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| 1 100节腰椎椎体HU值与DXA结果的相关性及骨质疏松诊断阈值 |
| The correlation between CT hounsfield units of 1100 lumbar vertebral bodies and DXA results, and the diagnostic threshold for osteoporosis |
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| DOI：10.3969/j.issn.1006-7108.2026.06.007 |
| 中文关键词: Hounsfield单位 双能X射线吸收法 骨质疏松 相关性分析 ROC曲线 |
| 英文关键词:hounsfield units dual-energy X-ray absorptiometry osteoporosis correlation analysis receiver operating characteristic curve |
| 基金项目:北京市科学技术委员会-首都临床诊疗技术研究及转化应用 |
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| 中文摘要: |
| 目的 探讨中国人群腰椎CT Hounsfield单位（HU）与双能X射线吸收法（DXA）骨密度参数的相关性，建立基于中国人群的骨质疏松诊断阈值，为使用HU值筛查骨质疏松提供依据。方法 横断面研究纳入2024年1月至2024年8月单中心三甲医院在3个月内同时接受腰椎DXA及腹部/腰椎CT检查的275例受试者（女性占比68.7 %，平均年龄66.9岁）。测量L1~L4椎体松质骨HU值，评估观察者间一致性，分析其与DXA面积骨密度（aBMD）及T值的相关性。通过受试者工作特征曲线（ROC）确定HU值诊断骨质疏松及骨量减少的最佳诊断阈值和筛查阈值。结果 共分析1 100个椎体，HU值观察者间相关系数为0.992（P<0.001），一致性极佳。L1~L4椎体HU值与aBMD及T值均呈强正相关（|r|>0.5，P<0.001），L1~L4椎体HU值预测骨质疏松和骨量减少的诊断效能优良（ROC曲线下面积均＞0.75，P<0.001）。报告了最大约登指数确定的最佳诊断阈值（L1=112/128，L2=79/133，L3=73/116，L4=94/94），报告了特异性不低于50 %时最高敏感度的筛查阈值（ L1=123/135，L2=116/133，L3=106/122，L4=105/115）。结论 腰椎CT HU值与DXA骨密度高度相关，使用HU值诊断骨质疏松和骨量减少具有优良的诊断效能。CT检查HU值评估是由医生基于已获取的CT数据进行的，具有零附加成本和高可重复性的优点，尤适用于缺少DXA设备的基层医疗机构的骨质疏松筛查。 |
| 英文摘要: |
| Objective To explore the correlation between Hounsfield units (HU) of lumbar CT and bone mineral density (BMD) parameters measured by dual-energy X-ray absorptiometry (DXA) in the Chinese population, establish diagnostic thresholds for osteoporosis based on the Chinese population, and provide a basis for screening osteoporosis using HU values. Methods A cross-sectional study was conducted on 275 subjects (68.7% female, mean age 66.9 years) who underwent both lumbar DXA and abdominal/lumbar CT examinations within 3 months at a single tertiary hospital from January 2024 to August 2024. HU values of the cancellous bone in L1-L4 vertebrae were measured, and inter-observer consistency was evaluated. The correlations between HU values and DXA area BMD (aBMD) and T-scores were analyzed. The optimal diagnostic thresholds and screening thresholds for osteoporosis and osteopenia were determined using receiver operating characteristic (ROC) curves. Results A total of 1100 vertebrae were analyzed. The inter-observer correlation coefficient of HU values was 0.992 (P < 0.001), indicating excellent consistency. HU values of L1-L4 vertebrae were strongly positively correlated with aBMD and T-scores (|r| > 0.5, P < 0.001). The diagnostic efficacy of HU values for predicting osteoporosis and osteopenia was excellent (area under the ROC curve > 0.75, P < 0.001). The best diagnostic thresholds determined by the maximum Youden index were reported ( L1=112/128，L2=79/133，L3=73/116，L4=94/94), and the screening thresholds with the highest sensitivity when specificity was not less than 50% were reported ( L1=123/135，L2=116/133，L3=106/122，L4=105/115). Conclusion HU values of lumbar CT are highly correlated with BMD measured by DXA. Using HU values for diagnosing osteoporosis and osteopenia has excellent diagnostic efficacy. The assessment of HU values from CT examinations is performed by doctors based on the obtained CT data, which has the advantages of zero additional cost and high repeatability, and is particularly suitable for osteoporosis screening in primary medical institutions lacking DXA equipment. |
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