Department of Radiology, Shandong First Medical University, Tai'an, Shandong, China.
Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Tai'an 271000, Shandong, China.
Acad Radiol. 2024 Apr;31(4):1491-1500. doi: 10.1016/j.acra.2023.08.041. Epub 2023 Sep 30.
In vertebrae, the amount of cortical bone has been estimated at 30-60%, but 45-75% of axial load on a vertebral body is borne by cortical bone (1).
The purpose of this study is to investigate the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of vertebral body cortical thickness in predicting osteoporosis (OP) by analyzing the relationship between vertebral body cortical thickness and bone mineral density (BMD) in different age and gender groups. The optimal diagnostic cut-off value of vertebral body cortical thickness in predicting OP was analyzed.
The data of 150 patients (50-89 years old) who underwent chest or abdominal Quantitative computed tomography (QCT) scan (obtained in one scan) in our hospital from July 2021 to July 2022 were retrospectively analyzed. The average volume bone mineral density (vBMD) of L1-L2 vertebral bodies was obtained and grouped according to BMD, age, and gender. According to BMD, the patients were divided into three groups: osteoporosis, osteopenia and normal. According to age, the patients were divided into three groups: 50-59 years, 60-69 years and ≥70 years. The axial images of T11, T12 and L1 were reconstructed with 1.25 mm slice thickness by AW4.7 workstation provided by General Electric Co (GE) Company. The images were imported into the computed tomography (CT) Spine Bone Quantification System software for spine analysis, and the vertebral body cortical thickness values were obtained. CT Spine Bone Quantification System is a software for quantitative analysis and separation of cortical bone and cancellous bone.
A total of 150 patients were enrolled in this study, including 49 patients in the osteoporosis group, 51 patients in the osteopenia group, and 50 patients in the normal group. The cortical thickness values of T11, T12 and L1 were positively correlated with BMD, and the correlation coefficient was 0.750 at T11. According to the receiver operating characteristic (ROC) curve analysis of T11, T12, L1 cortical thickness value and BMD, OP was diagnosed when T11 < 2.75 mm, T12 < 3.06 mm, and L1 < 2.67 mm. The sensitivity was 83.67%, 87.76%, 75.51%, respectively. The specificity was 79.21%, 71.29% and 90.10%, respectively, and the difference was statistically significant.
Vertebral body cortical thickness is correlated with BMD and age. According to the cut-off value of different vertebral bodies, OP can be predicted when T11 < 2.75 mm or T12 < 3.06 mm or L1 < 2.67 mm.
在椎体中，皮质骨的含量估计为 30-60%，但椎体上 45-75%的轴向负荷由皮质骨承担。
本研究旨在通过分析不同年龄和性别组中椎体皮质厚度与骨密度（BMD）之间的关系，来研究椎体皮质厚度预测骨质疏松症（OP）的准确性、灵敏度、特异性、阳性预测值和阴性预测值。分析了预测 OP 时椎体皮质厚度的最佳诊断截断值。
回顾性分析了 2021 年 7 月至 2022 年 7 月期间我院 150 例（50-89 岁）接受胸部或腹部定量计算机断层扫描（QCT）扫描（一次扫描获得）的患者数据。获得 L1-L2 椎体的平均容积骨密度（vBMD），并根据 BMD、年龄和性别进行分组。根据 BMD，患者被分为三组：骨质疏松症、骨量减少和正常。根据年龄，患者被分为三组：50-59 岁、60-69 岁和≥70 岁。使用通用电气公司（GE）提供的 AW4.7 工作站对 T11、T12 和 L1 的轴向图像进行 1.25mm 层厚重建。将图像导入 CT 脊柱骨定量系统软件进行脊柱分析，并获得椎体皮质厚度值。CT 脊柱骨定量系统是一种用于皮质骨和松质骨定量分析和分离的软件。
本研究共纳入 150 例患者，其中骨质疏松组 49 例，骨量减少组 51 例，正常组 50 例。T11、T12 和 L1 的皮质厚度值与 BMD 呈正相关，T11 处的相关系数为 0.750。根据 T11、T12、L1 皮质厚度值和 BMD 的受试者工作特征（ROC）曲线分析，当 T11<2.75mm、T12<3.06mm 和 L1<2.67mm 时诊断为 OP。T11 的灵敏度分别为 83.67%、87.76%、75.51%，特异性分别为 79.21%、71.29%和 90.10%，差异有统计学意义。
椎体皮质厚度与 BMD 和年龄相关。根据不同椎体的截断值，当 T11<2.75mm 或 T12<3.06mm 或 L1<2.67mm 时，可预测 OP。
