Burian Egon, Grundl Lioba, Greve Tobias, Junker Daniela, Sollmann Nico, Löffler Maximilian, Makowski Marcus R, Zimmer Claus, Kirschke Jan S, Baum Thomas
Department of Diagnostic and Interventional Neuroradiology, Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.
Department of Diagnostic and Interventional Radiology, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.
Diagnostics (Basel). 2021 Feb 4;11(2):240. doi: 10.3390/diagnostics11020240.
In this case-control study the value of bone mineral density (BMD) at different vertebral levels, subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) to identify patients with incident osteoporotic vertebral fractures in routine multi-detector computed tomography (MDCT) exams was assessed.
Seventeen patients who underwent baseline and follow-up routine contrast-enhanced MDCT and had an incident osteoporotic vertebral fracture at follow-up were included. Seventeen age-, sex- and follow-up duration-matched controls were identified. Trabecular BMD (from Th5 to L5) as well as cross-sectional area of SAT and VAT were extracted.
BMD performed best to differentiate patients with an incident fracture from controls at the levels of Th5 (area under the curve [AUC] = 0.781, = 0.014), Th7 (AUC = 0.877, = 0.001), and Th9 (AUC = 0.818, = 0.005). Applying multivariate logistic regression BMD at Th7 level remained the only significant predictor of incident vertebral fractures (Th5-L5) with an odds ratio of 1.07 per BMD SD decrease. VAT and SAT did not show significant differences between the fracture and control group ( > 0.05).
The local BMD measurement appears to be more suitable than standard mean BMD from L1-L3 for fracture risk assessment.
在这项病例对照研究中，评估了在常规多排螺旋计算机断层扫描（MDCT）检查中，不同椎体水平的骨密度（BMD）、皮下脂肪组织（SAT）和内脏脂肪组织（VAT）对于识别新发骨质疏松性椎体骨折患者的价值。
纳入17例接受了基线和随访常规增强MDCT检查且在随访时发生骨质疏松性椎体骨折的患者。确定了17例年龄、性别和随访时间匹配的对照。提取了第5胸椎至第5腰椎的小梁骨密度以及SAT和VAT的横截面积。
在第5胸椎（曲线下面积[AUC]=0.781，P=0.014）、第7胸椎（AUC=0.877，P=0.001）和第9胸椎（AUC=0.818，P=0.005）水平，BMD在区分新发骨折患者与对照方面表现最佳。应用多因素逻辑回归分析，第7胸椎水平的BMD仍然是新发椎体骨折（第5胸椎至第5腰椎）的唯一显著预测因素，每降低1个BMD标准差，优势比为1.07。VAT和SAT在骨折组与对照组之间未显示出显著差异（P>0.05）。
对于骨折风险评估，局部BMD测量似乎比L1-L3的标准平均BMD更合适。
