Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Calcif Tissue Int. 2012 Jun;90(6):481-7. doi: 10.1007/s00223-012-9596-3. Epub 2012 Apr 7.
We obtained baseline and follow-up bone mineral density (BMD) values of the lumbar spine from sagittal reformations of routine abdominal contrast-enhanced multidetector computed tomography (MDCT) using a reference phantom and assessed their performance in differentiating patients with no, existing, and incidental osteoporotic fractures of the spine. A MDCT-to-QCT (quantitative computed tomography) conversion equation for lumbar BMD measurements was developed by using 15 postmenopausal women (63 ± 12 years), who underwent standard lumbar QCT (L1-L3) and afterward routine abdominal contrast-enhanced MDCT. Sagittal reformations were used for corresponding lumbar BMD measurements. The MDCT-to-QCT conversion equation was applied to baseline and follow-up routine abdominal contrast-enhanced MDCT scans of 149 postmenopausal women (63 ± 10 years). Their vertebral fracture status (no, existing, or incidental osteoporotic fracture) was assessed in the sagittal reformations. A correlation coefficient of r = 0.914 (p < 0.001) was calculated for the BMD values of MDCT and standard QCT with the conversion equation BMD(QCT) = 0.695 × BMD(MDCT) - 7.9 mg/mL. Mean follow-up time of the 149 patients was 20 ± 12 months. Fifteen patients (10.1 %) had an existing osteoporotic vertebral fracture at baseline. Incidental osteoporotic vertebral fractures were diagnosed in 13 patients (8.7 %). Patients with existing and incidental fractures showed significantly (p < 0.05) lower converted BMD values (averaged over L1-L3) than patients without fracture at baseline and at follow-up. In this longitudinal study, BMD values of the lumbar spine derived from sagittal reformations of routine abdominal contrast-enhanced MDCT predicted incidental osteoporotic vertebral fractures.
我们从常规腹部增强多排 CT（MDCT）的矢状重建中获得了腰椎的基线和随访骨密度（BMD）值，使用参考体模评估了它们在区分无、现有和偶然骨质疏松性脊柱骨折患者中的表现。通过使用 15 名绝经后女性（63 ± 12 岁）开发了用于腰椎 BMD 测量的 MDCT 至 QCT（定量计算机断层扫描）转换方程，这些女性接受了标准腰椎 QCT（L1-L3）检查，随后进行了常规腹部增强 MDCT 检查。矢状重建用于相应的腰椎 BMD 测量。将 MDCT 至 QCT 转换方程应用于 149 名绝经后女性（63 ± 10 岁）的基线和随访常规腹部增强 MDCT 扫描。在矢状重建中评估了她们的椎体骨折状态（无、现有或偶然骨质疏松性骨折）。用转换方程 BMD(QCT) = 0.695 × BMD(MDCT) - 7.9 mg/mL 计算的 MDCT 和标准 QCT 的 BMD 值的相关系数 r = 0.914（p < 0.001）。149 名患者的平均随访时间为 20 ± 12 个月。基线时有 15 名患者（10.1%）存在现有骨质疏松性椎体骨折。在 13 名患者（8.7%）中诊断出偶然骨质疏松性椎体骨折。基线时和随访时存在和偶然骨折的患者的转换 BMD 值明显（p < 0.05）低于无骨折的患者。在这项纵向研究中，常规腹部增强 MDCT 矢状重建的腰椎 BMD 值预测了偶然骨质疏松性椎体骨折。
