老年女性髋部骨折患者大腿上部软组织三维CT定量研究

Three-dimensional quantitative study of the upper Thigh's soft tissue at CT for elderly women with hip fracture

目的:探讨大腿上端软组织三维CT参数在评估老年女性低能量髋部骨折风险中的价值。方法:回顾性搜集2019年1月-2021年1月因跌倒行髋部CT检查的老年女性的临床及CT资料。按照有无髋部骨折分为骨折组与未骨折组。在CT后处理工作站上人工测量骨折健侧及未骨折组右侧大腿上部肌肉体积(VMT)、肌间脂肪体积(VIMAT)、皮下脂肪体积(VSAT)以及T_(20)(小转子上方20 mm处)股骨颈长径皮质比率。比较两组患者的临床资料及上述CT参数的差异。结果:30例低能量髋部骨折患者与34例未骨折者的年龄、身高、体重及BMI无统计学差异。骨折组T_(20)长径皮质比率及大腿上部肌肉体积均明显小于未骨折组(11.59%±1.42 vs 14.31%±2.55,P<0.001;299.80±42.32 mm^(3) vs 323.79±39.82mm^(3),P=0.023)。结论:除股骨颈骨皮质厚度,CT测量的大腿上部肌肉体积可作为评估老年女性低能量髋部骨折的风险指标。

Objective:To explore the value of three-dimensional quantitative parameters of the upper thighs’soft tissue at CT in evaluating the risk of low-trauma hip fracture in elderly women.Methods:The retrospective study was performed on elderly female patients who underwent hip CT scans due to fall in our hospital from Jan 2019 to Jan 2021.Clinical characteristics and CT images were retrospective collected.The patients were divided into hip fracture group and non-hip fracture group.Volume of muscle tissue(VMT),volume of intramuscular adipose tissue(VIMAT),volume of subcutaneous adipose tissue(VSST)of the upper thigh,and T_(20)(at the level of 20mm higher than the apex of lesser trochanter)cortex ratio of the femoral neck were manual measured in the normal side of hip fracture group and right side of non-hip fracture group at CT workstation.The clinical characteristics and CT quantitative parameters were compared between the two groups.Results:There were 30 elderly women with low-trauma hip fractures and 34 elderly women without hip fractures.There were no significant differences in mean age,height,weight,and body mass index(BMI)between the two groups(all P>0.05).Hip fracture subjects had a lower femoral neck’s cortex ratio of T_(20) long diameter and VMT than control subjects(11.59%±1.42 vs.14.31%±2.55,P<0.001,P<0.001;299.80±42.32mm^(3) vs.323.79±39.82mm^(3),P=0.023).Conclusion:In addition to the cortical thickness of the femoral neck,the volume of the upper thigh muscle measured at CT could also be used to assess the risk of low-trauma hip fracture for elderly women.