Muğla Sıtkı Koçman University Training and Research Hospital, Department of Radiology, Mugla, Turkey.
Balıkesir University, Faculty of Medicine, Department of Orthopedics and Traumatology, Balıkesir, Turkey.
Acta Radiol. 2022 Jul;63(7):933-941. doi: 10.1177/02841851211021035. Epub 2021 Jun 2.
Osteoporosis is associated with decreases in bone mineral density (BMD) and is diagnosed using dual-energy X-ray absorptiometry (DXA). Computed tomography (CT), performed in routine practice, can also be used to evaluate bone quality without additional cost.
To determine whether Hounsfield units (HU), a standardized CT attenuation coefficient, measured from the femoral head correlated with DXA-measured BMD.
We evaluated 82 patients (14 men, 68 women; mean age, 67 years) undergoing femoral DXA and CT (non-enhanced abdominopelvic and hip scans) with 130 kV to determine whether HU correlated with T-scores. HU were measured by two radiologists using the largest spherical region of interest including the medullary bone of the femoral head from the junction point of the most caudal section of the femoral head with the femoral neck in 5-mm axial sections. The correlations of both sides' HU values with their ages and DXA femur T-score were evaluated.
HU values obtained from both femoral heads showed significant variation between the osteoporotic and non-osteoporotic groups (both = 0.000) and strongly correlated with each other and DXA femur T-scores (left r = 0.75, right r = 0.73, respectively). In ROC curve analysis, predictive power of left HU values in identifying patients with osteoporotic femur DXA T-score was 0.905, and for right HU values it was 0.924. Osteoporosis cutoff values were 198 HU and 204 HU for the left and right hips, respectively.
HU obtained from CT performed in routine practice correlated with the DXA scores, thus providing an alternative method to determine regional bone quality without additional cost. This may be useful when choosing a fixation method, especially in trauma cases with already-performed abdominopelvic or pelvic CT in emergency services.
骨质疏松症与骨密度（BMD）降低有关，可通过双能 X 射线吸收法（DXA）进行诊断。在常规实践中进行的计算机断层扫描（CT）也可用于评估骨质量，而无需额外费用。
确定从股骨头测量的亨氏单位（HU），一种标准化的 CT 衰减系数，是否与 DXA 测量的 BMD 相关。
我们评估了 82 名患者（14 名男性，68 名女性；平均年龄 67 岁）进行股骨 DXA 和 CT（非增强的腹盆腔和髋关节扫描），使用 130 kV 确定 HU 是否与 T 评分相关。HU 由两位放射科医生使用最大的球形感兴趣区域进行测量，该区域包括股骨头髓腔内从股骨头最尾段的交界点到股骨颈的 5mm 轴位切片。评估了两侧 HU 值与其年龄和 DXA 股骨 T 评分的相关性。
从股骨头获得的 HU 值在骨质疏松组和非骨质疏松组之间存在显著差异（均为 P <.0001），并且与彼此和 DXA 股骨 T 评分呈强相关（左侧 r = 0.75，右侧 r = 0.73）。在 ROC 曲线分析中，左侧 HU 值在识别骨质疏松性股骨 DXA T 评分患者方面的预测能力为 0.905，右侧 HU 值为 0.924。骨质疏松的截断值为左侧髋部 198 HU 和右侧髋部 204 HU。
在常规实践中进行的 CT 获得的 HU 值与 DXA 评分相关，因此提供了一种无需额外费用即可确定局部骨质量的替代方法。在选择固定方法时，特别是在急诊服务中已经进行了腹盆腔或骨盆 CT 的创伤病例中，这可能是有用的。
