Kutleša Zvonimir, Ordulj Ivan, Perić Iva, Jerković Kristian, Poljak Dino, Gavrilović Vlado, Čapkun Vesna, Devčić Šime, Budimir Mršić Danijela
Department of Orthopaedics and Traumatology, Split-Dalmatia County Health Center, Kavanjinova 2, 21000, Split, Croatia.
Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinčičeva 1, Šoltanska 2, 21000, Split, Croatia.
Osteoporos Int. 2023 Apr;34(4):775-782. doi: 10.1007/s00198-023-06699-6. Epub 2023 Feb 17.
Whole-body CT in polytrauma patients revealed bone mineral density variations throughout the skeleton. Bone density was the highest in cranial bones and the lowest in proximal extremities and pelvis. Skeletal age-related changes were generally more pronounced than sex-related changes. Cranial bones did not follow the same aging pattern compared to other bones.
Whole-body CT (WBCT) in polytrauma patients enables the detection of numerous incidental findings, such as estimates of bone mineral density (BMD) at multiple skeletal sites. This could help in better understanding of age- and sex-related changes in BMD through skeleton.
Data were retrospectively retrieved from the WBCTs requested during a 2-year period. BMD, expressed in CT Hounsfield units (HU), was measured at frontal and occipital bone, four vertebrae (C4, Th7, L4, and S2), iliac bone, and proximal humerus and femur. Measurements were done on native and postcontrast scans. The population sample was age-, sex-, and visceral fat volume adjusted for analysis.
A total of 296 patients were included, with a median age of 51 years. BMD varied from the highest HU in cranial bones (629 HU) to the lowest HU in the pelvic bones (114 HU), P < 0.001. Sex differences were independent predictors of BMD in cranial bones and proximal humerus. The age-related decline in BMD was significant in all other bones, but the association with age differed among the measurement's sites. Visceral fat showed the strongest correlation with the lumbar spine and iliac wing, although multivariate analysis revealed it was not an independent predictor of bone density, such as age and sex.
BMD varies through skeleton, being the highest in the proximal axial skeleton. Age-related changes in BMD are significant and more pronounced than sex-related changes in almost all bones. Cranial bones do not follow the same pattern compared to other bones.
多发伤患者的全身CT显示整个骨骼的骨密度存在差异。颅骨的骨密度最高，近端肢体和骨盆的骨密度最低。与性别相关的变化相比，骨骼年龄相关的变化通常更为明显。与其他骨骼相比，颅骨的老化模式不同。
多发伤患者的全身CT（WBCT）能够检测到许多偶然发现，例如多个骨骼部位的骨矿物质密度（BMD）估计值。这有助于更好地了解整个骨骼中与年龄和性别相关的BMD变化。
回顾性检索两年期间所要求的WBCT数据。以CT亨氏单位（HU）表示的BMD在额骨和枕骨、四个椎体（C4、Th7、L4和S2）、髂骨以及近端肱骨和股骨处进行测量。在平扫和增强扫描上进行测量。对人群样本进行年龄、性别和内脏脂肪体积调整后进行分析。
共纳入296例患者，中位年龄为51岁。BMD从颅骨的最高HU（629 HU）到骨盆骨的最低HU（114 HU）不等，P < 0.001。性别差异是颅骨和近端肱骨BMD的独立预测因素。在所有其他骨骼中，BMD与年龄相关的下降均显著，但测量部位之间与年龄的关联有所不同。内脏脂肪与腰椎和髂骨翼的相关性最强，尽管多变量分析显示它不是骨密度的独立预测因素，如年龄和性别。
BMD在整个骨骼中存在差异，近端中轴骨骼的BMD最高。几乎所有骨骼中，BMD与年龄相关的变化显著且比与性别相关的变化更明显。与其他骨骼相比，颅骨的模式不同。
