A feasibility study of quantitative evaluation of lumbar bone quality in patients with chronic kidney disease using conventional CT
Objective Firstly,to explore the feasibility of using CT value instead of bone mineral density(BMD)to evaluate bone quality and then to analyze the relationship between clinical stage and CT value of of lumbar vertebra 1 and 2 in patients with chronic kidney disease.Method The imaging data of healthy subjects who underwent quantitative computed tomography(QCT)and abdominal CT in Gansu Provincial People's Hospital from January to December 2023 were retrospectively collected.The CT values of lumbar vertebra 1 and 2 were respectively measured,and QCT used as the bone mass standard to observe the cor-relation between CT values of lumbar 1,2 vertebra and the bone mineral density.Then,the clinical and im-aging data of patients with chronic kidney disease who had undergone abdominal CT scan were reviewed,and the CT values of lumbar 1,2 vertebra were measured to analyze the differences between clinical stages of chronic kidney disease and lumbar CT values.ANOVA was performed on laboratory examination results of patients with different stages of CKD.Finally,multiple linear regression analysis was conducted with"average CT values of lumbar vertebra 1 and 2"as dependent variables and laboratory examination as indepen-dent variables to explore the possible causes of bone mass loss caused by chronic kidney disease.Results The correlation coefficients between CT values of lumbar vertebrae 1,2 and BMD values measured by QCT were 0.888 and 0.892,respectively,and the CT truncation values that defined normal bone mass,reduced bone mass and osteoporosis were 130.275 and 87.250 HU,respectively.Moreover,with the increase of the clinical stage,CT value decreased,and blood PTH and blood P of patients gradually decreased.Regression analysis showed that the average CT values of lumbar vertebra 1 and 2 in CKD patients had a linear regression relation-ship with PTH,and the CT values of vertebral body had the greatest influence(P=0.045).Conclusion There is a good correlation between CT values of lumbar 1,2 vertebra and BMD values measured by QCT.There-fore,CT values of lumbar 1 and 2 vertebra measured by conventional CT can reflect vertebral bone mass,and can be used to evaluate bone mass loss in patients with chronic kidney disease.
chronic kidney diseasebone quality evaluationcomputed tomographyquantitative computed tomographybone mineral densityosteoporosis
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