| 潘亚玲,陈彤彤,王晗琦,程晓光,陆勇.定量CT测量T12骨密度替代病变腰椎用于骨质疏松诊断的可行性[J].中国医学影像技术,2019,35(7):1086~1090 |
| 定量CT测量T12骨密度替代病变腰椎用于骨质疏松诊断的可行性 |
| Feasibility of bone mineral density of T12 measured with quantitative CT for replacing abnormal lumbar vertebrae for diagnosis of osteoporosis |
| 投稿时间：2019-01-16 修订日期：2019-05-07 |
| DOI：10.13929/j.1003-3289.201901102 |
| 中文关键词: 骨质疏松 胸椎 腰椎 骨密度 体层摄影术,X线计算机 |
| 英文关键词:osteoporosis thoracic vertebra lumbar vertebra bone density tomography, X-ray computed |
| 基金项目:上海市科学技术委员会科研计划项目（17411964900）、重大疾病防治科技行动计划（2017ZX01001-S12）。 |
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| 中文摘要: |
| 目的 探讨在低剂量CT肺癌筛查联合定量CT骨密度检查中，以测量T12椎体骨密度替代病变的L1或L2用于骨质疏松诊断的可行性。方法 选取1 298名接受低剂量CT肺癌筛查联合定量CT骨密度检查的健康体检者，测量其T12、L1、L2椎体骨密度，并计算校准的T12骨密度，记为T12*。以L1+L2为诊断标准，分别分析各椎体组合T12+L1、T12+L2、T12*+L1、T12*+L2与L1+L2评估骨量的一致性和诊断骨质疏松的差异性。结果 各椎体组合与L1+L2评估骨量的一致性均较好（Kappa均>0.75，P均<0.05）。各椎体组合诊断骨质疏松的特异度均>98%。T12+L1、T12+L2诊断骨质疏松的敏感度分别为73.33%（143/195）及77.95%（152/195）；而T12*+L1、T12*+L2诊断骨质疏松的敏感度分别为83.08%（162/195）及90.26%（176/195）。结论 定量CT测量T12骨密度替代病变L1或L2，可能降低诊断骨质疏松的敏感度，应对其进行校准。 |
| 英文摘要: |
| Objective To explore the feasibility of bone mineral density (BMD) of T12 for replacing abnormal L1 or L2 for diagnosis of osteoporosis during lung cancer screening with low-dose CT and bone mineral density examination with quantitative CT. Methods Totally 1 298 healthy individuals who underwent lung cancer screening with low-dose CT and BMD examination with quantitative CT were enrolled. BMD of T12 to L2 vertebrae were measured, and the calibrated BMD of T12 was calculated and recorded as T12*. Taking L1+L2 as diagnostic criteria, the consistencies in bone mass assessment and the differences in diagnosis of osteoporosis among vertebral combinations of T12+L1, T12+L2, T12*+L1, T12*+L2 and L1+L2 were analyzed, respectively. Results There were good consistencies between vertebral combinations and L1+L2 in bone mass assessment (all Kappa>0.75, all P<0.05). The specificities of vertebral combinations in osteoporosis diagnosis were all >98%. The sensitivities of T12+L1 and T12+L2 in osteoporosis diagnosis were 73.33% (143/195) and 77.95% (152/195), respectively, whereas of T12*+L1 and T12*+L2 in osteoporosis diagnosis were 83.08% (162/195) and 90.26% (176/195), respectively. Conclusion BMD of T12 for replacing abnormal L1 or L2 during quantitative CT can reduce the sensitivity in diagnosis of osteoporosis, therefore BMD of T12 should be calibrated in measurement. |
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