多层螺旋CT评价慢性阻塞性肺病患者骨质疏松的临床应用研究

Clinical application of MSCT in evaluation of osteoporosis in patients with chronic obstructive pulmonary disease

目的探讨多层螺旋cT评价慢性阻塞性肺病((20PD)患者骨质疏松的临床应用价值。方法 50例COPD患者((;OPD组)及130例同年龄健康体检者(健康对照组)行胸部多层螺旋cT扫描并测T10-T。L。椎体cT值。健康对照组L,、T10-T1:椎体CT值进行线性相关分析,以单侧95%可信区间确定胸椎CT值测量正常参考值范围。COPD组cT值的测量与DXA测量结果采用z2检验进行比较。结果健康对照组T10-T1:椎体平均cT值:男性(142.6-4-27.2)Hu,女性(141.9士26.5)Hu,L1与T旷T,:椎体cT值及3椎体平均CT值呈直线正相关(r=0.859、0.893、0.959、0.936,均P<0.01);椎弓根层面CT值下限为男性136.5 Hu,女性134.5 HU。比较COPD组多层螺旋cT测量C'r值和DXA测量腰椎骨密度的检出率(矿=4.780,P<0.05),多层螺旋CT测量cT值评价骨质疏松的检出率高于DXA测量骨密度。结论胸部多层螺旋CT测胸椎cT值是评价COPD患者胸椎骨质改变敏感且简便的方法,具有一定的临床应用价值。

Objective To explore the clinical value of multi-slice spiral CT in the evaluation of osteoporosis in patients with chronic obstructive pulmonary disease （COPD）. Methods 50 patients with COPD （COPD group） and 130 healthy volunteers at the same age （healthy control group）underwent chest multi-slice spiral CT scan, then the CT value of T10 - T12, LI of vertebra were measured. Linear correlation was applied to analyze the CT value of L1 and T10 -T12 vertebra from healthy control group, and the normal reference range of CT values in the thoracic spine were determined by unilateral 95% confidence interval. Compared the result of COPD group between CT and DXA with chi-square test. Results The mean CT value of T10-T12 vertebra in healthy control group was （142.6±27.2）HU for male, （141.9±26.5）HU for female. There was a linear positive correlation between the L1 CT value and T10 - T12 CT value, L1 CT value and the mean value of the three vertebrae （ r = 0.859, 0.893, 0.959, 0.936; P 〈 0.01）; and the minimum CT value was 136.5 HU for male and 134.5 HU for female in pedicle level. Detectable rate was significantly higher by the MSCT compared to DXA in the COPD group （χ^2= 4.780, P 〈 0.05）. Conclusion Measuring the CT value of thoracic vertebra by chest MSCT scan is a sensitive and simple method with certain clinical application value.