老年女性椎后伸肌群肌肉面积及密度与腰椎定量CT骨密度的相关性研究

The relationship between cross-sectional area and average CT value of posterior vertebral extensor group and bone mineral density in postmenopausal women

目的探讨老年女性椎后伸肌群肌肉面积及密度与腰椎定量CT（QCT）骨密度的关系。方法连续选取2015年12月至2016年12月在该医院行腰椎QCT骨密度测量的114例女性患者,年龄55-87岁。将原始图像传至图像后处理工作站,采用Mindways QCT Pro软件,分别测量L2-L4椎体骨密度。由2名诊断医师于L4椎体水平轴位CT图像上分别测量双侧椎后伸肌群横截面积（CSA）与平均CT值,并对数据进行统计分析,探讨其与腰椎QCT骨密度的相关性。结果不同侧别间腰部椎后肌群平均CT值差异有统计学意义（P〈0.01）;腰部椎后伸肌群平均CT值与腰椎定量CT骨密度呈正相关（P〈0.01）;腰部椎后伸肌群横截面积与腰椎QCT骨密度之间无明显相关性。结论腰部椎后伸肌群肌量减少可能是腰椎骨质疏松的重要危险因素;在评价腰部椎后伸肌群变化时,测量其肌肉密度相比横截面积更有意义。

Objective To investigate the relationship between cross-sectional area（CSA）and average CT value of posterior vertebral extensor group and bone mineral density（BMD）in postmenopausal women.Methods Totally 114 postmenopausal women being eligible for inclusion were enrolled.All the subjects,ages range from 55 to 87years old,underwent quantitative computed tomography（QCT）scans from December 2015 to December 2016 in Beijing Jishuitan Hospital.The original image was transmitted to the image postprocessing workstation,using Mindways QCT Pro software,vertebral bone mineral density of L2-L4 were measured.CSA and average CT value of bilateral posterior vertebral muscles were measured by 2diagnostic physicians in the L4 vertebral body horizontal axis CT images,and analyzed respectively.Results Average CT values of posterior vertebral muscles between the left and the right side had a significant difference（P〈0.01）.The average CT value of bilateral posterior vertebral muscles was positively correlated with lumbar bone mineral density measured by QCT（P〈0.01）.There was no significant correlation between the CSA of posterior vertebral extensor group and BMD.Conclusion The loss of posterior vertebral muscle mass may be an important risk factor for osteoporosis.The average CT value of posterior vertebral extensor group is more promising than CSA in the evaluation of the degenerative muscles.