Bekki Hirofumi, Arizono Takeshi, Suzuki Yuki, Inokuchi Akihiko, Hamada Takahiro, Imamura Ryuta, Oyama Ryunosuke, Hyodo Yuki, Kinoshita Eiji, Kita Takumi
Department of Orthopaedic Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.
J Osteoporos. 2021 May 26;2021:5526359. doi: 10.1155/2021/5526359. eCollection 2021.
Identifying the factors related to low bone mineral density (BMD) can have significant implications for preventing hip fractures. The correlation between ascending aortic calcification and BMD has never been reported. Therefore, the purpose of the current study is to confirm the hypothesis that ascending aortic calcification can be used as a predictive factor for low BMD and to find a radiographic sign to show it.
Plain film and computed tomography (CT) images of the thorax were obtained from 91 patients with hip fractures. Using the images, the calcification line of the ascending aorta adjacent to the aortic arch was evaluated. A prominent calcification line confirmed by both plain film and CT was classified as +2. A line which was ambiguous on plain film but confirmed by CT was classified as +1. Cases with no calcification were categorized as 0 (control). We compared the classified score with the BMD and calculated the kappa coefficient to measure intraobserver reliabilities for this radiographic finding.
Twenty-eight patients showed a +2 line, twenty-four patients showed a +1 line, and thirty-nine patients showed 0 lines. The median BMD of each group was 0.37 for the +2 line, 0.45 for the +1 line, and 0.51 for the 0 line. The BMD for the +2 group was significantly lower than the others. The kappa coefficient was approximately 0.6 ( < 0.01).
The imaging finding of calcification of the ascending aorta might be considered as a potential surrogate marker of low BMD. In such subjects, BMD might be ordered for the confirmation of diagnosis of osteoporosis. . The Aortic Arch Tail Sign, a calcification line on the ascending aorta, was relevant to low BMD in the current study. BMD can be ordered for the confirmation of diagnosis of osteoporosis in a subject incidentally found to have ascending aorta calcification on X-ray or CT.
识别与低骨密度（BMD）相关的因素对于预防髋部骨折具有重要意义。升主动脉钙化与骨密度之间的相关性从未被报道过。因此，本研究的目的是证实升主动脉钙化可作为低骨密度预测因素的假设，并找到一种影像学征象来显示这一点。
从91例髋部骨折患者中获取胸部X线平片和计算机断层扫描（CT）图像。利用这些图像，评估主动脉弓附近升主动脉的钙化线。X线平片和CT均证实的明显钙化线分类为+2。X线平片上不明确但CT证实的线分类为+1。无钙化的病例分类为0（对照组）。我们将分类评分与骨密度进行比较，并计算kappa系数以测量该影像学发现的观察者内信度。
28例患者显示+2线，24例患者显示+1线，39例患者显示0线。每组的骨密度中位数，+2线组为0.37，+1线组为0.45，0线组为0.51。+2组的骨密度明显低于其他组。kappa系数约为0.6（<0.01）。
升主动脉钙化的影像学表现可能被视为低骨密度的潜在替代标志物。对于此类患者，可能需要进行骨密度检查以确诊骨质疏松症。在本研究中，升主动脉上的钙化线——主动脉弓尾征与低骨密度相关。对于在X线或CT检查中偶然发现升主动脉钙化的患者，可进行骨密度检查以确诊骨质疏松症。
