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利用胸部定量计算机断层扫描对组织成分含量变化进行机会性评估。

Opportunistic assessment of variations in tissue composition content using chest QCT.

作者信息

Li Jujia, Zhang Wei, Zhang Xuesong, Liu Ying, Li Junfei, Yang Fan, Zhao Jian

机构信息

Medical Imaging Department, Hebei Medical University Third Hospital, Shijiazhuang, 050051, Hebei, China.

出版信息

Sci Rep. 2025 Jul 28;15(1):27428. doi: 10.1038/s41598-025-13001-7.

DOI:10.1038/s41598-025-13001-7
PMID:40721469
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12304271/
Abstract

Utilize Quantitative Computed Tomography (QCT) to acquire quantitative parameters of bone, muscle, and adipose tissue in subjects, and subsequently investigate the disparities in these parameters based on classifications of Bone Mineral Density (BMD) and gender. Employ the average values of various parameters at the age of 30 as the baseline to compute the growth rate every five years and analyze the variations in these parameters of different tissues with respect to age and gender. Collect subjects who underwent combined chest CT and QCT scans at our hospital. Following parameters were obtained: volumetric bone mineral density (vBMD) of T12-L2 vertebrae, fat fractions (FF) of liver, pancreas, and paraspinal muscles, the content (including mass and area) of cortical mineral, cancellous mineral, abdominal total adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, splanchnic soft tissue (excluding visceral adipose tissue), paraspinal intramuscular adipose tissue, paraspinal intramuscular muscle tissue at the central level of L2 vertebrae. Based on vBMD, the subjects were categorized into three groups: normal, osteopenia, and osteoporosis group. They were further subgrouped by BMD and gender to compare differences in various parameters. Taking the average values of these parameters at age 30 as the baseline, we calculated the growth rate every five years, observing the age-related changes in these parameters of different tissues in both males and females. Among males, no notable disparities were observed in the splanchnic soft tissue and paraspinal intramuscular muscle content across various vBMD categories, whereas other parameters exhibited significant variations in accordance with vBMD. In females, all parameters, with the exception of liver fat fraction, demonstrated significant changes across different vBMD categories. Males exhibit a higher liver FF, as well as greater content of total adipose tissue, visceral adipose tissue, splanchnic soft tissue, cortical mineral, cancellous mineral, and paraspinal intramuscular muscle compared to females. Conversely, females demonstrate higher muscle FF, paraspinal intramuscular adipose tissue, and subcutaneous adipose tissue content than males. In age-related changes, there is an increase in FF of the liver, pancreas, and paraspinal muscles, accompanied by an augmentation in the content of total adipose tissue, visceral adipose tissue, and paraspinal intramuscular adipose tissue. Conversely, there is a decline in BMD, cortical and trabecular content, as well as in the content of paraspinal intramuscular muscle tissue. The difference lies in the reduction of subcutaneous fat content in males, as opposed to an increase in females. The trend of variations in mass and area within the same tissue does not always align consistently. Furthermore, the content of both cortical and cancellous mineral decreased with age, but cortical mineral loss occurs earlier and faster than cancellous mineral. As vBMD diminishes, muscle content decreases concurrently with an augmentation in fat infiltration. In males, visceral fat infiltration prevails, whereas in females, both muscle loss and fat accumulation are pronounced. The depletion of cortical minerals may transpire earlier and at a quicker rate compared to the loss of cancellous minerals, indicating that clinical attention to osteoporosis cannot ignore changes in the cortical bone.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ea/12304271/f2d4bcf969ca/41598_2025_13001_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ea/12304271/f2d4bcf969ca/41598_2025_13001_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ea/12304271/f2d4bcf969ca/41598_2025_13001_Fig1_HTML.jpg
摘要

利用定量计算机断层扫描(QCT)获取受试者骨骼、肌肉和脂肪组织的定量参数,随后根据骨密度(BMD)分类和性别研究这些参数的差异。以30岁时各参数的平均值为基线,每五年计算一次生长率,并分析不同组织的这些参数随年龄和性别的变化。收集在我院接受胸部CT和QCT联合扫描的受试者。获得以下参数:T12-L2椎体的体积骨密度(vBMD)、肝脏、胰腺和椎旁肌的脂肪分数(FF)、皮质矿物质、松质矿物质、腹部总脂肪组织、内脏脂肪组织、皮下脂肪组织、内脏外软组织(不包括内脏脂肪组织)、椎旁肌内脂肪组织、L2椎体中央水平的椎旁肌内肌肉组织的含量(包括质量和面积)。根据vBMD,将受试者分为三组:正常组、骨量减少组和骨质疏松组。再根据BMD和性别进行亚组划分,以比较各参数的差异。以30岁时这些参数的平均值为基线,每五年计算一次生长率,观察男性和女性不同组织的这些参数随年龄的变化。在男性中,不同vBMD类别之间的内脏外软组织和椎旁肌内肌肉含量未观察到显著差异,而其他参数则根据vBMD表现出显著变化。在女性中,除肝脏脂肪分数外,所有参数在不同vBMD类别之间均表现出显著变化。与女性相比,男性的肝脏FF、总脂肪组织、内脏脂肪组织、内脏外软组织、皮质矿物质、松质矿物质和椎旁肌内肌肉含量更高。相反,女性的肌肉FF、椎旁肌内脂肪组织和皮下脂肪组织含量高于男性。在与年龄相关的变化中,肝脏、胰腺和椎旁肌的FF增加,同时总脂肪组织、内脏脂肪组织和椎旁肌内脂肪组织的含量增加。相反,BMD、皮质和小梁含量以及椎旁肌内肌肉组织的含量下降。不同之处在于男性皮下脂肪含量减少,而女性则增加。同一组织内质量和面积的变化趋势并不总是一致的。此外,皮质和松质矿物质的含量均随年龄下降,但皮质矿物质的流失比松质矿物质更早、更快。随着vBMD降低,肌肉含量减少,同时脂肪浸润增加。在男性中,内脏脂肪浸润占主导,而在女性中,肌肉流失和脂肪堆积都很明显。皮质矿物质的消耗可能比松质矿物质的流失更早、更快地发生,这表明对骨质疏松症的临床关注不能忽视皮质骨的变化。

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