[1]蔡金辉,叶浩翊,申忱,等.椎体压缩骨折机会性筛查：常规胸部、腹部CT测量T12、L1椎体CT值的价值[J].中华老年骨科与康复电子杂志,2022,(04):217-223.[doi:10.3877/cma.j.issn.2096-0263.2022.04.005]
　Opportunistic screening for vertebral compression fracture using routine thoracic and abdominal CT scans according to T12 and L1 trabecular attenuation[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(04):217-223.[doi:10.3877/cma.j.issn.2096-0263.2022.04.005]
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椎体压缩骨折机会性筛查：常规胸部、腹部CT测量T12、L1椎体CT值的价值()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2022年04期
页码:
217-223
栏目:
三维影像
出版日期:
2022-08-05

文章信息/Info

Title:
Opportunistic screening for vertebral compression fracture using routine thoracic and abdominal CT scans according to T12 and L1 trabecular attenuation
作者:
蔡金辉1; 2; 叶浩翊2; 申忱2; 林良业2; 刁凡登2; 郭栋华2; 刘志锋2; 刘庆余1
518107 深圳，中山大学附属第七医院放射科1；511300 广州医科大学附属第四医院影像科2
Author(s):
Cai Jinhui1,2, Ye Haoyi2, Shen Chen2, Lin Liangye2, Diao Fandeng2, Guo Donghua2, Liu Zhifeng2, Liu Qingyu1.
关键词:
骨质疏松症;  椎体骨折;  电子计算机断层扫描
Keywords:
Osteoporosis;  Vertebral compression fracture;  Computed Tomography
DOI:
10.3877/cma.j.issn.2096-0263.2022.04.005
文献标志码:
A
摘要:
目的 探讨运用常规胸部、腹部CT检查中椎体CT值进行骨质疏松性椎体压缩性骨折（OVCF）的机会性筛查及评估的可行性。方法 回顾性分析2019年12月至2020年6月在我院进行胸部或者腹部CT检查、年龄≥60岁的1 229例患者临床资料，年龄60～99岁[中位年龄72（12）岁]，男性728例，女501例，并测量T12、L1椎体CT值，评价T12、L1椎体CT值与中、重度椎体压缩骨折的相关性。结果 T12、L1椎体CT值与患者年龄呈负相关（T12：r=-0.458，P＜0.01；L1：r=-0.445，P＜0.01）。椎体骨折组T12、L1椎体CT值均明显低于对照组[T12：（55.1±30.3）Hu vs （100.8±36.9）Hu，L1：（50.5±31.4）Hu vs （94.4±36.9）Hu]（均P＜0.01）；骨折椎体＜3节的患者T12、L1椎体CT值均高于骨折椎体≥3节的患者[T12：（60.8±28.1）Hu vs （37.3±30.4）Hu，L1：（56.8±28.6）Hu vs （30.8±32.1）Hu]（均P＜0.01）；椎体中度压缩骨折的患者T12、L1椎体CT值均高于椎体重度压缩骨折的患者[T12：（60.1±30.4）Hu vs （45.9±31.8）Hu，L1：（56.5±29.5）Hu vs （38.9±35.4）Hu]（均P＜0.05）。T12、L1椎体CT值ROC曲线对OVCF具有良好的诊断效能（T12：AUC=0.831，L1：AUC=0.818）；按患者年龄分层（60～69岁、70～79岁、≥80岁）进行亚组分析，60～69岁的患者T12、L1椎体CT值对椎体骨折的诊断效能最佳（T12：AUC= 0.866，L1：AUC= 0.843），而≥80岁的患者T12、L1椎体CT值对椎体骨折的诊断效能偏低（T12：AUC=0.760，L1：AUC=0.759）。二元logistics回归分析结果显示，T12 [OR=1.039，95% CI：1.032，1.046]、L1[OR=1.036，95% CI：1.030，1.043]椎体CT值是椎体骨折的独立危险因素。结论 常规胸部、腹部CT检查中T12、L1椎体CT值与 OVCF 密切相关，可作为骨质疏松症及OVCF机会性筛查的良好工具。
Abstract:
Objective To investigate the feasibility of opportunistic screening for osteoporotic vertebral compression fracture (OVCF) according to the trabecular attenuation (Hounsfield units, HU) of T12 and L1 from routine thoracic or abdominal CT examination. Methods 1, 229 patients whose age ≥60 years with thoracic or abdominal CT examination in our hospital from December 2019 to June 2020 were enrolled in the present study. Among these patients, aged from 60 to 99 years [M(QR) 72(12)], and 728 males and 501 females. Clinical data and the HU value of T12 and L1 trabecular attenuation were obtained, and compared between the OVCF group and the control group. Results The HU value of T12 and L1 trabecular attenuation were negatively correlated with age (T12: r=-0.458, P<0.01, L1: r=-0.445, P<0.01). The HU value of T12 and L1 trabecular attenuation in the OVCF group were significantly lower than the control group [T12: (55.1±30.3) Hu vs (100.8±36.9) Hu, L1: (50.5±31.4) Hu vs (94.4±36.9) Hu](P<0.01). In patients with fractured vertebral body <3 segments, the HU value of T12 and L1 trabecular attenuation were higher than those with fractured vertebral body ≥3 segments [T12, (60.8±28.1)Hu vs (37.3±30.4) Hu, L1, (56.8±28.6) Hu vs (30.8±32.1) Hu] (P<0.01). In patients with moderate vertebral compression fractures, the HU value of T12 and L1 trabecular attenuation were higher than those of severe vertebral compression fractures [T12, (60.1±30.4) Hu vs (45.9±31.8) Hu, L1, (56.5±29.5) Hu vs (38.9±35.4) Hu] (P<0.05). The ROC curve analysis shows that the HU value of T12 and L1 trabecular attenuation had good diagnostic efficacy for OVCF (T12: AUC=0.831, L1: AUC=0.818). The ROC curve of the HU value of T12 and L1 trabecular attenuation had the highest diagnostic performance for OVCF in patients of age range from 60-69 years (T12: AUC=0.866, L1: AUC=0.843) and the lowest diagnostic performance in patients of age ≥80 years (T12: AUC=0.760, L1: AUC=0.759). The results of binary logistics regression analysis showed that the HU value of T12 [OR=1.039, 95% CI: 1.032, 1.046] and L1[OR=1.036, 95% CI: 1.030，1.043] trabecular attenuation were independent risk factors for vertebral compression fractures. Conclusion The HU value of T12 and L1 trabecular attenuation in routine thoracic or abdominal CT examination are associated with OVCF, and may be an useful tool for osteoporosis and OVCF opportunistic screening.

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备注/Memo

备注/Memo:
基金项目：广东省医学科研基金（B2021117），广州市增城区科技计划项目（[2021]045号）
更新日期/Last Update: 2022-09-29