能谱CT物质分离技术诊断腰椎骨质疏松的临床效能研究

Clinical Efficacy Study Ondual-Energy CT Material Separation Technique inthe Diagnosis of Lumbar Osteoporosis

目的 探讨能谱CT物质分离技术诊断腰椎骨质疏松的临床效能。方法 回顾性分析行腰椎能谱CT及双能X线骨密度仪(DXA)检查的患者数据。据DXA结果将其分为骨质疏松组(OP)与非骨质疏松组(non-OP)。测量每个患者L~L椎体松质骨的各物质对值,包括HAP(Fat)、HAP (Water)、Fat(HAP)、Fat(Calcium)、Calcium(Fat)、Calcium(Water)。用受试者工作特性(ROC)曲线分析各物质对诊断骨质疏松的效能并计算最优物质对诊断骨质疏松的阈值及敏感度、特异度。结果 OP与non-OP组各物质对均值均存在明显统计学差异。各物质对的ROC曲线下面积均大于0.7。Fat(Calcium)曲线下面积最大,阈值取986.01 mg/cm~3时,诊断骨质疏松的敏感度及特异度分别为90.70%、81.25%。结论 人体腰椎能谱CT物质分离技术对骨质疏松的诊断有较高的效能。

Objective To explore the clinical efficacy of dual energy CT material separation technique in the diagnosisof lumbar osteoporosis.Methods The data of 50 patients who underwent DECT and dual energy X ray absorptiometry(DXA) of lumar spine were analyzed retrospectively. According to the results of DXA which were used as the gold standardfor diagnosing osteoporosis,they were divided into two groups,osteoporotic group( OP) and non-osteoporotic group( non-op). The concentration of HAP(Fat)、HAP(Water)、Fat(HAP)、Fat(Calcium)、Calcium(Fat),Calcium(Water) at cen-tral part of L1-L4centrum of spongy bone were measured. The measurements of the research group were analyzed and the re-ceiver operator characteristic curve(ROC) was used to analyze and evaluate the diagnostic threshold of osteoporosis.Results There were significant statistical differences in the concentration of each substance of DECT between OP and non-OP,and the area under the curve(AUC) of ROC were all greater than 0. 75. The AUC of FAT(Calcium) was 0. 929. Whenthe threshold was 986. 01 mg/cm3,the sensitivity and specificity of osteoporosis were 90. 70% and 81. 25% respectively.Conclusion Quantitative parameters of DECT material separation technique have high clinical efficacy for the diagnosis oflumbar osteoporosis.