Kim Youngjune, Lee Sejoon, Lee Eugene, Lee Joon Woo
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
Seoul National University College of Medicine, Seoul, Republic of Korea.
Acta Radiol. 2025 Mar 3:2841851251322928. doi: 10.1177/02841851251322928.
Opportunistic screening of osteoporosis using computed tomography (CT) should be optimized according to CT protocols. However, to date, no study has evaluated the different contrast phases of CT urography in osteoporosis screening.
To compare the diagnostic performance of different contrast phases of CT urography in opportunistic screening of osteoporosis.
In this single-center retrospective study, 210 consecutive patients (181 men, 29 women; mean age = 72.0 ± 9.5 years) who underwent both CT urography and dual-energy X-ray absorptiometry (DXA) within 3 months in July to December 2020 were included. The attenuation value was measured at the center of the L1 vertebral body in the axial plane of the precontrast, corticomedullary, and excretory phases. The mean and standard deviation (SD) of attenuation values were calculated. The area under the receiver operating characteristic curve (AUC) in differentiating osteoporosis versus osteopenia/normal was measured in each phase, and non-parametric comparisons between precontrast and the other phases were performed.
According to DXA results, 90, 90, and 30 patients were classified into the normal, osteopenia, and osteoporosis groups, respectively. The mean ± SD of attenuation values in the precontrast, corticomedullary, and excretory phases were 114.9 ± 47.8, 132.8 ± 49.3, and 126.2 ± 47.2 HU, respectively. A significant difference was observed between AUCs measured in the precontrast (0.804, 95% confidence interval [CI] = 0.717-0.890) and corticomedullary phases (0.760, 95% CI = 0.661-0.860) (= 0.003) and those between the precontrast and excretory phases (0.774, 95% CI = 0.678-0.869) (= 0.005).
The precontrast phase outperformed the other phases in the opportunistic screening of osteoporosis using CT urography.
利用计算机断层扫描（CT）对骨质疏松症进行机会性筛查应根据CT协议进行优化。然而，迄今为止，尚无研究评估CT尿路造影不同对比期在骨质疏松症筛查中的情况。
比较CT尿路造影不同对比期在骨质疏松症机会性筛查中的诊断性能。
在这项单中心回顾性研究中，纳入了2020年7月至12月期间在3个月内连续接受CT尿路造影和双能X线吸收法（DXA）检查的210例患者（181例男性，29例女性；平均年龄=72.0±9.5岁）。在平扫期、皮质髓质期和排泄期的轴位平面上测量L1椎体中心的衰减值。计算衰减值的平均值和标准差（SD）。测量各期区分骨质疏松症与骨质减少/正常的受试者操作特征曲线（AUC）下面积，并对平扫期与其他期进行非参数比较。
根据DXA结果，分别有90例、90例和30例患者被分为正常组、骨质减少组和骨质疏松组。平扫期、皮质髓质期和排泄期衰减值的平均值±SD分别为114.9±47.8、132.8±49.3和126.2±47.2 HU。平扫期（0.804，95%置信区间[CI]=0.717-0.890）与皮质髓质期（0.760，95%CI=0.661-0.860）测量的AUC之间存在显著差异（=0.003），平扫期与排泄期（0.774，95%CI=0.678-0.869）测量的AUC之间也存在显著差异（=0.005）。
在利用CT尿路造影对骨质疏松症进行机会性筛查时，平扫期的表现优于其他期。
