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利用腹部和骨盆计算机断层扫描进行机会性骨密度测量以预测50至64岁无骨质疏松风险因素女性的骨折风险

Opportunistic Bone Density Measurement on Abdomen and Pelvis Computed Tomography to Predict Fracture Risk in Women Aged 50 to 64 Years Without Osteoporosis Risk Factors.

作者信息

Fang Jieming, Franconeri Andrea, Boos Johannes, Nimhuircheartaigh Jennifer, Zhang Zheng, Brook Alexander, Brook Olga R

机构信息

From the Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

出版信息

J Comput Assist Tomogr. 2018 Sep/Oct;42(5):798-806. doi: 10.1097/RCT.0000000000000744.

Abstract

OBJECTIVE

The aim of this study is to evaluate opportunistic vertebral bone density measurement in abdominal and pelvic computed tomography (CT) to predict future osteoporotic fracture in women aged 50 to 64 years without known osteoporosis risk factors.

METHODS

Consecutive female patients 50 to 64 years old without osteoporosis risk factors with 2 CT examinations more than 10 years apart were included. Vertebral height and bone density in each vertebra from T10 to L5 were measured. Vertebral fractures were diagnosed on CT preformed 10 years after the original CT and through online medical records.

RESULTS

Thirty (15%) of 199 patients developed osteoporotic fracture. Bone density was lower in patients who developed fractures compared with those who did not (P < 0.05). Development of osteoporotic fracture of any grade was predicted for patients having bone density less than 180 HU at L4 with sensitivity of 90% (95% confidence interval, 74%-97%) and specificity of 43% (95% confidence interval, 34%-50%).

CONCLUSIONS

Opportunistic bone density screening can identify women at elevated risk of developing fractures within 10 years.

摘要

目的

本研究旨在评估腹部和盆腔计算机断层扫描(CT)中的机会性椎体骨密度测量,以预测50至64岁无已知骨质疏松风险因素女性未来的骨质疏松性骨折。

方法

纳入年龄在50至64岁之间、无骨质疏松风险因素且两次CT检查间隔超过10年的连续女性患者。测量从T10至L5每个椎体的椎体高度和骨密度。通过原始CT检查10年后进行的CT及在线医疗记录诊断椎体骨折。

结果

199例患者中有30例(15%)发生骨质疏松性骨折。发生骨折的患者骨密度低于未发生骨折的患者(P<0.05)。对于L4骨密度低于180 HU的患者,预测任何等级骨质疏松性骨折发生的敏感性为90%(95%置信区间,74%-97%),特异性为43%(95%置信区间,34%-50%)。

结论

机会性骨密度筛查可识别出10年内发生骨折风险升高的女性。

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