Genant H K, Block J E, Steiger P, Glueer C C, Smith R
Department of Radiology, University of California, San Francisco 94143.
Semin Nucl Med. 1987 Oct;17(4):316-33. doi: 10.1016/s0001-2998(87)80024-7.
Computed tomography (CT) has been widely investigated and applied in recent years as a means for noninvasive quantitative bone mineral determination. The usefulness of computed tomography for measurement of bone mineral lies in its ability to provide a quantitative image and, thereby, measure trabecular, cortical, or integral bone, centrally or peripherally. For measuring the spine, the potential advantages of quantitative computed tomography (QCT) over dual-photon absorptiometry (DPA) are its capability for precise three-dimensional anatomic localization providing a direct density measurement, and its capability for spatial separation of highly responsive cancellous bone from less responsive compact bone. Currently, QCT vertebral mineral determination has been implemented at over 800 sites encompassing a wide geographic distribution and a wide array of commercial scanners. With a world-wide distribution of approximately 8,000 advanced CT body scanners, the capability now exists for widespread application of vertebral bone mineral determination by quantitative computed tomography. These QCT techniques for vertebral mineral determination have been used to study skeletal changes in osteoporosis and other metabolic bone diseases. Longitudinal and cross-sectional bone mass measurements have been obtained at the University of California at San Francisco (UCSF) in over 3,000 patients seen clinically or on research protocols. The results presented here illustrate the use of QCT spinal mineral measurement in the delineation of normal age-related bone loss, in the evaluation of estrogen effects on bone, in the assessment of fracture threshold and risk, and in the study of the effects of various exercise regimens on bone mineral and the determination of relationships to other techniques of bone mineral measurement. The laboratory and clinical results presented herein indicate that QCT provides a reliable means to evaluate and monitor the many forms of osteoporosis and the various interventions aimed at ameliorating this condition. The greatest advantages of spinal QCT for noninvasive bone mineral measurement lie in the high precision of the technique, the high sensitivity of the vertebral trabecular measurement site, and the potential for widespread application.
近年来，计算机断层扫描（CT）作为一种无创定量骨矿物质测定方法得到了广泛研究和应用。计算机断层扫描用于测量骨矿物质的作用在于它能够提供定量图像，从而测量中央或外周的小梁骨、皮质骨或整体骨。对于测量脊柱，定量计算机断层扫描（QCT）相对于双能光子吸收测定法（DPA）的潜在优势在于其能够进行精确的三维解剖定位以提供直接密度测量，以及能够在空间上分离反应性高的松质骨和反应性低的密质骨。目前，QCT椎体矿物质测定已在800多个地点实施，这些地点分布广泛且使用了各种商业扫描仪。全球约有8000台先进的CT全身扫描仪，现在具备了通过定量计算机断层扫描广泛应用椎体骨矿物质测定的能力。这些用于椎体矿物质测定的QCT技术已被用于研究骨质疏松症和其他代谢性骨病中的骨骼变化。加利福尼亚大学旧金山分校（UCSF）对3000多名临床就诊或参与研究方案的患者进行了纵向和横断面骨量测量。此处呈现的结果说明了QCT脊柱矿物质测量在描绘正常年龄相关骨丢失、评估雌激素对骨的影响、评估骨折阈值和风险以及研究各种运动方案对骨矿物质的影响以及确定与其他骨矿物质测量技术的关系方面的应用。本文呈现的实验室和临床结果表明，QCT提供了一种可靠的手段来评估和监测多种形式的骨质疏松症以及旨在改善这种状况的各种干预措施。脊柱QCT用于无创骨矿物质测量的最大优势在于该技术的高精度、椎体小梁测量部位的高灵敏度以及广泛应用的潜力。
