Walter Reed National Military Medical Center.
Uniformed Services University of the Health Sciences, Bethesda, MD.
Clin Spine Surg. 2020 Mar;33(2):E58-E62. doi: 10.1097/BSD.0000000000000879.
A retrospective cohort.
The objective of this study to determine the correlation between Hounsfield unit (HU) measurements from the C4 vertebral body and dual-energy x-ray absorptiometry (DXA) T-score.
Recent attention has turned to the utilization of HU measurements from computed tomography (CT) as a potential screening method for low bone mineral density (BMD). We hypothesized that cervical spine CT HU measurements will correlate with BMD measurements conducted with DXA scans of the femoral neck.
Patients with cervical CT and femoral neck DXA scans at 1 institution were included in the study. HUs were manually measured from the cancellous bone in the C4 vertebrae by 1 author blinded to DXA scans. HU measurements were compared with femoral neck DXA T-scores for the entire population.
A total of 149 patients with 149 cervical CT and femoral neck DXA scans were included in the study. The low BMD group (osteoporotic and osteopenic combined) showed a significant difference in HU compared with the normal groups within the study (P<0.0001). A low BMD screening value of 447 HU captured over 95% of patients with low BMD within our study and provided a sensitivity of 92% and negative predictive value of 82.1%. The male and female intrasex analysis demonstrated a significant difference between the low BMD and normal BMD groups with P=0.001 and P=0.0001, respectively.
HU measurements taken from the C4 vertebral body on CT scan correlate with low BMD of the femoral neck as determined by DXA scan T-scores. Screening values of 447 HU captured 95% of patients with low BMD, with a high degree of sensitivity, and negative predictive value of 80%. Utilization of cervical spine HU as a screening method provides a simple, quick, and easily assessable screening tool for assessing low BMD.
Level III-diagnostic.
回顾性队列研究。
本研究旨在确定 C4 椎体的 Hounsfield 单位 (HU) 测量值与双能 X 射线吸收法 (DXA) T 评分之间的相关性。
最近人们开始关注 CT 中的 HU 测量值作为一种潜在的低骨密度 (BMD) 筛查方法。我们假设颈椎 CT 的 HU 测量值将与股骨颈 DXA 扫描的 BMD 测量值相关。
本研究纳入了 1 家机构的颈椎 CT 和股骨颈 DXA 扫描患者。1 位作者对 DXA 扫描进行盲法，手动测量 C4 椎体松质骨的 HU 值。HU 值与全人群的股骨颈 DXA T 评分进行比较。
共纳入 149 例颈椎 CT 和股骨颈 DXA 扫描患者。低 BMD 组（骨质疏松症和骨量减少）与研究中的正常组相比，HU 值有显著差异（P<0.0001）。低 BMD 筛查值 447 HU 可捕获本研究中超过 95%的低 BMD 患者，具有 92%的敏感性和 82.1%的阴性预测值。男女同性别分析显示，低 BMD 组与正常 BMD 组之间存在显著差异，P 值分别为 0.001 和 0.0001。
CT 扫描中 C4 椎体的 HU 值与 DXA 扫描 T 评分确定的股骨颈低 BMD 相关。筛查值 447 HU 可捕获 95%的低 BMD 患者，具有较高的敏感性和 80%的阴性预测值。利用颈椎 HU 值作为筛查方法，为评估低 BMD 提供了一种简单、快速、易于评估的筛查工具。
III 级-诊断。
