1] Sui Yuan;Dong Bei;Li Yiming;Li Yuzhou;Zheng Yinshi(Medical Imaging Center,the First People's Hospital of Shangqiu City,Shangqiu 476100,China)

机构地区：[1]河南省商丘市第一人民医院医学影像中心,商丘476100

出　　处：《中华内分泌外科杂志(中英文)》2025年第1期96-100,共5页Chinese Journal of Endocrine Surgery

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191496)。

摘　　要：目的:探究基于能谱CT物质分离技术预测骨质疏松性椎体骨折术后骨折再发的价值,为术后骨折再发评估提供参考。方法:选取2020年1月至2021年12月河南省商丘市第一人民医院就诊的80例行经皮椎体成形术治疗的骨质疏松性椎体骨折患者,于术前行能谱CT物质分离技术检查,术后随访至少2年,根据骨折再发情况设为再发组与无再发组。比较两组临床资料及能谱CT物质分离技术检查结果,采用Logistic回归分析影响骨折再发的相关因素,并采用受试者工作特征曲线(ROC)评估基于能谱CT物质分离技术对骨折再发的预测价值。结果:术后随访至少2年,80例中有26例术后骨折再发。再发组年龄、钙-水、羟基磷灰石(HAP)-水值比无再发组高,骨水泥渗漏占比比无再发组高(t/Fisher=2.57、5.40、3.96、-,P=0.012、<0.001、<0.001、0.033)。Logistic回归分析结果显示,钙-水(OR=2.321,95%CI:1.464~3.679)、HAP-水(OR=1.784,95%CI:1.246~2.554)值为影响骨质疏松性骨折患者术后骨折再发的相关因素(P<0.001)。ROC示钙-水、HAP-水值联合预测患者术后骨折再发的AUC 0.868、灵敏度88.46%、特异度79.63%(P<0.001)。结论:基于能谱CT物质分离技术预测骨质疏松性椎体骨折术后骨折再发的临床应用价值较高,为术后骨折再发的临床评估提供新思路。Objective:To explore the value of material separation technique based on energy spectrum CT in predicting the recurrence of osteoporotic vertebral fractures after operation,in order to provide reference for the evaluation of postoperative recurrence of fractures.Methods:A total of 80 cases with percutaneous vertebroplasty(PVP)treated in the First People’s Hospital of Shangqiu,Henan Province from Jan.2020 to Dec.2021 were selected for pre-operative CT material separation examination and postoperative follow-up for at least 2 years.The patients were divided into recurrence group and no recurrence group according to the recurrence of fracture.The clinical data and the results of material separation technique by energy spectrum CT were compared.The relevant factors for fracture recurrence was assessed by Logistic regression analysis,and ROC curve was used to evaluate the predictive value of material separation technique based on energy spectrum CT in the recurrence of fracture.Results:After a follow-up of at least 2 years,26 of the 80 patients had a recurrence of the fracture.The age,calcium water and hydroxyapatite(HAP)-water values in recurrent group were higher than those in no recurrent group,and the proportion of bone cement leakage was higher(t/Fisher=2.57,5.40,3.96,-P=0.012<0.001,<0.001,0.033).Logistic regression analysis showed that calcium-water(OR=2.321,95%CI:1.464-3.679)and HAP-water(OR=1.784,95%CI:1.246-2.554)values were the factors for postoperative fracture recurrence in osteoporotic fractures(P<0.001).ROC curve showed that AUC,sensitivity and specificity of combined calcium-water and HAP-water values in predicting postoperative fracture recurrence were 0.868,88.46%and 79.63%,respectively(P<0.001).Conclusions:The material separation technique based on energy spectrum CT in predicting the recurrence of osteoporotic vertebral fractures after operation has high clinical application value,and provides a new idea for the clinical evaluation of postoperative recurrence of fractures.

关 键 词：骨质疏松性骨折 再发骨折 双能CT 经皮椎体成形术 

分 类 号：R687.3[医药卫生—骨科学]