目的:本研究旨在对比腰骶椎椎体松质骨的CT值与双能X线骨密度仪(dual energy X ray absorptiometry,DXA)的骨密度值,评估腰骶椎椎体CT值诊断绝经后女性骨质疏松症的应用价值.方法:收集95例临床均确诊为绝经后女性患者,年龄≥59,且≤96岁,平均(76.45±10.88)岁,均在入院2周内进行腰椎CT和DXA检查.本研究测量腰椎CT检查中的L2至S1椎体CT值,与测量DXA检查的总T-score值进行分析.结果:骨量减少组与骨质疏松组L2至S1椎体的CT值均低于骨质正常组椎体的CT值(P＜0.01).L2至S1椎体CT值和总T-score值为显著正相关(P＜0.01).ROC曲线分析显示,L2和L5椎体CT值的曲线下面积最大,且L2椎体CT值的相关系数最大.因此,本研究选择L2椎体CT值低于72.25HU,作为提示发生骨质疏松症的阈值.结论:通过测量绝经后女性腰椎CT检查中的L2至S1椎体CT值,或将成为提前筛查骨质疏松症、降低患者开支和不良预后风险的有力方式.
The Diagnostic Value of CT Values of Lumbosacral Vertebrae in Postmenopausal Women for Osteoporosis
Objective:This study aims to compare the CT values of the cancellous bone of the lumbo-sacral vertebrae with the bone density values of dual energy X-ray absorptiometry(DXA),and evaluate the application value of lumbosacral vertebral CT values in diagnosing postmenopausal osteoporosis in women.Methods:95 patients who were clinically diagnosed as postmenopausal women,whose ages ranged from 59 to 96(mean age:76.45±10.88 years),were enrolled and underwent lumbar CT and DXA examinations within 2 weeks of admission.We measured the CT values of the L2 to S1 vertebral bodies in lumbar CT ex-amination and analyzed them with the total T-score values measured in DXA examination.Results:The CT values of the L2 to S1 vertebrae in the osteopenia group and osteoporosis group were lower than those in the normal bone group(P＜0.01).The CT values of the L2 to S1 vertebral bodies were significantly posi-tively correlated with the total T-score values(P＜0.01).The ROC curve analysis shows that the area under the curve for the CT values of L2 and L5 vertebral bodies is the largest,and the correlation coefficient for the CT values of L2 vertebral bodies is the highest.Therefore,we chose the L2 vertebral CT value below 72.25HU as the threshold for indicating the occurrence of osteoporosis.Conclusion:By measuring the L2 to S1 vertebral CT values in postmenopausal women's lumbar spine CT scans,it may become a powerful way to screen for osteoporosis in advance,reduce patient expenses,and lower the risk of poor prognosis.
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