CT能谱成像与定量CT技术对骨质疏松的诊断效能分析

Diagnostic Efficacy Analysis of CT Spectroscopy and Quantitative CT in Osteoporosis

目的:分析骨质疏松诊断中CT能谱成像与定量CT技术的诊断效能差异.方法:选取2020年2月—2022年1月于本院进行体检的200例疑似骨量减少者为研究对象,分别采用CT能谱成像及定量CT测定骨密度,并实施双能X线骨密度(DXA)测定(金标准),以金标准为标准,观察2种诊断方式的诊断效能.结果:DXA诊断结果显示,骨质疏松阳性96例,阴性104例;定量CT诊断结果显示,骨质疏松阳性78例,阴性122例,CT能谱成像技术诊断结果显示,骨质疏松阳性90例,阴性106例.基于DXA诊断结果,骨质疏松诊断中CT能谱成像技术的诊断灵敏度为92.71%,特异性为93.27%,阳性预测值为93.68%,阴性预测值为93.27%,综合诊断准确率为93.00%,均高于定量CT的64.58%,84.62%,79.49%,72.13%,77.00%,差异有统计学意义(P<0.05);在骨质疏松群体、低骨量群体及正常骨量群体中,CT成像技术得到的骨密度均高于CT定量成像,差异有统计学意义(P<0.05).结论:在骨质疏松的诊断筛查中,能谱CT较定量CT具有显著优势,其可提供更为准确的诊断效能,具有重要应用价值.

Objective:To analyze the difference between CT spectral imaging and quantitative CT in the diagnosis of osteoporosis.Methods:200 patients with suspected bone loss who underwent physical examination in our hospital from February 2020 to January 2022 were selected as the study objects.Bone mineral density(BMD)was determined by CT spectroscopy and quantitative CT,and dual-energy X-ray(DXA)bone mineral density(gold standard)was applied to observe the diagnostic efficacy of the two diagnostic methods.Results:The results of DXA showed that 96 patients were positive for osteoporosis and 104 were negative.Quantitative CT diagnostic results showed that 78 cases were positive for osteoporosis and 122 were negative.CT energy spectrum imaging diagnostic results showed that 90 cases were positive for osteoporosis and 106 were negative.Based on the diagnosis results of DXA,the diagnostic sensitivity,specificity,positive predictive value and negative predictive value of CT imaging for osteoporosis diagnosis were 92.71%,93.27%,93.68%,93.27%,and the comprehensive diagnostic accuracy was 93.00%,all higher than 64.58%,84.62%,79.49%,72.13%,77.00%of the control group.the differences between groups were statistically significant(P<0.05);In osteoporosis,low bone mass and normal bone mass,BMD obtained by CT imaging was higher than that obtained by quantitative CT imaging,and the differences were statistically significant(P<0.05).Conclusion:In the diagnosis and screening of osteoporosis,energy spectrum CT has significant advantages over quantitative CT,which can provide more accurate diagnostic efficiency and has important application value.