能谱CT与DXA测量骨密度准确性的比较研究
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摘要
目的:以羊腰椎体骨煅烧后的灰重密度为标准,比较能谱CT与双能X线骨密度仪(DXA)测量椎体骨密度(BMD)的准确性,探讨能谱CT对BMD的测量价值。方法:选取36节新鲜市售羊腰椎椎体作为研究对象,清除椎体周围软组织及其附件后,分别采用能谱CT与DXA测量BMD,然后煅烧椎体得到灰重密度。将两种方法测量所得BMD值与灰重密度值进行比较,同时分析两种方法测量所得BMD值与灰重密度值的相关性;最后将能谱CT测得BMD的偏离度与DXA测得体积BMD的偏离度进行比较。结果:能谱CT、DXA测得BMD值与灰重密度值差异有统计学意义(P<0.05);相关性分析可得,能谱CT与DXA测得BMD值与灰重密度值均有显著相关性(P<0.05),但能谱CT相关性更高;能谱CT测得BMD的偏离度(平均值为0.288)低于DXA测得BMD的偏离度(平均值为0.372)(P<0.05)。结论:能谱CT测量椎体BMD值更接近灰重密度值,准确性及相关性均优于DXA测量方法,能够更好、更精确地反映BMD变化。
Objective With the ash density of sheep lumbar vertebrae as the standard, to compare the accuracy of spectral computed tomography(CT) and dual-energy X-ray absorptiometry(DXA) for vertebral bone mineral density(BMD)measurement, and to investigate the value of spectral CT in BMD measurement. Methods A total of 36 freshly prepared sheep lumbar vertebrae were selected as the research object. After removing soft tissue around the vertebral body and its attachments, BMD was measured by spectral CT and DXA, and the vertebral body was calcined to obtain the ash density.The BMD values measured by the two methods were compared with ash density, and the correlations between the measured BMD values and ash density were analyzed. Finally, the deviation of BMD measured by energy spectrum CT was compared with the deviation of BMD measured by DXA. Results The difference between measured BMD and ash density was statistically significant(P<0.05). There was a significant correlation between measured BMD and ash density(P<0.05), but the correlation of ash density and BMD measured with spectral CT was higher. The mean deviation of BMD measured by spectral CT was lower than the mean deviation of BMD measured by DXA(0.288 vs 0.372, P<0.05). Conclusion The BMD measured by spectral CT is closer to ash density. Spectral CT is superior to DXA in BMD measurement accuracy and the correction with ash density, which indicates that spectral CT can reflect the changes of BMD more accurately.
Objective With the ash density of sheep lumbar vertebrae as the standard, to compare the accuracy of spectral computed tomography(CT) and dual-energy X-ray absorptiometry(DXA) for vertebral bone mineral density(BMD)measurement, and to investigate the value of spectral CT in BMD measurement. Methods A total of 36 freshly prepared sheep lumbar vertebrae were selected as the research object. After removing soft tissue around the vertebral body and its attachments, BMD was measured by spectral CT and DXA, and the vertebral body was calcined to obtain the ash density.The BMD values measured by the two methods were compared with ash density, and the correlations between the measured BMD values and ash density were analyzed. Finally, the deviation of BMD measured by energy spectrum CT was compared with the deviation of BMD measured by DXA. Results The difference between measured BMD and ash density was statistically significant(P<0.05). There was a significant correlation between measured BMD and ash density(P<0.05), but the correlation of ash density and BMD measured with spectral CT was higher. The mean deviation of BMD measured by spectral CT was lower than the mean deviation of BMD measured by DXA(0.288 vs 0.372, P<0.05). Conclusion The BMD measured by spectral CT is closer to ash density. Spectral CT is superior to DXA in BMD measurement accuracy and the correction with ash density, which indicates that spectral CT can reflect the changes of BMD more accurately.
引文
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[17]张进,宋飞鹏,郜璐璐,等. CT能谱成像、定量CT骨密度测定值与骨灰重密度值的比较实验研究[J].中华临床医师杂志(电子版), 2015,9(17):3250-3254.ZHANG J, SONG F P, GAO L L, et al. Comparative study of CTemission imaging, quantitative CT bone densitometry and ash denseweight density[J]. Chinese Journal of Clinicians(Electronic Edition),2015, 9(17):3250-3254.
[18]雷立昌,陈建宇.能谱CT的临床应用与研究进展[J].中国医学影像技术, 2013, 29(1):146-149.LEI L C, CHEN J Y. Clinical application and research progress ofspectral CT[J]. Chinese Journal of Medical Imaging Technology,2013, 29(1):146-149.
[19]黄仁军,李勇刚.能谱CT的临床应用与研究进展[J].放射学实践,2015, 30(1):81-83.HUANG R J, LI Y G. Clinical application and research progress ofspectral CT[J]. Radiologic Practice, 2015, 30(1):81-83.
[20]ZHAO Y, WU Y, ZUO Z, et al. CT angiography of the kidney usingroutine CT and the latest gemstone spectral imaging combination ofdifferent noise indexes:image quality and radiation dose[J]. RadiolMed, 2017, 122(5):327-336.
[2] FARDELLONE P, CORTET B, LEGRAND E, et al. Cost-effectivenessmodel of using zoledronic acid once a year versus current treatmentstrategies in postmenopausal osteoporosis[J]. Joint Bone Spine, 2010,77(1):53-57.
[3] EBELING P R, DALY R M, KERR D A, et al. Building healthy bonesthroughout life:an evidence-informed strategy to prevent osteoporosisin Australia[J]. Med J Aust, 2013, 199(7 Suppl):S1.
