Fujian Medical University, Fuzhou City, 350001, Fujian Province, China.
Department of Neurosurgery, Fujian Medical University Union Hospital, No.29 Xinquan, Fuzhou City, 350001, Fujian Province, China.
Eur Spine J. 2023 Nov;32(11):3912-3918. doi: 10.1007/s00586-023-07938-4. Epub 2023 Sep 16.
Hounsfield unit (HU) measurements and vertebral bone quality (VBQ) scores are opportunistic screening methods for evaluating bone quality. Since studies comparing the efficacies of the two methods are rare, this retrospective study aimed to examine the efficacy of VBQ scores compared with that of HU measurements for diagnosing osteoporosis in lumbar spine surgery patients.
We selected patients who had undergone spinal surgery between January 2020 and May 2022 from our database. The VBQ scores based on magnetic resonance imaging (MRI) and HU measurements based on computed tomography (CT) were calculated. Correlation analysis of the dual-energy X-ray absorptiometry (DEXA) T score and study parameters was performed. The Delong test and decision curve analysis (DCA) were used to compare the efficacies of the two methods.
We included 118 consecutive patients who underwent selective spinal surgery. The VBQ score and HU measurement were significantly correlated with the DEXA T score. Based on the Delong test, HU measurement predicted osteoporosis more effectively than the VBQ score did. The DCA revealed that the VBQ score performed better than the HU measurement did.
The calculation of VBQ scores is a novel opportunistic screening method for diagnosing osteoporosis; however, CT-based HU measurements outperform MRI-based VBQ scores. HU measurements can be used as a screening method when pre-operative CT scans are available.
亨氏单位（HU）测量值和椎体骨质量（VBQ）评分是评估骨质量的机会性筛查方法。由于比较两种方法疗效的研究很少，本回顾性研究旨在检查 VBQ 评分与 HU 测量值在诊断腰椎手术患者骨质疏松症方面的疗效。
我们从数据库中选择了 2020 年 1 月至 2022 年 5 月期间接受脊柱手术的患者。计算了基于磁共振成像（MRI）的 VBQ 评分和基于计算机断层扫描（CT）的 HU 测量值。对双能 X 线吸收法（DEXA）T 评分和研究参数进行了相关性分析。采用 Delong 检验和决策曲线分析（DCA）比较两种方法的疗效。
我们纳入了 118 例连续接受选择性脊柱手术的患者。VBQ 评分和 HU 测量值与 DEXA T 评分显著相关。基于 Delong 检验，HU 测量值比 VBQ 评分更有效地预测骨质疏松症。DCA 显示，VBQ 评分的表现优于 HU 测量值。
VBQ 评分的计算是一种新的骨质疏松症诊断机会性筛查方法；然而，基于 CT 的 HU 测量值优于基于 MRI 的 VBQ 评分。当术前 CT 扫描可用时，HU 测量值可用作筛查方法。
