Wakolbinger-Habel Robert, Bittner-Frank Martin, Desch Simon, Lang Clemens, Scheffold Brigitte Elisabeth, Reinmuth Marc, Cernakova Miroslava, Breuer Robert, Schartel Manuela, Mirzaei Siroos, Hohenstein Klaus, Jauker Jakob, Buda Daniel, Nagel-Albustin Karin, Berger Georg, Kainz Nikolett, van Melle Max, Lomoschitz Friedrich, Zehetner-Nics Helena, Oljaca Ana, Zehetbauer Theresa, Strasser-Kirchweger Barbara, Paternostro-Sluga Tatjana, Mousavi Mehdi, Ringl Helmut, Kraus Daniel Arian, Fiala Rainer
Department of Physical and Rehabilitation Medicine (PRM), Vienna Healthcare Group, Clinic Donaustadt, Vienna, Austria.
Department of Orthopaedics and Traumatology, Vienna Healthcare Group, Clinic Donaustadt, Vienna, Austria.
Ann Med. 2025 Dec;57(1):2554930. doi: 10.1080/07853890.2025.2554930. Epub 2025 Sep 5.
The incidence of osteoporosis and osteoporotic fragility fractures is increasing due to demographic changes. Therefore, early diagnosis is desirable in order to preserve bone health and prevent low-trauma fractures. Opportunistic screening for osteoporosis by frequently performed computed tomography scans could offer a potential solution. Cranial computed tomography is often performed in potential high-risk patients for osteoporosis due to frequent falls in older ages. The aim of this study was to examine the potential value of opportunistic osteoporosis screening by cranial computed tomography-derived Hounsfield units in the overall clinical context, including sustained major osteoporotic fractures, pre-existing diseases and lifestyle factors.
This retrospective multi-center study was conducted at the Vienna Healthcare Group, an association of the main clinics of the City of Vienna, Austria. The records of patients who received both a cranial computed tomography and a dual energy X-ray absorptiometry within one year were reviewed. The cranial computed tomography scans were assessed by two observers, and the mean Hounsfield Units were calculated for the frontal bone.
In total, 311 patients were analyzed. Hounsfield units significantly correlated with the T scores at the lumbar spine, total hip and femoral neck, and significant differences in Hounsfield units between patients with normal bone mineral density, osteopenia and osteoporosis were observed. These relationships remained significant in the geriatric subgroup. For the lumbar spine, 606 Hounsfield units were calculated as optimal cutoff value for the prediction of osteoporosis. Patients with sustained major osteoporotic fractures had significantly lower Hounsfield units (650) compared to patients without history of major osteoporotic fracture (715).
Cranial computed tomography-derived Hounsfield units may assist to detect patients with densitometric osteoporosis and with major osteoporotic fractures at earlier stages, thereby facilitating early treatment and future fracture prevention.
由于人口结构变化，骨质疏松症及骨质疏松性脆性骨折的发病率正在上升。因此，为了维护骨骼健康并预防低创伤骨折，早期诊断很有必要。通过频繁进行计算机断层扫描进行骨质疏松症的机会性筛查可能是一种潜在的解决方案。由于老年人经常跌倒，颅骨计算机断层扫描常在骨质疏松症的潜在高危患者中进行。本研究的目的是在整体临床背景下，包括持续性重度骨质疏松性骨折、既往疾病和生活方式因素，探讨通过颅骨计算机断层扫描得出的亨氏单位进行骨质疏松症机会性筛查的潜在价值。
这项回顾性多中心研究在维也纳医疗集团进行，该集团是奥地利维也纳市主要诊所的联合体。对在一年内同时接受颅骨计算机断层扫描和双能X线吸收测定的患者记录进行了回顾。由两名观察者对颅骨计算机断层扫描进行评估，并计算额骨的平均亨氏单位。
总共分析了311名患者。亨氏单位与腰椎、全髋和股骨颈的T值显著相关，并且观察到骨密度正常、骨量减少和骨质疏松患者之间的亨氏单位存在显著差异。这些关系在老年亚组中仍然显著。对于腰椎，计算出606亨氏单位作为预测骨质疏松症的最佳临界值。与无重度骨质疏松性骨折病史的患者（715）相比，持续性重度骨质疏松性骨折患者的亨氏单位显著更低（650）。
颅骨计算机断层扫描得出的亨氏单位可能有助于在更早阶段检测出密度测定显示的骨质疏松症患者和重度骨质疏松性骨折患者，从而促进早期治疗和未来的骨折预防。
