Micro-CT参数对骨质疏松性椎体压缩性骨折术后复发的预测价值

Predictive Value of Micro-CT Parameters for Postoperative Recurrence of Osteoporotic Vertebral Compression Fractures

本研究探讨Micro-CT参数对骨质疏松性椎体压缩性骨折(OVCF)患者术后复发的预测价值。选取OVCF患者127例,根据术后6个月骨折复发情况分为复发组(n=41)与未复发组(n=86)。患者均接受Micro-CT检查,对比两组Micro-CT参数,即骨体积分数(BV/TV)、骨小梁厚度(Tb.Th)、骨小梁间隙(Tb.Sp)、结构模型指数(SMI),以及骨密度(BMD)、骨矿含量(BMC),分析各参数与BMD、BMC及术后复发相关性,并评价各参数对术后复发的预测价值。结果显示,复发组骨体积分数(BV/TV)、骨小梁厚度(Tb.Th)低于未复发组,骨小梁间隙(Tb.Sp)、结构模型指数(SMI)高于未复发组(P<0.05);BV/TV、Tb.Th与骨密度(BMD)、骨矿含量(BMC)呈正相关,Tb.Sp、SMI与BMD、BMC呈负相关(P<0.05);将年龄、BMD、BMC等其他因素控制后,BV/TV、Tb.Sp、Tb.Th、SMI与OVCF术后骨折复发显著相关(P<0.05);BV/TV、Tb.Sp、Tb.Th、SMI联合预测OVCF术后骨折复发的曲线下面积(AUC)最大,为0.888(P<0.05)。提示Micro-CT参数在OVCF患者中呈异常表达,采用Micro-CT检查可为临床预测OVCF术后骨折复发提供科学指导。

The predictive value of Micro-CT parameters for postoperative recurrence of osteoporotic vertebral compression fractures(OVCF) were explored. A total of 127 patients with OVCF in our hospital were selected and divided into recurrence group(n=41) and non-recurrence group(n=86) according to their fracture recurrence 6 months after operation. All patients received Micro-CT examination. Micro-CT parameters [bone volume fraction(BV/TV), bone trabecular thickness(Tb.Th), bone trabecular space(Tb.Sp), structure Model index(SMI)], bone mineral density(BMD) and bone mineral content(BMC) were compared.The correlation of each parameter with BMD, BMC and postoperative recurrence was analyzed, and the predictive value of each parameter for postoperative recurrence was evaluated. The results showed that the bone volume fraction(BV/TV) and bone trabecular thickness(Tb.Th)of the recurrence group were lower than those of the non-recurring group,and the bone trabecular space(Tb.Sp)and structural model index(SMI)were higher than those of the non-recurring group(P<0.05);BV/TV and Tb.Th were positively correlated with bone mineral density(BMD)and bone mineral content(BMC),and Tb.Sp and SMI were negatively correlated with BMD and BMC(P<0.05).After BMD,BMC and other factors were controlled,BV/TV,Tb.Sp,Tb.Th,SMI were significantly related to fracture recurrence after OVCF(P<0.05);BV/TV,Tb.Sp,Tb.Th and SMI were combined,the area under the curve(AUC)for predicting postoperative fracture recurrence after OVCF was the largest,which is0.888(P<0.05).It is suggested that Micro-CT parameters are abnormally expressed in OVCF patients,and the use of Micro-CT examination can provide scientific guidance for clinical prediction of fracture recurrence after OVCF.