Department of Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675, Munich, Germany.
TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Eur Radiol. 2022 Sep;32(9):6207-6214. doi: 10.1007/s00330-022-08721-7. Epub 2022 Apr 6.
To determine the correlation between cervicothoracic and lumbar volumetric bone mineral density (vBMD) in an average cohort of adults and to identify specific diagnostic thresholds for the cervicothoracic spine on the individual subject level.
In this HIPPA-compliant study, we retrospectively included 260 patients (59.7 ± 18.3 years, 105 women), who received a contrast-enhanced or non-contrast-enhanced CT scan. vBMD was extracted using an automated pipeline ( https://anduin.bonescreen.de ). The association of vBMD between each vertebra spanning C2-T12 and the averaged values at the lumbar spine (L1-L3) was analyzed before and after semiquantitative assessment of fracture status and degeneration, and respective vertebra-specific cut-off values for osteoporosis were calculated using linear regression.
In both women and men, trabecular vBMD decreased with age in the cervical, thoracic, and lumbar regions. vBMD values of cervicothoracic vertebrae showed strong correlations with lumbar vertebrae (L1-L3), with a median Pearson value of r = 0.87 (range: r = 0.76 to r = 0.96). The correlation coefficients were significantly lower (p < 0.0001) without excluding fractured and degenerated vertebrae, median r = 0.82 (range: r = 0.69 to r = 0.93). Respective cut-off values for osteoporosis peaked at C4 (209.2 mg/ml) and decreased to 83.8 mg/ml at T12.
Our data show a high correlation between clinically used mean L1-L3 values and vBMD values elsewhere in the spine, independent of age. The proposed cut-off values for the cervicothoracic spine therefore may allow the determination of low bone mass even in clinical cases where only parts of the spine are imaged.
vBMD of all cervicothoracic vertebrae showed strong correlation with lumbar vertebrae (L1-L3), with a median Pearson's correlation coefficient of r = 0.87 (range: r = 0.76 to r = 0.96). The correlation coefficients were significantly lower (p < 0.0001) without excluding fractured and moderate to severely degenerated vertebrae, median r = 0.82 (range: r = 0.69 to r = 0.93). We postulate that trabecular vBMD < 200 mg/ml for the cervical spine and < 100 mg/ml for the thoracic spine are strong indicators of osteoporosis, similar to < 80 mg/ml at the lumbar spine.
确定成年人平均队列中颈椎和腰椎容积骨密度（vBMD）之间的相关性，并确定颈椎在个体层面上的特定诊断阈值。
在这项符合 HIPPA 规定的研究中，我们回顾性纳入了 260 名患者（59.7±18.3 岁，105 名女性），他们接受了增强或非增强 CT 扫描。使用自动化管道（https://anduin.bonescreen.de）提取 vBMD。在对骨折状态和退变进行半定量评估之前和之后，分析了每个跨越 C2-T12 的椎骨的 vBMD 与腰椎（L1-L3）的平均值之间的相关性，并使用线性回归计算了各自椎骨的骨质疏松症的特定截断值。
在女性和男性中，颈椎、胸椎和腰椎的小梁 vBMD 随年龄增长而降低。颈椎和胸椎的 vBMD 值与腰椎（L1-L3）有很强的相关性，中位数 Pearson 值 r=0.87（范围：r=0.76 至 r=0.96）。没有排除骨折和退变的椎体，相关系数显著降低（p<0.0001），中位数 r=0.82（范围：r=0.69 至 r=0.93）。骨质疏松症的各自截断值在 C4 处达到峰值（209.2mg/ml），在 T12 处降至 83.8mg/ml。
我们的数据表明，在脊柱的其他部位使用临床常用的 L1-L3 平均值与 vBMD 值之间存在高度相关性，与年龄无关。因此，提出的颈椎和胸椎的截断值可用于确定低骨量，即使在只有部分脊柱成像的临床情况下也是如此。
所有颈椎和胸椎的 vBMD 值与腰椎（L1-L3）有很强的相关性，中位数 Pearson 相关系数 r=0.87（范围：r=0.76 至 r=0.96）。没有排除骨折和中度至重度退变的椎体，相关系数显著降低（p<0.0001），中位数 r=0.82（范围：r=0.69 至 r=0.93）。我们假设颈椎的小梁 vBMD<200mg/ml 和胸椎的小梁 vBMD<100mg/ml 是骨质疏松症的强烈指标，与腰椎的 vBMD<80mg/ml 相似。
