骨质疏松性脊柱骨折类型与QCT体积骨密度差异研究
Study of the types of osteoporotic vertebral fractures and the difference of volumetric BMD detected using QCT
  
DOI:10.3969/j.issn.1006.7108.2014.11.002
中文关键词:  骨质疏松  骨质疏松CT诊断标准  骨密度  QCT  绝经后妇女  腰椎骨折
英文关键词:Osteoporosis  Diagnostic criteria for osteoporosis in CT  BMD  QCT  Postmenopausal women  Lumbar vertebral fracture
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蒋雯 李新民 程克斌 王晨 程晓光* 北京积水潭医院放射科北京100035 
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中文摘要:
      目的 应用定量CT(QCT)测定腰椎骨密度,探讨骨质疏松性脊柱骨折不同类型间的椎体体积骨密度是否存在差异。方法 以因腰椎骨折来北京积水潭医院进行腰椎QCT检查的77例绝经后女性患者为研究对象,所有患者均为脆性骨折,且骨折仅累及一个腰椎椎体,年龄55 -85岁,平均71±7.84岁。QCT测量L1-4中未骨折椎体的骨密度值,并计算每位患者L1- 4未骨折椎体的骨密度均值。根据脊柱CT扫描矢状重建的图像将椎体骨折类型分为楔形、双凹及挤压三种类型。使用两组独立样本的t检验比较楔形与双凹骨折组间的骨密度是否存在差异。使用两组独立样本的t检验比较楔形与双凹骨折组间的年龄是否存在差异。结果 楔形(年龄均值70. 26±7. 99岁)和双凹(年龄均值70. 92±7. 80岁)骨折组间的年龄差异没有统计学意义(t = -0. 347,P =0. 730),可以基本排除年龄因素的干扰。楔形和双凹骨折组间的骨密度差异有统计学意义(t = 2.254,P =0.028);双凹组(组均值32.08 mg/ cm3)骨密度较楔形组(组均值45.05 mg/ cm3)低。结论 骨质疏松性脊柱骨折的类型与椎体体积骨密度可能存在一定的相关性,双凹形骨折可能比楔形骨折的骨密度低。
英文摘要:
      Objective To evaluate if the difference exists between the different types of osteoporotic vertebral fractures and the vertebral volumetric bone mineral density (BMD) detected using quantitative computed tomography (QCT). Methods The QCT BMD was obtained from a cohort of 77 postmenopausal female patients with lumbar fracture ( aging from 55 to 85 years, mean age 71±7. 84 years). All the fractures were fragile ones. Patients with only one lumbar vertebral body fracture were involved. BMD of the non-fractured vertebrae was measured and calculated using QCT. The fractures were divided to wedge,biconcave,and crush type according to the saggital CT image. Independent-samples t test was used to evaluate the difference of BMD and age between wedge and biconcave type of fractures. Results The difference in age between wedge ( mean age 70. 26 ±7. 99 years) and biconcave (mean age 70. 92 ±7. 80 years) fracture was not statistically significant (t = -0. 347,P =0.730),therefore excluding the interference of age factor. There was statistically significant difference between wedge and biconcave fractures (t = 2. 254,P = 0. 028). BMD in group of biconcave fracture ( mean 32. 08 mg/cm3) was lower than that of wedge fracture ( mean 45. 05 mg/ cm3). Conclusion There may be correlation between type of osteoporotic lumbar fractures and BMD. BMD in biconcave fractures may be higher than that in wedge fractures.
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