赵明月,刘义军,魏巍,李贝贝,王旭,范勇,王诗耕,童小雨.能谱CT基物质成像技术测定骨密度及评估骨质状态的可行性[J].中国医学影像技术,2022,38(11):1720~1725
能谱CT基物质成像技术测定骨密度及评估骨质状态的可行性
Feasibility of measuring bone mineral density and evaluating bone status with spectral CT based material imaging technology
投稿时间:2022-04-05  修订日期:2022-06-28
DOI:10.13929/j.issn.1003-3289.2022.11.028
中文关键词:  骨密度  体层摄影术,X线计算机  基物质对
英文关键词:bone mineral density  tomography, X-ray computed  basis material pair
基金项目:
作者单位E-mail
赵明月 大连医科大学附属第一医院放射科, 辽宁 大连 116011  
刘义军 大连医科大学附属第一医院放射科, 辽宁 大连 116011 yijunliu1965@126.com 
魏巍 大连医科大学附属第一医院放射科, 辽宁 大连 116011  
李贝贝 大连医科大学附属第一医院放射科, 辽宁 大连 116011  
王旭 大连医科大学附属第一医院放射科, 辽宁 大连 116011  
范勇 大连医科大学附属第一医院放射科, 辽宁 大连 116011  
王诗耕 大连医科大学附属第一医院放射科, 辽宁 大连 116011  
童小雨 大连医科大学附属第一医院放射科, 辽宁 大连 116011  
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中文摘要:
      目的 观察能谱CT基物质成像技术测定骨密度(BMD)评估骨质状态的可行性。方法 选取255例接受全腹部CT平扫及增强扫描患者,年龄25~86岁,其中6例<30岁(A组),53例30~49岁(B组),148例50~69岁(C组),48例 ≥ 70岁(D组)。将重建的平扫图像传至定量CT(QCT)pro工作站,测量L1~L3椎体BMD(QCT BMD);以宝石能谱成像(GSI)后处理软件重组三期增强羟基磷灰石(HAP)和碘(Iodine)基物质对图像,测量L1~L3椎体骨松质HAP(Iodine)密度值,分析HAP(Iodine)密度值与QCT BMD值的相关性。根据QCT BMD将椎体分为骨质疏松(BMDČ<80 mg/cm3)、骨量减少(80 mg/cm3 ≤ BMD ≤ 120 mg/cm3)及骨量正常组(BMD>120 mg/cm3),对比其腰椎HAP(Iodine)密度值。绘制受试者工作特征(ROC)曲线,分析以椎体HAP(Iodine)密度值评估骨质状态的效能。对比各年龄组间L3椎体的HAP(Iodine)密度值,建立HAP(Iodine)密度值与年龄的拟合曲线。结果 共纳入765个腰椎,QCT BMD值为(116.81±42.41)mg/cm3,HAP(Iodine)密度值为(693.16±18.76)2mg/cm3,二者呈正相关(r=0.960,P<0.05);其中162个腰椎骨质疏松、285个骨量减少、318个骨量正常,椎体HAP(Iodine)密度值分别为(669.84±6.58)、(686.57±6.69)及(710.95±12.33)2mg/cm3,两两比较差异均有统计学意义(P均<0.05)。以695.92 2mg/cm3为HAP(Iodine)密度值的截断值判断骨量正常与骨量异常(骨质疏松+骨量减少)的曲线下面积(AUC)为0.987[95%CI(0.982,0.993)];以677.34 2mg/cm3为HAP(Iodine)密度值的截断值判断骨质疏松与骨量减少的AUC为0.963[95%CI(0.947,0.979)]。各年龄组间L3椎体QCT BMD值及HAP(Iodine)密度值差异均有统计学意义(P均<0.05)。A组HAP(Iodine)密度值与年龄无明显线性相关性(P>0.05),而B、C、D组HAP(Iodine)密度值与年龄均呈负相关(r=-0.467、-0.506、-0.426,P均<0.05)。≥ 30岁者HAP(Iodine)密度值=-1.509×年龄+751.642(2mg/cm3)。结论 能谱CT基物质成像技术可用于测定BMD及评估骨质状态。
英文摘要:
      Objective To explore the feasibility of measuring bone mineral density (BMD) and evaluating bone status with spectral CT based material imaging technology.Methods Totally 255 patients (aged 25-86 years) underwent both plain and contrast-enhanced abdominal CT were enrolled, including 6 patients aged <30 years (group A), 53 aged 30-49 years (group B), 148 aged 50-69 years (group C) and 48 patients aged ≥ 70 years (group D). The reconstructed images of plain CT were transmitted to quantitative CT (QCT) pro software to measure BMD of L1-L3. The basis material images of hydroxyapatite (HAP) (Iodine) on images of three enhanced phases were reconstructed with gemstone spectral imaging (GSI) post-processing workstation, and HAP (Iodine) density of L1-L3 vertebral bodies were measured. The correlation between HAP (Iodine) density value and QCT BMD was analyzed. According to the diagnostic criteria of QCT, the vertebral bodies were divided into osteoporosis (BMD<80 mg/cm3), osteopenia (80 mg/cm3 ≤ BMD ≤ 120 mg/cm3) and normal bone mass (BMD>120 mg/cm3) groups. HAP (Iodine) density values of vertebral bodies were compared among the above bone state groups. Receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of HAP (Iodine) density value for evaluating bone status. HAP (Iodine) density values of L3 were compared among different age groups. The correlated fitting curve between HAP (Iodine) density value and age in each group was established.Results Totally 765 lumbar vertebrae were enrolled, with QCT BMD value of (116.81±42.41) mg/cm3 and density value of HAP (Iodine) of (693.16±18.76) 2mg/cm3, and there was positive correlation between the latter two (r=0.96, P<0.05). Referring to QCT BMD diagnostic criteria, there were 162 lumbar vertebrae with osteoporosis, 285 with osteopenia and 318 lumbar vertebrae with normal bone mass, the HAP (Iodine) value was (669.84±6.58), (686.57±6.69) and (710.95±12.33) 2mg/cm3 , respectively, and the difference between any 2 groups was significant (all P<0.05). Taken 695.92 2mg/cm3 as the cut-off value of HAP (Iodine) density for judging normal and abnormal bone mass (osteoporosis+osteopenia), the area under the curve (AUC) was 0.987 (95%CI [(0.982, 0.993]). Taken 677.34 2mg/cm3 as the cut-off value of HAP (Iodine) density for diagnosis of osteoporosis and osteopenia, the AUC was 0.963 (95%CI [0.947, 0.979]). There were significant differences of QCT BMD values and HAP (Iodine) density values of L3 among different age groups (all P<0.05). HAP (Iodine) value showed no correlation to age in group A (P>0.05), but were negatively correlated with age in groups B, C and D (r=-0.467, -0.506, -0.426, all P<0.05). HAP (Iodine) value of patients ≥ 30 years=-1.059×age+751.642 (2mg/cm3).Conclusion Spectral CT based material imaging technology could be used to measure BMD and evaluate bone status.
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