Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima-shi 734-8551, Japan.
Radiology. 2011 Aug;260(2):472-9. doi: 10.1148/radiol.11101746. Epub 2011 Apr 14.
To evaluate the accuracy of trabecular analysis of the lumbar spine by using multidetector computed tomography (CT) in differentiating multiple myeloma patients without spinal fractures from control subjects.
This retrospective single-institution study was approved by the institutional review board, with a waiver of informed consent. Spinal microarchitecture was examined by using 64-detector row CT in 29 patients with multiple myeloma and 51 control subjects. The patients were 13 men and 16 women (mean ages, 71.1 and 69.2 years, respectively). By using multidetector CT data, eight parameters were calculated for the L3 vertebral trabeculae with a three-dimensional image analysis system. The χ(2) test was used to select a preliminary set of predictors for multiple myeloma. A multivariable generalized linear model was constructed to identify parameters that could be used to differentiate between patients and controls. Parameters with findings of P < .05 were included in the multivariable model.
Generalized linear models showed that mean trabecular thickness (TbTh) (patients, 703.7 μm ± 46.7 [standard deviation]; controls, 661.1 μm ± 35.7) and fractal dimension (FD) (patients, 2.23 ± 0.24; controls, 2.41 ± 0.15) in men (P = .05 and .03, respectively) and degree of anisotropy (DA) (patients, 1.63 ± 0.23; controls, 1.38 ± 0.10) in women (P = .02) had significant effects in differentiation between patients and controls.
Significant differences were observed in spinal microarchitecture between control subjects and multiple myeloma patients without pathologic fractures. Independent predictors of multiple myeloma included TbTh and FD in male patients and DA in female patients.
通过使用多层螺旋 CT（MSCT）评估腰椎小梁分析对无脊柱骨折的多发性骨髓瘤患者与对照组的鉴别准确性。
本回顾性单中心研究经机构审查委员会批准，豁免知情同意。对 29 例多发性骨髓瘤患者和 51 例对照组患者进行 64 排 CT 检查。患者中男 13 例，女 16 例（平均年龄分别为 71.1 岁和 69.2 岁）。使用三维图像分析系统对 L3 椎体小梁，通过多层 CT 数据计算 8 个参数。采用卡方检验选择多发性骨髓瘤的初步预测因子。建立多变量广义线性模型，以确定可用于区分患者和对照组的参数。将 P<.05 的参数纳入多变量模型。
广义线性模型显示，男性患者平均小梁厚度（TbTh）（患者，703.7μm±46.7[标准差]；对照组，661.1μm±35.7）和分形维数（FD）（患者，2.23±0.24；对照组，2.41±0.15）（P=.05 和 P=.03），女性患者的各向异性度（DA）（患者，1.63±0.23；对照组，1.38±0.10）（P=.02）在患者和对照组之间具有显著差异。
无病理性骨折的多发性骨髓瘤患者与对照组之间的脊柱微观结构存在显著差异。多发性骨髓瘤的独立预测因子包括男性患者的 TbTh 和 FD，以及女性患者的 DA。
