腰椎多层螺旋CT容积扫描用于老年女性骨质疏松症的价值及临床意义

The diagnostic value and clinical significance of multi-detector helical CT volumetric scanning of the lumbar vertebrae in senile women with osteoporosis

目的探讨在腰椎多层螺旋CT容积(multi-detector CT volumetric helical,MDCT VH)扫描中添加骨密度检查内容诊断骨质疏松症的准确性及临床意义。方法选取进行腰椎检查的体检者80名(56-68岁老年女性),分别采用多层螺旋CT容积扫描与定量CT(quantitative CT,QCT)两种方法测算受检者L2-L4椎体骨密度(bone mineral density,BMD),按照2007国际临床骨测量学会(ISCD)制定的QCT骨质疏松症诊断标准对同组受检者诊断,采用SPSS19.0软件分析两组骨质疏松诊断结果:L2BMD值、L3 BMD值、L4 BMD值、平均BMD(mean BMD)值、T值、Z值进行一致性分析,对两者间出现的差异与可能影响因素如:年龄、体质指数、腹围、臀围、扫描层面夹角等进行相关性研究。结果两种测量方法测量反映骨质疏松程度的meanBMD值、T值、Z值均无明显差异(P>0.05),且两法测量BMD值、T值相关性较高,BMD值的相关系数=0.975(P<0.05),T值的相关系数=0.97(P<0.05)。结论腰椎MDCT VH扫描骨密度测量具有诊断骨质疏松的效能,获取内容丰富,能间接减少患者辐射剂量、节约医疗成本,临床实用意义高,可尝试作为诊断骨质疏松的备选方案。

Objective To explore the diagnostic accuracy and clinical significance of multi-detector helical CT volumetric （MDCT VH） scanning of the bone mineral density （BMD） of the lumbar vertebrae.Methods A total of 80 senile women （56-68 years old） were selected.The MDCT volumetric scanning and QCT were used respectively to measured the L2-L4 BMD.The diagnosis was made according to 2007 osteoporosis diagnosis standard established by the International Society for Clinical Densitometry （ISCD）.The results in both groups, such as BMD of the L2-L4, the average BMD, T value, and Z value, were analyzed using a SPSS 19.0 software.The correlational analysis of the difference and possible influencing factors in both groups, such as age, body mass index, the abdominal circumference, the hip circumference, and the included angle of scanning plane, was also performed.Results No statistically significant difference of mean BMD value, T value, and Z value between the two methods was observed （ P〉0.05） .Both BMD and T value had high correlation with osteoporosis degree using the two methods. The correlation coefficient of BMD and T value were 0.975 and 0.973, respectively （ P 〈0.05 ） .Conclusion MDCT VH scanning of the lumbar vertebrae is efficient in the diagnosis of osteoporosis.The information collected is rich.The radiation dose is reduced indirectly.The medical cost is saved.It has high clinical practical significance, and can be used as the alternative method for the diagnosis of osteoporosis.