摘要
目的探讨在低剂量CT肺癌筛查联合定量CT骨密度检查中,以测量T12椎体骨密度替代病变的L1或L2用于骨质疏松诊断的可行性。方法选取1 298名接受低剂量CT肺癌筛查联合定量CT骨密度检查的健康体检者,测量其T12、L1、L2椎体骨密度,并计算校准的T12骨密度,记为T12^*。以L1+L2为诊断标准,分别分析各椎体组合T12+L1、 T12+L2、 T12^*+L1、T12^*+L2与L1+L2评估骨量的一致性和诊断骨质疏松的差异性。结果各椎体组合与L1+L2评估骨量的一致性均较好(Kappa 均>0.75,P均<0.05)。各椎体组合诊断骨质疏松的特异度均>98%。T12+L1、 T12+L2 诊断骨质疏松的敏感度分别为73.33%(143/195)及77.95%(152/195);而T12^*+L1、T12^*+L2诊断骨质疏松的敏感度分别为83.08%(162/195)及90.26%(176/195)。结论定量CT测量T12骨密度替代病变L1或L2,可能降低诊断骨质疏松的敏感度,应对其进行校准。
Objective To explore the feasibility of bone mineral density (BMD) of T12 for replacing abnormal L1 or L2 for diagnosis of osteoporosis during lung cancer screening with low-dose CT and bone mineral density examination with quantitative CT.Methods Totally 1 298 healthy individuals who underwent lung cancer screening with low-dose CT and BMD examination with quantitative CT were enrolled.BMD of T12 to L2 vertebrae were measured,and the calibrated BMD of T12 was calculated and recorded as T12^*.Taking L1+L2 as diagnostic criteria,the consistencies in bone mass assessment and the differences in diagnosis of osteoporosis among vertebral combinations of T12+L1,T12+L2,T12^*+L1,T12^*+L2 and L1+L2 were analyzed,respectively.Results There were good consistencies between vertebral combinations and L1+L2 in bone mass assessment (all Kappa >0.75,all P<0.05).The specificities of vertebral combinations in osteoporosis diagnosis were all >98%.The sensitivities of T12+L1 and T12+L2 in osteoporosis diagnosis were 73.33%(143/195) and 77.95%(152/195),respectively,whereas of T12^*+L1 and T12^*+L2 in osteoporosis diagnosis were 83.08%(162/195) and 90.26%(176/195),respectively.Conclusion BMD of T12 for replacing abnormal L1 or L2 during quantitative CT can reduce the sensitivity in diagnosis of osteoporosis,therefore BMD of T12 should be calibrated in measurement.
作者
潘亚玲
陈彤彤
王晗琦
程晓光
陆勇
PAN Yaling;CHEN Tongtong;WANG Hanqi;CHENG Xiaoguang;LU Yong(Department of Radiology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Radiology,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《中国医学影像技术》
CSCD
北大核心
2019年第7期1086-1090,共5页
Chinese Journal of Medical Imaging Technology
基金
上海市科学技术委员会科研计划项目(17411964900)
重大疾病防治科技行动计划(2017ZX01001-S12)
关键词
骨质疏松
胸椎
腰椎
骨密度
体层摄影术
X线计算机
osteoporosis
thoracic vertebra
lumbar vertebra
bone density
tomography,X-ray computed