利用超低剂量胸部CT对囊性纤维化患者进行骨密度的机会性评估。
Opportunistic assessment of bone mineral density in cystic fibrosis patients using ultra-low dose thoracic CT.
作者信息
Shet Sahil, Henry Catherine, O'Donnell Mairead, Kakish Eid, Ghauri Muhammad, O'Regan Patrick, Deasy Kevin, Ibrahim Hisham, Maher Michael, Plant Barry, Ryan David J
机构信息
Department of Radiology, School of Medicine, University College Cork, Cork, Ireland.
Department of Radiology, Cork University Hospital, Cork, Ireland.
出版信息
Arch Osteoporos. 2025 Jul 12;20(1):91. doi: 10.1007/s11657-025-01578-5.
UNLABELLED
In this study, we used routine ultra-low dose computed tomography scans of patients with cystic fibrosis to predict bone mineral density (BMD). A strong correlation was found between the attenuation of trabecular bone in thoracic vertebrae and the BMD in the proximal femur and lumbar spine as measured on DEXA.
PURPOSE
Osteoporosis is a serious global health concern with millions of people affected worldwide. A particularly vulnerable cohort in developing osteoporosis are patients with cystic fibrosis (CF). Bone mineral density (BMD) is typically measured with dual energy X-ray absorptiometry (DEXA) scanning; however, this comes at a cost to the healthcare system and an exposure to ionising radiation. In our institution, patients with cystic fibrosis undergo routine ultra-low dose computed tomography (ULDCT) for monitoring of disease progression. The aim of this study was to assess the validity of estimating BMD using data derived from ULDCT scans.
METHODS
Adult CF patients were included if they had undergone a routine ULDCT scan within 12 months of a DEXA scan. Additionally, 100 non-CF patients with non-contrast standard dose CT scans were selected to act as the control group. Trabecular bone density (T-BD) at T4, T7 and T10 was measured on PACS in Hounsfield units (HU) and compared to DEXA scan results and a formula developed to the predict BMD.
RESULTS
Fifty-two female and 62 male patients were included with mean ages of 34.4 and 35.1 respectively. Moderately strong correlation was found between the T-BD and BMD of both the lumbar spine (r = 0.629, p < 0.001) and proximal femur (r = 0.649, p < 0.001). Receiver operator characteristic (ROC) curve analysis found a sensitivity and specificity of 0.700 and 0.714 respectively at predicting osteoporosis at T-BD of 193.33 HU or below.
CONCLUSION
T-BD measured on ULDCT may be a valuable tool in the early identification of CF patients at risk of osteoporosis.
未标注
在本研究中，我们使用囊性纤维化患者的常规超低剂量计算机断层扫描来预测骨密度（BMD）。发现胸椎小梁骨衰减与双能X线吸收法（DEXA）测量的近端股骨和腰椎骨密度之间存在强相关性。
目的
骨质疏松是一个严重的全球健康问题，全球数百万人受其影响。患骨质疏松症的一个特别脆弱的群体是囊性纤维化（CF）患者。骨密度（BMD）通常用双能X线吸收法（DEXA）扫描测量；然而，这对医疗系统来说有成本，且会使患者暴露于电离辐射。在我们机构，囊性纤维化患者接受常规超低剂量计算机断层扫描（ULDCT）以监测疾病进展。本研究的目的是评估使用ULDCT扫描数据估计骨密度的有效性。
方法
纳入在DEXA扫描后12个月内接受过常规ULDCT扫描的成年CF患者。此外，选择100名接受非增强标准剂量CT扫描的非CF患者作为对照组。在PACS上以亨氏单位（HU）测量T4、T7和T10的小梁骨密度（T-BD），并与DEXA扫描结果以及为预测骨密度而开发的公式进行比较。
结果
纳入52名女性和62名男性患者，平均年龄分别为34.4岁和35.1岁。发现腰椎（r = 0.629，p < 0.001）和近端股骨（r = 0.649，p < 0.001）的T-BD与BMD之间存在中度强相关性。受试者操作特征（ROC）曲线分析发现在预测T-BD为193.33 HU或更低时的骨质疏松时，敏感性和特异性分别为0.700和0.714。
结论
ULDCT测量的T-BD可能是早期识别有骨质疏松风险的CF患者的有价值工具。
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