Study on CT value of cancellous bone in lumbar spine in diagnosis of osteoporotic fracture
腰椎体松质骨CT值诊断骨质疏松性骨折的研究

摘要

目的 探究腰椎体松质骨CT值诊断骨质疏松性骨折的价值。方法 将24例于我院行常规腰椎CT平扫的骨质疏松性骨折患者前瞻性纳入研究，并设定为观察组；另将24例年龄、BMI相匹配的无骨折患者纳入研究，并设定为对照组。通过单ROI法取得患者L1椎体松质骨的CT值，双能X线骨密度仪（DXA）取得L1椎体的骨密度（BMD）T值。对比两组L1椎体CT值及BMD-T值差异并分析其相关性，通过ROC曲线分析松质骨CT值及BMD-T值诊断骨质疏松性骨折的价值。结果 观察组L1椎体CT值及BMD-T值显著低于对照组，组间对比明显（P＜0.05）。且两组L1椎体CT值及BMD-T值均呈现正相关（r=0.739、0.374，P＜0.05）；松质骨CT值及BMD-T值鉴别诊断骨质疏松性骨折的价值差异无统计学意义（P＞0.05）。结论 腰椎体松质骨CT值可用于鉴别诊断骨质疏松性骨折患者，且具有较高敏感性。

Abstract

Objective To evaluate the CT value of cancellous bone of lumbar spine in the diagnosis of osteoporotic fracture.
Methods A total of 24 patients with osteoporotic fractures who underwent routine CT scan in our hospital were prospectively included in the study and assigned as the observation group. In addition, 24 patients with no fracture matching age and BMI were included in the study and set as the control group. CT values of cancellous bone of L1 vertebral body were obtained by single ROI method, and bone mineral density (BMD) T values of L1 vertebral body were obtained by dual-energy X-ray absorptiometry (DXA). The difference of CT value and BMD-T value of L1 vertebra between the two groups was compared and the correlation was analyzed. The value of cancellous bone CT value and BMD-T value in the diagnosis of osteoporotic fracture was analyzed by ROC curve.
Results The CT and BMD-T values of L1 vertebra in observation group were significantly lower than those in control group, and the comparison between groups was significant (P < 0.05). CT and BMD-T values of L1 vertebra were positively correlated between the two groups (r=0.739, 0.374, P < 0.05). There was no significant difference between CT and BMD-T values of cancellous bone in the differential diagnosis of osteoporotic fractures (P > 0.05).
Conclusion   CT values of lumbar cancellous bone can be used in the differential diagnosis of osteoporotic fractures with high sensitivity.