[4] LEVINE J P. Identification, diagnosis, and prevention of osteoporosis[J]. Am J Manag Care, 2011, 17(Suppl 6):S170-S176.
[5] MATSUMOTO K, JINZAKI M, TANAMI Y, et al. Virtualmonochromatic spectral imaging with fast kilovoltage switching:improved image quality as compared with that obtained withconventional 120-kVp CT[J]. Radiology, 2011, 259(1):257-262.
[6]韩合理,郁万江,马千里,等.宝石能谱CT(GSI)诊断骨质疏松的应用价值初探[J].医学影像学杂志, 2018, 28(2):294-297.HAN H L, YU W J, MA Q L, et al. The application value of gemspectrum CT(GSI)in diagnosing osteoporosis[J]. Journal of MedicalImaging, 2018, 28(2):294-297.
[7]崔杰,李征,何惠宇,等.去抗原羊椎松质骨支架微观空间结构的分析[J].中国组织工程研究, 2013, 17(42):7341-7348.CUI J, LI Z, HE H Y, et al. Analysis of microscopic spatial structureof degenerative vertebral cancellous bone scaffold[J]. Chinese Journalof Tissue Engineering Research, 2013, 17(42):7341-7348.
[8]罗民华,徐琼琼,朱庆霞.羟基磷灰石分解和恢复的研究[J].中国陶瓷, 2007, 43(4):15-17.LUO M H, XU Q Q, ZHU Q X. Hydroxyapatite decomposition andrecovery[J]. Chinese pottery, 2007, 43(4):15-17.
[9] KANIS J A, MCCLOSKEY E V, JOHANSSON H, et al. A referencestandard for the description of osteoporosis[J]. Bone, 2008, 42(3):467-475.
[10]STEWART K J, DEREGIS J R, TURNER K L, et al. Fitness, fatnessand activity as predictors of bone mineral density in older persons[J].J Intern Med, 2002, 252(5):381-388.
[11]王秋灵,杨乃龙,王军,等.两种双能X射线吸收法骨密度仪数据共享:Challenger与Holigic仪器的交叉校正[J].中国组织工程研究与临床康复, 2008, 12(35):6871-6874.WANG Q L, YANG N L, WANG J, et al. Two kinds of dual-energyX-ray absorption bone densitometer data sharing:cross-correction ofChallenger and Holigic Instruments[J]. Chinese Journal of TissueEngineering Research, 2008, 12(35):6871-6874.
[12]GAUSDEN E B, NWACHUKWU B U, SCHREIBER J J, et al.Opportunistic use of CT imaging for osteoporosis screening and bonedensity assessment:a qualitative systematic review[J]. J Bone JointSurg Am, 2017, 99(18):1580-1590.
[13]王芳洁,赵小兰.骨质疏松检查方法的研究进展[J].检验医学与临床, 2016, 13(8):1137-1139.WANG F J, ZHAO X L. Research progress of osteoporosisexamination methods[J]. Laboratory Medicine and Clinic, 2016,13(8):1137-1139.
[14]DAMILAKIS J, ADAMS J E, GUGLIELMI G, et al. Radiationexposure in X-ray-based imaging techniques used in osteoporosis[J].Eur Radiol, 2010, 20(11):2707-2714.
[15]侯建明,蓝旭华,吴晖南,等.近5年国内外骨质疏松症诊疗指南比较[J].中华关节外科杂志(电子版), 2012, 6(3):472-478.HOU J M, LAN X H, WU H N, et al. Comparison of guidelines fordiagnosis and treatment of osteoporosis at home and abroad in the past5 years[J]. Chinese Journal of Joint Surgery(Electronic Edition),2012, 6(3):472-478.
[16]张智海,刘忠厚,李娜,等.中国人骨质疏松症诊断标准专家共识(第三稿·2014版)[J].中国骨质疏松杂志, 2014, 20(9):1007-1010.ZHANG Z H, LIU Z H, LI N, et al. Expert consensus on diagnosticcriteria for osteoporosis in China(third draft?2014 edition)[J].Chinese Journal of Osteoporosis, 2014, 20(9):1007-1010.
[17]张进,宋飞鹏,郜璐璐,等. CT能谱成像、定量CT骨密度测定值与骨灰重密度值的比较实验研究[J].中华临床医师杂志(电子版), 2015,9(17):3250-3254.ZHANG J, SONG F P, GAO L L, et al. Comparative study of CTemission imaging, quantitative CT bone densitometry and ash denseweight density[J]. Chinese Journal of Clinicians(Electronic Edition),2015, 9(17):3250-3254.
[18]雷立昌,陈建宇.能谱CT的临床应用与研究进展[J].中国医学影像技术, 2013, 29(1):146-149.LEI L C, CHEN J Y. Clinical application and research progress ofspectral CT[J]. Chinese Journal of Medical Imaging Technology,2013, 29(1):146-149.
[19]黄仁军,李勇刚.能谱CT的临床应用与研究进展[J].放射学实践,2015, 30(1):81-83.HUANG R J, LI Y G. Clinical application and research progress ofspectral CT[J]. Radiologic Practice, 2015, 30(1):81-83.
[20]ZHAO Y, WU Y, ZUO Z, et al. CT angiography of the kidney usingroutine CT and the latest gemstone spectral imaging combination ofdifferent noise indexes:image quality and radiation dose[J]. RadiolMed, 2017, 122(5):327-336.