【摘要】 目的 比较双能X线骨密度仪(dual-energy X-ray absorptiometry,DXA)和多层螺旋CT(multi-slice spiral CT,MSCT)在腰椎骨密度诊断的准确性,探讨MSCT在骨量减少和骨质疏松症中的诊断价值。方法 经腰椎DXA测量诊断为骨量减少65例行MSCT扫描及后重组处理。取L3椎体轴位椎弓根层面按前、中、后和左、中、右部位设定9个CT测量感兴趣区(ROI)测量CT值,评判标准:正常骨质,男>120 HU,女>110 HU;骨量减少,男110～120 HU,女100～110 HU;轻度骨质疏松,男100～110 HU,女90～100 HU;中度骨质疏松,男80～100 HU,女80～90 HU;重度骨质疏松,男、女均<80 HU。测量结果行统计学处理。结果(1)骨密度测量:男性T值为-1.1～-2.3,平均-1.5±0.5;女性T值为-1.1～-2.4,平均-1.8±0.4。(2) CT值测量:65例中,骨量减少仅有6例,正常骨量15例,轻度骨质疏松6例,中度骨质疏松9例,重度骨质疏松29例。(3)腰椎CT伴随征象:65例中,伴随征象有腹主动脉壁钙化,腰椎、椎小关节、椎旁韧带及椎间盘退行性变,椎体不同程度压缩性骨折等。结论 MSCT比DXA诊断腰椎骨量减少、骨质疏松及骨质疏松性骨折更有临床价值,两者结合能够提高诊断准确率。更多还原

【Abstract】 Objective To compare the diagnostic accuracy of bone mineral density(BMD) in the lumbar vertebrae between the dual-energy X-ray absorptiometry(DXA) and multi-slice spiral CT(MSCT),and to evaluate the diagnostic value of MSCT for osteopenia and osteoporosis.Methods 65 cases of osteopenia diagnosed by DXA performed lumbar vertebra MSCT examination.The CT value of cancellous bone in pedicle level of the third lumbar vertebrae was measured on 9 regions of interest at the front,middle,rear,left,middle and right area.The judgment standard of normal bone mass were:male>120 HU,female>110 HU;osteopenia:male 110-120 HU,female 100-110 HU;mild osteoporosis:male 100-110 HU,female 90-100 HU;moderate osteoporosis:male 80-100 HU,female 80-90 HU;severe osteoporosis:male<80 HU,female<80 HU.All results were analyzed by statistical methods.Results(1)Among 65 cases of osteopenia patients,the T-score values of male were from-1.1 to-2.3,average-1.5±0.5,female were from-1.1 to-2.4,average-1.8±0.4 on BMD measurement.(2)On CT value measurement,there were normal bone mass(n=15),osteopenia(n=6),mild osteoporosis(n=6),moderate(n=9),and severe(n=29).(3)Accompanying signs in lumbar CT:there were calcifications of the abdominal aortic wall,degeneration in the lumbar body,facet joints,paravertebral ligaments and inter-vertebral disc,and vertebral compression fractures at different degree.Conclusion MSCT has some important values in the diagnosis of osteopenia,osteoporosis and osteoporotic fractures of the lumbar vertebrae than DXA.MSCT can improve the diagnostic accuracy of osteopenia,osteoporosis and osteoporotic fractures in the lumbar vertebrae combining with DXA.更多还原