Department of Neurological Surgery, University of Miami MILLER School of Medicine, Miami, Florida, USA.
Department of Neurological Surgery, University of Miami MILLER School of Medicine, Miami, Florida, USA.
World Neurosurg. 2021 Jul;151:e418-e425. doi: 10.1016/j.wneu.2021.04.051. Epub 2021 Apr 20.
Computed tomography Hounsfield unit (HU) is an alternative tool to the dual energy x-ray absorptiometry scan T-score to quantify the bone quality. DEXA scan can overestimate the bone mineral density. We studied the correlation of the vertebral mid-axial and mid-sagittal HU to the T-score.
We retrospectively reviewed the electronic medical records of patients who underwent dual energy x-ray absorptiometry and computed tomography scans within 1 year. Age, sex, mid-axial and mid-sagittal HU, and T-score were collected and statistically analyzed.
We identified 100 patients with computed tomography of the L1-L4. There were 80 female and 20 male patients. The average age was 60.25 years (±12.54 years). Nineteen patients were diagnosed with degenerative spine disease. There were 56 patients with a normal T-score, 33 with osteopenia, and 11 with osteoporosis. The average HU for the mid-sagittal view was 163 (±59) for L1, 159 (±62) for L2, 151 (±59) for L3, and 150 (±62) for L4. The mid-axial and mid-sagittal HU were positively correlated to the DEXA T-score (P < 0.001). The HU was 177 (95% CI: 160-194) for normal T-scores, 132 (120-143) for T-scores indicating osteopenia, and 106 (88-124) for T-scores indicating osteoporosis (P < 0.001). Post hoc analysis showed no difference between osteopenia and osteoporosis (P = 0.46).
Mid-sagittal HU is positively correlated to the T-score, similar to the mid-axial HU. Therefore, it can be used to acquire a general overview of the bone quality before spinal instrumentation.
与双能 X 射线吸收法扫描 T 评分相比，计算机断层扫描的亨氏单位 (HU) 是一种量化骨质量的替代工具。DEXA 扫描可能会高估骨矿物质密度。我们研究了椎骨中轴和中矢状面 HU 与 T 评分的相关性。
我们回顾性分析了在 1 年内同时进行双能 X 射线吸收法和计算机断层扫描的患者的电子病历。收集年龄、性别、中轴和中矢状面 HU 及 T 评分，并进行统计学分析。
我们共纳入了 100 例行 L1-L4 计算机断层扫描的患者，其中 80 例女性，20 例男性，平均年龄 60.25 岁（±12.54 岁）。19 例患者诊断为退行性脊柱疾病，56 例 T 评分正常，33 例存在骨质疏松症前期，11 例存在骨质疏松症。中矢状面 L1、L2、L3 和 L4 的平均 HU 分别为 163（±59）、159（±62）、151（±59）和 150（±62）。中轴和中矢状面 HU 与 DEXA T 评分呈正相关（P<0.001）。T 评分正常的 HU 值为 177（95%CI：160-194），T 评分表示骨质疏松症前期的 HU 值为 132（120-143），T 评分表示骨质疏松症的 HU 值为 106（88-124）（P<0.001）。事后分析显示骨质疏松症前期和骨质疏松症之间无差异（P=0.46）。
中矢状面 HU 与 T 评分呈正相关，与中轴 HU 相似。因此，它可以用于在脊柱器械植入前获得骨骼质量的大致概况。
