| 姜文蓁,张宇威,崔效楠,武雅琳,韩丽珠,叶兆祥.胸部低剂量CT结合定量CT测量下段胸椎骨密度诊断骨质疏松[J].中国医学影像技术,2022,38(5):734~738 |
| 胸部低剂量CT结合定量CT测量下段胸椎骨密度诊断骨质疏松 |
| Low-dose CT combined with quantitative CT measurement of bone mineral density of lower thoracic vertebri for diagnosing osteoporosis |
| 投稿时间：2021-10-29 修订日期：2022-02-23 |
| DOI：10.13929/j.issn.1003-3289.2022.05.024 |
| 中文关键词: 骨质疏松 胸椎 骨密度 体层摄影术,X线计算机 |
| 英文关键词:osteoporosis thoracic vertebrae bone density tomography, X-ray computed |
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| 中文摘要: |
| 目的 观察胸部低剂量CT(LDCT)结合定量CT(QCT)测量下段胸椎骨密度(BMD)诊断骨质疏松的效能。方法 前瞻性收集接受胸部LDCT肺癌筛查联合QCT BMD检查的体检者,分别测量T9~L2各相邻2个椎体BMD的均值(BMDT9/T10~BMDL1/L2),分析BMDT9/T10~BMDT12/L1与BMDL1/L2之间的相关性及其差异。以BMDL1/L2结果为金标准,采用受试者工作特征曲线(ROC)评价BMDT9/T10~BMDT12/L1诊断骨质疏松的效能,分析其与BMDL1/L2诊断结果的一致性。结果 共纳入630例,骨质疏松患病率为28.25%(178/630)。胸腰椎BMDT9/T10~BMDT12/L1与BMDL1/L2均呈正相关(r=0.927~0.984,P均＜0.001),且自上而下相关系数逐渐增高,而BMDT9/T10~BMDT12/L1与BMDL1/L2的差异逐渐减低(P均＜0.001)。胸腰椎BMDT9/T10~BMDT12/L1诊断骨质疏松的曲线下面积(AUC)自上而下逐渐增大,除BMDT9/T10与BMDT10/T11外(Z=1.78,P＝0.08),其余各BMD的AUC差异均有统计学意义(P均＜0.05),尤以BMDT12/L1诊断骨质疏松效能最高(AUC=0.990);BMDT9/T10~BMDT12/L1与BMDL1/L2诊断骨质疏松的一致性中等至良好(Kappa为0.646~0.820,P均＜0.001)。结论 胸部LDCT结合QCT测量下段胸椎BMD诊断骨质疏松效能良好。 |
| 英文摘要: |
| Objective To observe the diagnostic performances of lower thoracic vertebrae bone mineral density (BMD) based on chest low-dose CT (LDCT) and quantitative CT (QCT) for diagnosing osteoporosis.Methods People who would undergo chest LDCT lung cancer screening and asynchronous QCT BMD examination were prospectively selected. The mean BMD of 2 consecutive vertebrae from T9—L2 (BMDT9/T10—BMDL1/L2) were measured. The correlations and differences of BMDT9/T10—BMDT12/L1 and BMDL1/L2 were analyzed. Taken the diagnostic results of BMDL1/L2 as the gold standards, receiver operating characteristic (ROC) curve was used to analyze the efficacy of BMDT9/T10—BMDT12/L1 for diagnosing osteoporosis, and their consistencies with results of BMDL1/L2 were analyzed.Results Totally 630 subjects were enrolled. The prevalence of osteoporosis was 28.25% (178/630). Thoracolumbar BMDT9/T10—BMDT12/L1 were positively correlated with BMDL1/L2 (r=0.927-0.984, all P＜0.001), and from top to bottom, the correlation coefficients gradually increased, while the differences of BMDT9/T10—BMDT12/L1 and BMDL1/L2 gradually decreased (all P＜0.001). The area under the curve (AUC) of thoracolumbar BMDT9/T10—BMDT12/L1 for diagnosis of osteoporosis gradually increased from top to bottom, and there were significant differences between them (all P＜0.05) except for BMDT9/T10 and BMDT10/T11 (Z=1.78, P=0.08). Among them, BMDT12/L1 had the highest efficacy for diagnosing osteoporosis (AUC=0.990). The diagnostic consistencies of BMDT9/T10—BMDT12/L1 and BMDL1/L2 for diagnosing osteoporosis were moderate to good (Kappa=0.646-0.820, all P＜0.001).Conclusion Chest LDCT combined with QCT measurement of BMD of lower thoracic vertebrae had good diagnostic efficacy of osteoporosis. |
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